A scoping review of academic and grey literature on migrant health research conducted in Scotland

BACKGROUND

Migration to Scotland has increased since 2002 with an increase in European residents and participation in the Asylum dispersal scheme. Scotland has become more ethnically diverse, and 10% of the current population were born abroad. Migration and ethnicity are determinants of health, and information on the health status of migrants to Scotland and their access to and barriers to care facilitates the planning and delivery of equitable health services. This study aimed to scope existing peer-reviewed research and grey literature to identify gaps in evidence regarding the health of migrants in Scotland.

METHODS

A scoping review on the health of migrants in Scotland was carried out for dates January 2002 to March 2023, inclusive of peer-reviewed journals and grey literature. CINAHL/ Web of Science/SocIndex and Medline databases were systematically searched along with government and third-sector websites. The searches identified 2166 journal articles and 170 grey literature documents for screening. Included articles were categorised according to the World Health Organisation's 2016 Strategy and Action Plan for Refugee and Migrant Health in the European region. This approach builds on a previously published literature review on Migrant Health in the Republic of Ireland.

RESULTS

Seventy-one peer reviewed journal articles and 29 grey literature documents were included in the review. 66% were carried out from 2013 onwards and the majority focused on asylum seekers or unspecified migrant groups. Most research identified was on the World Health Organisation's strategic areas of right to health of refugees, social determinants of health and public health planning and strengthening health systems. There were fewer studies on the strategic areas of frameworks for collaborative action, preventing communicable disease, preventing non-communicable disease, health screening and assessment and improving health information and communication.

CONCLUSION

While research on migrant health in Scotland has increased in recent years significant gaps remain. Future priorities should include studies of undocumented migrants, migrant workers, and additional research is required on the issue of improving health information and communication.

National strategies for knowledge translation in health policy-making: A scoping review of grey literature

BACKGROUND AND OBJECTIVES

Without strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making.

METHODS

Websites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July-August 2017, and an updated search was carried out in April-June 2021. We included national strategies or elements of national strategies that dealt with KT activities, as well as similar strategies of individual institutions with a national policy focus. Two reviewers screened the strategies for inclusion. Data were analysed using qualitative content analysis.

RESULTS

A total of 65 unique documents were identified, of which 17 were eligible and analysed for their structure and content. Of the 17, 1 document was a national health KT action plan and 6 documents were institution-level KT strategies. The remaining 10 strategies, which were also included were 2 national health strategies, 5 national health research strategies and 3 national KT strategies (not specific to the field of health alone). In all, 13 structural elements and 7 major themes of health policy KT strategies were identified from the included documents.

CONCLUSION

KT in health policy, as emerged from the national strategies that our mapping identified, is based on the production and accessibility of policy-relevant research, its packaging for policy-making and the activities related to knowledge exchange. KT strategies may play different roles in the complex and context-specific process of policy-making. Our findings show that the main ideas of health-specific evidence-informed policy literature appear in these strategies, but their effectiveness depends on the way stakeholders use them. Specific knowledge-brokering institutions and organizational capacity, advocacy about the use of evidence, and close collaboration and co-decision-making with key stakeholders are essential in furthering the policy uptake of research results.

Regulatory Standards and Guidance for the Use of Health Apps for Self-Management in Sub-Saharan Africa: Scoping Review

BACKGROUND

Health apps are increasingly recognized as crucial tools for enhancing health care delivery. Many countries, particularly those in sub-Saharan Africa, can substantially benefit from using health apps to support self-management and thus help to achieve universal health coverage and the third sustainable development goal. However, most health apps published in app stores are of unknown or poor quality, which poses a risk to patient safety. Regulatory standards and guidance can help address this risk and promote patient safety.

OBJECTIVE

This review aims to assess the regulatory standards and guidance for health apps supporting evidence-based best practices in sub-Saharan Africa with a focus on self-management.

METHODS

A methodological framework for scoping reviews was applied. A search strategy was built and applied across the following databases, gray literature sources, and institutional websites: PubMed, Scopus, World Health Organization (WHO) African Index Medicus, OpenGrey, WHO Regional Office for Africa Library, ICTworks, WHO Directory of eHealth policies, HIS Strengthening Resource Center, International Telecommunication Union, Ministry of Health websites, and Google. The search covered the period between January 2005 and January 2024. The findings were analyzed using a deductive descriptive content analysis. The policy analysis framework was adapted and used to organize the findings. The Reporting Items for Stakeholder Analysis tool guided the identification and mapping of key stakeholders based on their roles in regulating health apps for self-management.

RESULTS

The study included 49 documents from 31 sub-Saharan African countries. While all the documents were relevant for stakeholder identification and mapping, only 3 regulatory standards and guidance contained relevant information on regulation of health apps. These standards and guidance primarily aimed to build mutual trust; promote integration, inclusion, and equitable access to services; and address implementation issues and poor coordination. They provided guidance on systems quality, software acquisition and maintenance, security measures, data exchange, interoperability and integration, involvement of relevant stakeholders, and equitable access to services. To enhance implementation, the standards highlight that legal authority, coordination of activities, building capacity, and monitoring and evaluation are required. A number of stakeholders, including governments, regulatory bodies, funders, intergovernmental and nongovernmental organizations, academia, and the health care community, were identified to play key roles in regulating health apps.

CONCLUSIONS

Health apps have huge potential to support self-management in sub-Saharan Africa, but the lack of regulatory standards and guidance constitutes a major barrier. Hence, for these apps to be safely and effectively integrated into health care, more attention should be given to regulation. Learning from countries with effective regulations can help sub-Saharan Africa build a more robust and responsive regulatory system, ensuring the safe and beneficial use of health apps across the region.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2018-025714.

Palliative care needs of people and/or their families with serious and/or chronic health conditions in low- or middle-income country (LMIC) humanitarian settings-a systematic scoping review protocol

BACKGROUND

Palliative care in low- or middle-income country (LMIC) humanitarian settings is a new area, experiencing a degree of increased momentum over recent years. The review contributes to this growing body of knowledge, in addition to identifying gaps for future research. The overall aim is to systematically explore the evidence on palliative care needs of patients and/or their families in LMIC humanitarian settings.

METHODS

Arksey and O'Malley's (Int J Soc Res Methodol. 8:19-32, 2005) scoping review framework forms the basis of the study design, following further guidance from Levac et al. (Implement Sci 5:1-9, 2010), the Joanna Briggs Institute (JBI) Peters et al. (JBI Reviewer's Manual JBI: 406-452, 2020), and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) from Tricco et al. (Ann Intern Med 169:467-73, 2018). This incorporates a five-step approach and the population, concept, and context (PCC) framework. Using already identified key words/terms, searches for both published research and gray literature from January 2012 to October 2022 will be undertaken using databases (likely to include Cumulative Index of Nursing and Allied Health (CINAHL), MEDLINE, Embase, Global Health, Scopus, Applied Social Science Index and Abstracts (ASSIA), Web of Science, Policy Commons, JSTOR, Library Network International Monetary Fund and World Bank, Google Advanced Search, and Google Scholar) in addition to selected pre-print sites and websites. Data selection will be undertaken based on the inclusion and exclusion criteria and will be reviewed at each stage by two reviewers, with a third to resolve any differences. Extracted data will be charted in a table. Ethical approval is not required for this review.

DISCUSSION

Findings will be presented in tables and diagrams/charts, followed by a narrative description. The review will run from late October 2022 to early 2023. This is the first systematic scoping review specifically exploring the palliative care needs of patients and/or their family, in LMIC humanitarian settings. The paper from the review findings will be submitted for publication in 2023.

Characteristics of constipation screening and assessment tools: a scoping review protocol

INTRODUCTION

Constipation is a common and significant burden on individuals and healthcare systems. Accurate assessment of constipation severity and symptom improvement are vital aspects of caring for patients with constipation. Therefore, nurses and allied healthcare professionals should possess knowledge regarding the characteristics of constipation assessment tools (ie, aim, scope, definition of constipation, content, structure, mode, administration time and context of use). However, existing reviews summarising characteristics of tools have been restricted to chronic constipation and self-reported measures. Furthermore, they have not included literature published after 2011. This scoping review aims to identify and comprehensibly map the characteristics of available tools for screening and assessment of constipation in order to manage the nursing care need related to constipation within any healthcare or research context and any patient group.

METHODS AND ANALYSIS

This review will include primary research articles, methodological papers and clinical guidelines using tools for constipation screening and assessment, pertinent to nursing care management. It is not limited to a specific population or healthcare setting. Databases to be searched include PubMed, Embase, CINAHL, ProQuest, ClinicalKey and Google Scholar. To identify grey literature, national health services in selected countries will be searched. Papers written in English, Nordic language or German will be included. The reviewers will independently review the retrieved citations against the inclusion criteria, and data from included papers will be extracted using a data extraction form developed for this review. The scoping review will be conducted following the Joanna Briggs Institute Guidelines. The results will be presented in a table accompanied by a narrative summary.

ETHICS AND DISSEMINATION

Ethical approval is not required, as no individual patient data are included. Findings will be shared and discussed with relevant stakeholders and disseminated through peer-reviewed publications and conference presentations. The protocol is registered on Open Science Framework (registration number: osf.io/h2vzd).

Engaging people with lived experiences on community advisory boards in community-based participatory research: a scoping review protocol

INTRODUCTION

Community-based participatory research (CBPR) is a collaborative research approach that equally engages researchers and community stakeholders throughout all steps of the research process to facilitate social change and increase research relevance. Community advisory boards (CABs) are a CBPR tool in which individuals with lived experience and community organisations are integrated into the research process and ensure the work aligns with community priorities. We seek to (1) explore the best practices for the recruitment and engagement of people with lived experiences on CABs and (2) identify the scope of literature on minimising power dynamics between organisations and community members with lived experience who work on CABs together.

METHODS AND ANALYSIS

This scoping review will follow the Arksey and O'Malley methodological framework, informed by Levac et al, and will be reported using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. Detailed and robust search strategies have been developed for Embase, Medline and PsychINFO. Grey literature references and reference lists of included articles published between 1 January 1990 and 30 March 2023 will be considered. Two reviewers will independently screen references in two successive stages of title/abstract and full-text screening. Conflicts will be decided by consensus or a third reviewer. Thematic analysis will be applied in three phases: open coding, axial coding and abstraction. Extracted data will be recorded and presented in a tabular format and/or graphical summaries, with a descriptive overview discussing how the research findings relate to the research questions. At this time, a preliminary search of peer-reviewed and grey literature has been conducted. Search results for peer-reviewed literature have been uploaded to Covidence for review and appraisal for relevance.

ETHICS AND DISSEMINATION

Formal ethics approval is not required for this review. Review findings will inform ongoing and future CBPR community advisory board dynamics.

REGISTRATION

The protocol has been registered prospectively on the Open Science Framework (https://doi.org/10.17605/OSF.IO/QF5D3).

Self-management needs, strategies and support for sickle cell disease in developing countries: a scoping review protocol

INTRODUCTION

Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies, and there is a notable dearth of evidence synthesis on SCD self-management in developing countries. This scoping review aims to identify and map self-management needs of individuals living with SCD, the strategies they employed to meet those needs, and the support systems available to them.

METHODS AND ANALYSIS

The review will be conducted following the Arksey and O'Malley's (2005) 29 framework to comprehensively examine the landscape of SCD self-management research. Searches will be performed in PubMed, Scopus, Embase and Dimensions AI, with additional searches in other databases and grey literature. Indexed literature published in English from inception to January 2024 will be included. Reference list from included studies will also be searched manually. Two teams will be constituted to independently screen titles, abstracts and full text against the eligible criteria. Data will be extracted from included studies onto a customised data extraction form.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review due to the fact that it synthesises information from available publications. The findings will be disseminated through publication in a peer-reviewed journal. Also, the findings will possibly be presented at relevant international and national conferences. This protocol has already been registered with the Open Science Framework. The study characteristics such as design and setting will be descriptively analysed and presented as graphs, tables and figures. Thematic analysis will also be conducted based on the study objectives and presented as a narrative summary.

Automated data analysis of unstructured grey literature in health research: A mapping review

The amount of grey literature and 'softer' intelligence from social media or websites is vast. Given the long lead-times of producing high-quality peer-reviewed health information, this is causing a demand for new ways to provide prompt input for secondary research. To our knowledge, this is the first review of automated data extraction methods or tools for health-related grey literature and soft data, with a focus on (semi)automating horizon scans, health technology assessments (HTA), evidence maps, or other literature reviews. We searched six databases to cover both health- and computer-science literature. After deduplication, 10% of the search results were screened by two reviewers, the remainder was single-screened up to an estimated 95% sensitivity; screening was stopped early after screening an additional 1000 results with no new includes. All full texts were retrieved, screened, and extracted by a single reviewer and 10% were checked in duplicate. We included 84 papers covering automation for health-related social media, internet fora, news, patents, government agencies and charities, or trial registers. From each paper, we extracted data about important functionalities for users of the tool or method; information about the level of support and reliability; and about practical challenges and research gaps. Poor availability of code, data, and usable tools leads to low transparency regarding performance and duplication of work. Financial implications, scalability, integration into downstream workflows, and meaningful evaluations should be carefully planned before starting to develop a tool, given the vast amounts of data and opportunities those tools offer to expedite research.

Attrition in Conversational Agent-Delivered Mental Health Interventions: Systematic Review and Meta-Analysis

BACKGROUND

Conversational agents (CAs) or chatbots are computer programs that mimic human conversation. They have the potential to improve access to mental health interventions through automated, scalable, and personalized delivery of psychotherapeutic content. However, digital health interventions, including those delivered by CAs, often have high attrition rates. Identifying the factors associated with attrition is critical to improving future clinical trials.

OBJECTIVE

This review aims to estimate the overall and differential rates of attrition in CA-delivered mental health interventions (CA interventions), evaluate the impact of study design and intervention-related aspects on attrition, and describe study design features aimed at reducing or mitigating study attrition.

METHODS

We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and Web of Science, and conducted a gray literature search on Google Scholar in June 2022. We included randomized controlled trials that compared CA interventions against control groups and excluded studies that lasted for 1 session only and used Wizard of Oz interventions. We also assessed the risk of bias in the included studies using the Cochrane Risk of Bias Tool 2.0. Random-effects proportional meta-analysis was applied to calculate the pooled dropout rates in the intervention groups. Random-effects meta-analysis was used to compare the attrition rate in the intervention groups with that in the control groups. We used a narrative review to summarize the findings.

RESULTS

The systematic search retrieved 4566 records from peer-reviewed databases and citation searches, of which 41 (0.90%) randomized controlled trials met the inclusion criteria. The meta-analytic overall attrition rate in the intervention group was 21.84% (95% CI 16.74%-27.36%; I2=94%). Short-term studies that lasted ≤8 weeks showed a lower attrition rate (18.05%, 95% CI 9.91%- 27.76%; I2=94.6%) than long-term studies that lasted >8 weeks (26.59%, 95% CI 20.09%-33.63%; I2=93.89%). Intervention group participants were more likely to attrit than control group participants for short-term (log odds ratio 1.22, 95% CI 0.99-1.50; I2=21.89%) and long-term studies (log odds ratio 1.33, 95% CI 1.08-1.65; I2=49.43%). Intervention-related characteristics associated with higher attrition include stand-alone CA interventions without human support, not having a symptom tracker feature, no visual representation of the CA, and comparing CA interventions with waitlist controls. No participant-level factor reliably predicted attrition.

CONCLUSIONS

Our results indicated that approximately one-fifth of the participants will drop out from CA interventions in short-term studies. High heterogeneities made it difficult to generalize the findings. Our results suggested that future CA interventions should adopt a blended design with human support, use symptom tracking, compare CA intervention groups against active controls rather than waitlist controls, and include a visual representation of the CA to reduce the attrition rate.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022341415; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341415.

Understanding and treating body image disturbances in eating disorders through body illusion interventions: a scoping review protocol

BACKGROUND

We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research.

METHODS/DESIGN

The scoping review process will be guided by the methodological framework of Arksey and O'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles.

DISCUSSION

A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929.

Finding a needle in a haystack: The identification of clinical practice guidelines for psychosocial oncology through an environmental scan of the academic and gray literature

OBJECTIVE

Clinical practice guidelines (CPGs) are evidence-based tools well-suited to translate the latest research evidence into recommendations for routine clinical care. Given the rapid expansion of psychosocial oncology research, they represent a key opportunity for informing the treatment decisions of overburdened clinicians, standardizing service delivery, and improving patient-reported outcomes. Yet, there is little consensus on how clinicians can most effectively access these tools and little to no information on the current availability and scope of CPGs for the range of psychosocial symptoms and concerns experienced by patients with cancer.

METHOD

Our environmental scan consisted of an academic and gray literature designed to identify currently available CPGs addressing a range of cancer-related psychosocial symptoms.

RESULTS

Findings revealed a total of 23 existing psychosocial oncology CPGs that met full eligibility criteria. The gray literature search was found to be more effective at identifying CPGs (n = 22) compared to the academic search (n = 9).

CONCLUSION

Several concerns arose from the systematic search. The limited publication of CPGs in peer-reviewed journals may make clinicians and stakeholders more hesitant to implement CPGs due to uncertainties about the methodological rigor of the development process. Further, many existing CPGs are outdated or failed to be updated according to guideline recommendations, meaning that the recommendations may fall short of their purpose to translate up-to-date research findings.

FUTURE DIRECTIONS

Future research should seek to systematically assess the quality of existing psychosocial oncology CPGs and shed light on the current state of implementation and adherence in clinical practice in order to better inform guideline developers on the current needs of the psychosocial oncology community.

What are the barriers and enablers to trauma-informed emergency departments? A scoping review protocol

INTRODUCTION

There is a high prevalence of psychological trauma among the population. Such people are more likely to have poorer health outcomes and these factors may contribute to increased use of the emergency department. There has been some attempt to implement a trauma-informed approach across public services, especially in health and social care. However, it is unclear how this concept applies to the challenging and high-demand emergency department context. The review aims to locate, examine and describe the literature on trauma-informed care in the unique and challenging healthcare delivery context that is the emergency department. The review aims to identify the barriers and enablers that may facilitate trauma-informed care in the emergency department context.

METHODS AND ANALYSIS

This scoping review will use the Joanna Briggs Institute methodology for scoping reviews. Systematic searches of relevant databases (CINAHL, MEDLINE, PsycINFO, EMBASE, Knowledge Network and Web of Science) will be conducted. Empirical studies of any methodological approach, published in English between January 2001 and September 2023 will be included. The 'grey' literature will also be accessed. Two reviewers will independently screen all studies. Data will be extracted, collated and charted to summarise all the relevant methods, outcomes and key findings in the articles.

ETHICS AND DISSEMINATION

Formal ethical approval is not required. The findings of this study will be disseminated through peer-reviewed publications, conference presentations and condensed summaries for key stakeholders in the field. The data generated will be used to inform a programme of work related to trauma-informed care.

Scope, range and effectiveness of interventions to address social norms to prevent and delay child marriage and empower adolescent girls: a systematic review

OBJECTIVES

Harmful gender and social norms prescribe divergent opportunities for girls and boys and drive child marriage. This systematic review examines the scope, range and effectiveness of interventions to change social norms and delay child marriage.

DESIGN

We systematically assess the contributions made by interventions that work to shift norms to prevent child marriage or to limit its harmful consequences. Our analysis classifies each study's quality in evaluation and implementation design regarding shifting norms.

DATA SOURCES

We conducted a search of electronic databases (PubMed, PsycINFO, Embase, CINAHL Plus, Popline, Web of Science and Cochrane Library) and grey literature (targeted hand-searches of 15 key organisations and Google Scholar).

ELIGIBILITY CRITERIA

Included interventions sought to change norms related to child marriage, were evaluated in experimental or quasi-experimental evaluations, collected data on age at marriage and norms/attitudes, and were published in English from January 2000 to September 2021.

DATA EXTRACTION AND SYNTHESIS

We used a standardised form to extract data from all eligible studies, and double-screened to validate coding and reporting. We classified the studies by low, medium and high quality for evaluation and risk of bias, and separately by the extent to which they addressed social norms.

RESULTS

Our assessment of the 12 eligible studies identified revealed little evidence of a systematic relationship between social norms related to marriage and changes in child marriage behaviours. We found stronger evidence of programme effect on child marriage outcomes than on social norms, though only a minority of studies found an effect for either. Studies that appeared effective in changing child marriage norms varied greatly in scale and extent of programming, and few attempted to identify the appropriate reference groups for measuring social norms.

CONCLUSION

The studies evaluated by our review provide only weak evidence on the impact of interventions on norms, and on the link between shifts in norms and marriage behaviour.

Barriers and enablers of integrated care in the UK: a rapid evidence review of review articles and grey literature 2018-2022

Integrated care refers to person-centered and coordinated, health and social care, and community services. Integrated care systems are partnerships of organizations that deliver health and care services which were placed on a statutory footing in England, April 2022. Due to the need for fast, accessible, and relevant evidence, a rapid review was conducted according to World Health Organization methods to determine barriers and enablers of integrated care across the United Kingdom, 2018-2022. Nine databases were searched for review articles reporting evaluation of integrated care interventions involving medical (clinical and diagnostic) and nonmedical (public health services and community-based or social care/person-centred care) approaches, quality checked with the Critical Appraisal Skills Program qualitative checklist. OpenGrey and hand searches were used to identify grey literature, quality checked with the Authority, Accuracy, Coverage, Objectivity, Date, and Significance checklist. Thirty-four reviews and 21 grey literature reports fitted inclusion criteria of adult physical/mental health outcomes/multiple morbidities. Thematic analysis revealed six themes (collaborative approach; costs; evidence and evaluation; integration of care; professional roles; service user factors) with 20 subthemes including key barriers (cost effectiveness; effectiveness of integrated care; evaluation methods; focus of evidence; future research; impact of integration) and enablers (accessing care; collaboration and partnership; concept of integration; inter-professional relationships; person-centered ethos). Findings indicated a paucity of robust research to evaluate such interventions and lack of standardized methodology to assess cost effectiveness, although there is growing interest in co-production that has engendered information sharing and reduced duplication, and inter-professional collaborations that have bridged task-related gaps and overlaps. The importance of identifying elements of integrated care associated with successful outcomes and determining sustainability of interventions meeting joined-up care and preventive population health objectives was highlighted.

How do children's hospitals address health inequalities: a grey literature scoping review

OBJECTIVES

Health inequalities are systematic differences in health between people, which are avoidable and unfair. Globally, more political strategies are required to address health inequalities, which have increased since the global SARS-CoV-2/COVID-19 pandemic, with a disproportionate impact on children. This scoping review aimed to identify and collate information on how hospitals around the world that deliver care to children have addressed health inequalities.

DESIGN

Scoping review focused solely on grey literature.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Following Joanna Briggs Institute guidelines, a four-step approach to identifying literature was adopted.

DATA SOURCES

Overton, OpenGrey, OpenMD, Trip Database, DuckDuckGo, Google, targeted websites and children's hospital websites were searched on March 2023 for items published since 2010.

DATA EXTRACTION AND SYNTHESIS

Retrieved items were screened against clear inclusion and exclusion criteria before data were extracted by two independent reviewers using a data extraction tool. Studies were tabulated by a hospital. A meta-analysis was not conducted due to the varied nature of studies and approaches.

RESULTS

Our study identified 26 approaches to reduction of health inequalities, from 17 children's hospitals. Approaches were categorised based on their size and scope. Seven approaches were defined as macro, including hospital-wide inequality strategies. Ten approaches were classed as meso, including the establishment of new departments and research centres. Micro approaches (n=9) included one-off projects or interventions offered to specific groups/services. Almost half of the reported approaches did not discuss the evaluation of impact.

CONCLUSIONS

Children's hospitals provide a suitable location to conduct public health interventions. This scoping review provides examples of approaches on three scales delivered at hospitals across high-income countries. Hospitals with the most comprehensive and extensive range of approaches employ dedicated staff within the hospital and community. This review indicates the value of recruitment of both public health-trained staff and culturally similar staff to deliver community-based interventions.

How can quality be measured within a physician-led Community Emergency Medical service? A scoping review protocol

BACKGROUND

Quality measurement as part of quality improvement in healthcare is integral for service delivery and development. This is particularly pertinent for health services that deliver care in ways that differ from traditional practice. Community Emergency Medicine (CEM) is a novel and evolving concept of care delivered by services in parts of the UK and Ireland. This scoping review aims to provide a broad overview of how quality may be measured within services delivering CEM.

METHODS AND ANALYSIS

The methodology follows both the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). It is guided by recognised work of Arksey and O'Malley and the guidelines developed by the Joanna Briggs Institute. Several databases will be searched: MEDLINE, EMbase, EMcare, CINAHL, Scopus, the Cochrane Library and grey literature. Search terms have been developed by representatives within Community Emergency Medicine services. Two reviewers will independently screen eligible studies for final study selection. Results will be collected and analysed in descriptive and tabular form to illustrate the breadth of quality indicators that may be applicable to CEM services. This scoping review protocol has been registered with the Open Science Framework platform (osf.io/e7qxg).

DISCUSSION

This is the first stage of a larger research study aimed at developing national quality indicators for CEM. The purpose of this scoping review is to provide a comprehensive review of quality indicators that could be used within CEM. The results will be mapped using a framework and identify gaps in the literature to help guide future-focused research.

Recent changes to adult national immunization programs for pneumococcal vaccination in Europe and how they impact coverage: A systematic review of published and grey literature

Despite widespread use of pneumococcal vaccines throughout Europe, the burden of pneumococcal disease (PD) in adults is considerable. To mitigate this burden, National Immunization Technical Advisory Groups (NITAGs) and Health Technology Assessment (HTA) agencies assess the value of different vaccine schedules for protecting against PD. The aim of this review was to assess the evidence and rationales used by NITAGs/HTA agencies, when considering recent changes to National Immunization Programs (NIPs) for adults, and how identified changes affected vaccine coverage rates (VCRs). A systematic review was conducted of published literature from PubMed® and Embase®, and gray literature from HTA/NITAG websites from the last 5 y, covering 31 European countries. Evidence related to NIP recommendations, epidemiology (invasive PD, pneumonia), health economic assessments and VCRs were collected and synthesized. Eighty-four records providing data for 26 countries were identified. Of these, eight described explicit changes to NIPs for adults in seven countries. Despite data gaps, some trends were observed; first, there appears to be a convergence of NIP recommendations in many countries toward sequential vaccination, with a pneumococcal conjugate vaccine (PCV), followed by pneumococcal polysaccharide vaccine 23. Second, reducing economic or healthcare burden were common rationales for implementing changes. Third, most health economic analyses assessing higher-valency PCVs for adults found its inclusion in NIPs cost-effective. Finally, higher coverage rates were seen in most cases where countries had expanded their NIPs to cover at-risk populations. The findings can encourage agencies to improve surveillance systems and work to reach the NIP's target populations more effectively.

Scoping review of African health histories: a protocol

INTRODUCTION

The history of African health is closely entwined with the history of the continent itself-from precolonial times to the present day. A study of African health histories is critical to understanding the complex interplay between social, economic, environmental and political factors that have shaped health outcomes on the continent. Furthermore, it can shed light on the successes and failures of past health interventions, inform current healthcare policies and practices, and guide future efforts to address the persistent health challenges faced by African populations. This scoping review aims to identify existing literature on African health histories.

METHODS AND ANALYSIS

The Arksey and O'Malley's framework for conducting scoping reviews will be utilised for the proposed review, which will be reported in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The main review question is 'What literature exists on the history of health practices and healthcare delivery systems in Africa from the precolonial era through to the sustainable development goal era?' Keywords such as Africa, health and histories will be used to develop a search strategy to interrogate selected databases and grey literature repositories such as PubMed, Scopus, Web of Science and WHOLIS. Two authors will independently screen titles and abstracts of retrieved records. One author will extract data from articles that meet the inclusion criteria using a purposively designed data charting. The data would be coded and analysed thematically, and the findings presented narratively.

ETHICS AND DISSEMINATION

The scoping review is part of a larger project which has approval from the WHO AFRO Ethics Research Committee (Protocol ID: AFR/ERC/2022/11.3). The protocol and subsequent review will be submitted to the integrated African Health Observatory and published in a peer-reviewed journal.

REGISTRATION DETAILS

https://osf.io/xsaez/.

Tools and resources used to support implementation of workplace healthy food and drink policies: A scoping review of grey literature

AIMS

This study aimed to identify and evaluate tools and resources used to support the implementation of workplace healthy food and drink policies, primarily in Australia and New Zealand.

METHODS

A scoping grey literature review included searches of government agencies and non-governmental organisations' websites in six English-speaking countries, public health nutrition intervention databases and Google search engine queries. Paper-based and digital tools were included if they were written in English, referred to within a policy or on a policy's website, and primarily targeting supply-side stakeholders. Tools were evaluated on two domains: 'Features' (summarised descriptively) and 'Usability and Quality' (with inter-rater reliability scores calculated using an intraclass correlation coefficient).

RESULTS

Twenty paper-based tools were identified relating to Australian (n = 14) and New Zealand (n = 6) policies, and a further six digital tools were identified from Australia (n = 3) and Canada (n = 3). Target audiences included workplace managers, food providers and suppliers. The paper-based tools focused on general implementation guidance. In contrast, digital tools tended to support specific elements of policy implementation. 'Usability and Quality' scores ranged from 2.9 to 4.5 (out of 5.0) for paper-based tools, and 3.9 to 4.2 for digital tools, with a moderate agreement between reviewer scores (intraclass correlation coefficient 0.523, p = 0.010).

CONCLUSIONS

A range of tools have been developed to support the implementation of workplace healthy food and drink policies. Understanding the strengths and limitations of current tools will assist in developing improved aids to support policy implementation.

Implementation model for a national learning health system (IMPLEMENT-National LHS): a concept analysis and systematic review protocol

INTRODUCTION

Despite efforts and repeated calls to improve the organisation and quality of healthcare and services, and in view of the many challenges facing health systems, the results and capacity to adapt and integrate innovations and new knowledge remain suboptimal. Learning health systems (LHS) may be an effective model to accelerate the application of research for real quality improvement in healthcare. However, while recognising the enormous potential of LHS, the literature suggests the model remains more of an aspiration than a reality.

METHODS AND ANALYSIS

To reach a fine understanding of the implementation of the concepts involved in LHS, we will use a hybrid method which combines concept analyses with systematic review methodology. We will use a two-step analysis, a content analysis to analyse the definitions, uses and attributes of the concept and a systematic review to analyse the concept's implementation mechanisms. We will search eight databases and grey literature and present a broad synthesis of the available evidence regarding design, implementation and evaluation of LHS in a multilevel perspective. We will follow the latest Preferred Reporting Items for Systematic Review and Meta-Analysis statement for conducting and reporting a systematic review. Two reviewers will independently screen the titles and abstracts against the eligibility criteria followed by full-text screening of potentially relevant articles for final inclusion decision. Conflicts will be resolved with a senior author. We will include published primary studies that use qualitative, quantitative or mixed methods. The assessment of risk of bias will be made using the Mixed-Methods Appraisal Tool.

ETHICS AND DISSEMINATION

This systematic review is exempt from ethics approval. The results formulated will highlight evidence-based interventions that support the implementation of a national LHS. They will be of particular interest to decision makers, researchers, managers, clinicians and patients allowing finally to implement the promising proposal of LHSs at national scale.

PROSPERO REGISTRATION NUMBER

CRD42023393565.

What is known about what works in community-involved decision-making relating to urban green and blue spaces? A realist review protocol

BACKGROUND

There is now a relatively well-established evidence base suggesting that greener living environments and time spent in urban green and blue spaces (UGBS) can be beneficial for human health and wellbeing. However, benefits are not universal and there remain widespread social inequalities in access to such resources and experiences, particularly along axes of class, race, ethnicity, age and disability, and in relation to efforts to increase the availability and accessibility of such spaces. These injustices often relate to distributive, procedural and recognition-based processes. There is growing interest in how to ensure that efforts to increase access to or use of UGBS (whether through infrastructural or social programmes) result in equitable outcomes whilst minimising potential for exacerbating existing inequalities and injustices. Community engagement is considered an important step towards more inclusive UGBS decision-making, from planning and design to management and maintenance processes. It is thought to contribute to better and more widely trusted decisions, enhanced democracy, community satisfaction, civic interest and feelings of green space ownership, and greater longevity of UGBS projects. However, uneven representation and barriers to participation can create imbalances and undermine these benefits.

METHODS

An iterative, multi-stage realist-inspired review will be conducted to ask what works, in what context and in what ways relating to the meaningful involvement of communities in UGBS decision-making, focusing on the skills, capacities and capabilities of different stakeholders and the role of contexts and processes. 'Effectiveness' (or what works) will be understood as a multifaceted outcome, encompassing both the processes and results of community engagement efforts. Following a scoping stage to identify initial programme theory, inclusion/exclusion criteria and derive search terms, relevant databases and grey literature will be searched to identify interdisciplinary literature in two phases. The first phase will be used to further develop programme theories, which will be articulated as 'if then' statements. The second phase searches will be used to identify sources to further explore and evidence the programme and formal theory. We will assess all includable evidence for conceptual richness, prioritising more conceptually rich sources if needed.

DISCUSSION

The realist synthesis will explore the key context, mechanism and outcome configurations that appear to explain if and how different approaches to community-involved UGBS decision-making are or are not effective. We will consider factors such as different conceptualisations of community, and if and how they have been involved in UGBS decision-making; the types of tools and approaches used; and the socio-cultural and political or governance structures within which decision-making takes place.

Characteristics of programmes designed to link community-dwelling older adults in high-income countries from community to clinical sectors: a scoping review protocol

INTRODUCTION

Research on effectively navigating older adults into primary care is urgently needed. Community-clinic linkage models (CCLMs) aim to improve population health by linking the health and community sectors in order to improve patients' access to healthcare and, ultimately, population health. However, research on community-based points of entry linking adults with untreated medical needs into the healthcare sector is nascent. CCLMs implemented for the general adult population are not necessarily accessible to older adults. Given the recency of the CCLM literature and the seeming rarity of CCLM interventions designed for older adults, it is appropriate to employ scoping review methodology in order to generate a comprehensive review of the available information on this topic. This protocol will inform a scoping review that reviews characteristics of community-based programmes that link older adults with the healthcare sector.

METHODS AND ANALYSIS

The present protocol was developed as per JBI Evidence Synthesis best practice guidance and reporting items for the development of scoping review protocols. The proposed scoping review will follow Levac and colleagues' update to Arksey and O'Malley's scoping review methodology. Healthcare access at the system and individual levels will be operationalised in data extraction and analysis in accordance with Levesque and colleagues' Conceptual Framework of Access to Health. The protocol complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Beginning in August 2023 or later, citation databases (AgeLine (Ebsco); CINAHL Complete; MEDLINE (PubMed); Scopus Advanced (Elsevier); Social Services Abstracts (ProQuest); Web of Science Core Collection (Clarivate)) and grey literature (Google; American Public Health Association Annual Meeting Conference Proceedings; SIREN Evidence & Resource Library) will be searched.

ETHICS AND DISSEMINATION

The authors plan to disseminate their findings in conference proceedings and publication in a peer-reviewed journal and deposit extracted data in the Figshare depository. The study does not require Institutional Review Board approval.

REGISTRATION DETAILS

Protocol registered in Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2EF9D).

Checklists for interpreting chest radiographs: a scoping review protocol

INTRODUCTION

What is known about checklists for interpreting chest radiographs? The question will guide the development of the inclusion criteria for the scoping review. Breaking down the scoping review question will allow the evaluation of inclusion and exclusion criteria for the protocol. The eligibility of the proposed research question will be assessed using the Population or Participants, Concept and Context (PCC) framework.

BACKGROUND

X-ray reporting can be standardised using checklists. Checklists may reduce the time needed to produce a comprehensive X-ray report and improve the quality and consistency of detecting abnormalities on chest radiographs. This scoping review aims to map the available literature on what is known about checklists for interpreting chest radiographs.

METHODS

We will follow the methodological framework for scoping reviews originally described by Arksey and O'Malley. The scoping review will include articles that describe checklists for reducing diagnostic errors, checklists for analysing chest radiographs, checklists for identifying abnormalities on chest radiographs and checklists for reporting chest radiographs in all settings. Search terms are chest radiographs, checklists, and chest X-rays. We will search for peer-reviewed articles and grey literature including dissertations and theses. We will search online databases including Ovid Medline and Ebscohost, to identify articles published in English from 1994 to 2022. The searched articles will undergo two levels of screening, first the title and abstract screening, then a full-text screening by two reviewers. Data from the selected articles will be extracted, using a tested extraction form and charted using the Joanna Briggs Institute guidelines.

RESULTS

The results will be collated, summarised and discussed including any limitations of the included articles. The articles will be summarised in a table, as well as narratively. The distribution of studies will be summarised quantitatively and the numerical analysis will provide an overview and identify knowledge gaps. Content analysis will map different checklists available for chest interpretation.

DISCUSSION

The results of the scoping review will be used to develop a checklist that will be used by medical doctors in collaboration with radiographers working in settings where there are no radiologists on-site, for interpreting chest radiographs.

SYSTEMATIC REVIEW REGISTRATION

Scoping review protocol registered with Open Science Framework on 27 July 2022. Registration https://doi.org/10.17605/OSF.IO/JS5PQ.

Methods for the involvement of people living with dementia in research focused on the built environment: a protocol for a scoping review

INTRODUCTION

The positive influence of a well-designed built environment in dementia-specific care has been known for several years. Many studies focusing on the built environment have captured the perspectives of people living with dementia. However, it remains unclear to what degree and with which methods these individuals have been actively involved in research especially when attempting to understand their perspective. The planned scoping review aims to (1) synthesise methods and results from research about the built environment according to active involvement of people living with dementia and (2) describe facilitators and barriers to this active involvement to capture their perspectives in research.

METHODS AND ANALYSIS

We will use four search strategies: (1) searches in academic databases MEDLINE via PubMed, CINAHL and APA PsycINFO via EBSCO, and Scopus; (2) grey literature searches via Google Scholar; (3) handsearches of non-academic environmental planning and design journals and (4) identifying other publications of key authors in the field. Additionally, backward and forward citation tracking will be performed via reference lists and Google Scholar, respectively. Relevant literature published between 2013 and 2023 will be identified for data extraction and synthesis. One researcher will perform each strategy. Title-abstract/full text-screening will be conducted using Covidence by two researchers. Results will be displayed in a table and through figures illustrating identified facilitators and barriers.

ETHICS AND DISSEMINATION

We raised no ethical concerns for the planned scoping review. We will prepare the findings including the identified barriers with long-term care practitioners from our network to identify how changes in practical application methods can be addressed. This dialogue can serve as a basis for including people living with dementia to discuss highlighted barriers when researching their perspectives on the built environment. The scoping review results will be reported in both academic and non-academic journals and at academic conferences.

Decision Aids in the ICU: a scoping review

OBJECTIVE

The purpose of this scoping review was to synthesise the effectiveness and acceptability of decision aids for critically ill patients and family members in the intensive care unit (ICU).

METHODS

A systematic search of four electronic databases and grey literature was undertaken to identify relevant studies on the application of decision aids in the ICU, without publication date restriction, through March 2023. The methodological framework proposed by Arksey and O'Malley was used to guide the scoping review.

RESULTS

Fourteen papers were ultimately included in this review. However, only nine decision aids were available, and it is noteworthy that many of these studies focused on the iterative development and testing of individual decision aids. Among the included studies, 92% (n=13) were developed in North America, with a primary focus on goals of care and life-sustaining treatments. The summary of the effect of decision aid application revealed that the most common indicators were the level of knowledge and code status, and some promising signals disappeared in randomised trials.

CONCLUSIONS

The complexity of treatment decisions in the ICU exceeds the current capabilities of existing decision aids. There is a clear gap in decision aids that are tailored to different cultural contexts, highlighting the need to expand the scope of their application. In addition, rigorous quality control is very important for randomised controlled trial, and indicators for assessing the effectiveness of decision aids need to be further clarified.

Instruments for assessing quality policies and strategies in health systems: a scoping review protocol

INTRODUCTION

The World Organization recommends to implement National Quality Policies and Strategies in health systems, but few instruments have been proposed to assess and monitor these quality interventions at the system level. This study will map and compare instruments for the assessment of quality policies and strategies in health systems around the world.

METHODS AND ANALYSIS

This is a scoping review protocol developed according to the Joanna Briggs Institute's manual and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The search for articles will be performed in the following Embase, Medline/Pubmed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature. Searches will also be conducted on Google Scholar and grey literature (www.opengrey.eu). A descriptive analysis of studies mapped by analysis categories will be performed. The results will be presented through a narrative summary of the mapped findings to verify how the results correlate with the objective and research question of the review.

ETHICS AND DISSEMINATION

The study does not require an ethical review due to its nature. The submission of results for publication in a peer-reviewed journal and presentation at a scientific conference is expected. LINK TO THE PROTOCOL RECORD IN THE OPEN SCIENCE FRAMEWORK OSF: https://DOI.org/10.17605/OSF.IO/2KMTS.

Evaluation of frameworks demonstrating the role of private sector in non-communicable disease management and control: a systematic review and thematic synthesis

OBJECTIVES

Conduct a systematic review of existing frameworks to understand the for-profit private sector's roles in non-communicable disease (NCD) control and management. Control includes population-level control measures that prevent NCDs and mitigate the magnitude of the NCD pandemic, and management includes treatment and management of NCDs. The for-profit private sector was defined as any private entities that make profit from their activities (ie, pharmaceutical companies, unhealthy commodity industries, distinct from not-for-profit trusts or charitable organisations).

DESIGN

A systematic review and inductive thematic synthesis was performed. Comprehensive searches of PubMed, EMBASE, Cochrane Library, Web of Science, Business Source Premier and Proquest/ABI Inform were conducted on 15 January 2021. Grey literature searches were conducted on 2 February 2021 using the websites of 24 relevant organisations. Searches were filtered to only include articles published from the year 2000 onwards, in English. Articles that included frameworks, models or theories and the for-profit private sector's role in NCD control and management were included. Two reviewers performed the screening, data extraction and quality assessment. Quality was assessed using the tool developed by Hawker et al for qualitative studies.

SETTING

The for-profit private sector.

RESULTS

There were 2148 articles initially identified. Following removal of duplicates, 1383 articles remained, and 174 articles underwent full-text screening. Thirty-one articles were included and used to develop a framework including six themes that outlined the roles that the for-profit private sector plays in NCD management and control. The themes that emerged included healthcare provision, innovation, knowledge educator, investment and financing, public-private partnerships, and governance and policy.

CONCLUSION

This study provides an updated insight on literature that explores the role of the private sector in controlling and monitoring NCDs. The findings suggest that the private sector could contribute, through various functions, to effectively manage and control NCDs globally.

Analyzing referencing patterns in grey literature produced by influential global management consulting firms and international organizations

Given the growing influence of non-academic organizations in the policy sphere, it is important to investigate the evidence both produced by and relied on by these organizations. Using citation analysis, a methodology primarily used in academic literature, we investigated the evidence base supporting the grey literature published by leading global management consulting firms (GMCFs) and international organizations (IOs). With the topic of the skills needed for the future of work as a case study, we collected 234 reports published by influential GMCFs and IOs over twenty years. By extracting references from the bibliographies of these reports we: 1) analyzed referencing patterns by measuring citation counts, institutional self-referencing and utilization of scholarly sources; 2) compared reference patterns across GMCFs and IOs; and 3) described the most influential sources. Overall, both GMCFs and IOs showed increasing reliance on grey literature, demonstrated high levels of self-referencing, and had considerable variation in the number of sources referred to. Across type of publishing organization, we found that IOs had better referencing practices than GMCFs. Our findings call into question the evidence-base behind the reports published by these policy actors. We emphasize the need to rely on strong academic literature to inform policy decisions around the future of work.

Understanding how primary care practitioners can be supported to recognise, screen and initially diagnose oropharyngeal dysphagia: protocol for a behavioural science realist review

INTRODUCTION

Oropharyngeal dysphagia (OD) affects around 15% of older people; however, it is often unrecognised and underdiagnosed until patients are hospitalised. Screening is an important process which aims to facilitate proactive assessment, diagnosis and management of health conditions. Healthcare systems do not routinely screen for OD in older people, and healthcare professionals (HCPs) are largely unaware of the need to screen. This realist review aims to identify relevant literature and develop programme theories to understand what works, for whom, under what circumstances and how, to facilitate primary care HCPs to recognise, screen and initially diagnose OD.

METHODS AND ANALYSIS

We will follow five steps for undertaking a realist review: (1) clarify the scope, (2) literature search, (3) appraise and extract data, (4) evidence synthesis and (5) evaluation. Initial programme theories (IPTs) will be constructed after the preliminary literature search, informed by the Theoretical Domains Framework and with input from a stakeholder group. We will search Medline, Google Scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We will obtain additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature will be screened, evaluated and synthesised in Covidence. Evidence will be assessed for quality by evaluating its relevance and rigour. Data will be extracted and synthesised according to their relation to IPTs. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards quality and publication standards to report study results.

ETHICS AND DISSEMINATION

Formal ethical approval is not required for this review. We will disseminate this research through publication in a peer-reviewed journal, written pieces targeted to diverse groups of HCPs on selected online platforms and public engagement events.

PROSPERO REGISTRATION NUMBER

CRD42022320327.

Heath policy guiding the identification, analysis and management of secondary findings for individuals undergoing genomic sequencing: a systematic review protocol

INTRODUCTION

Genomic sequencing is increasingly enabling precision care across medical specialties; however, the discovery of genomic 'secondary findings' (SFs) unrelated to the patient's primary indication remains a profuse, unintended consequence. Existing practices within the continuum of SF identification, analysis and management are numerous, inconsistent and sometimes contradictory across health conditions and regions. Final decisions are often at the discretion of the genomic sequencing laboratory, bioinformatician or treating physician. This difference in healthcare delivery causes inconsistent information, disclosure and downstream impacts required to manage SFs and patient outcomes. Improving our understanding of the SF health policy landscape can determine components of the SF policy continuum spanning generation through to management that are in conflict, limitations of current guidance and existing needs across clinical settings.

METHODS AND ANALYSIS

We will carry out a systematic review to catalogue and appraise current guidance directing the identification, analysis and management of SFs for participants receiving genomic sequencing globally. We will conduct a comprehensive search of Medline (Medline R, Medline Epub Ahead of Print and Medline-In-Process & In-Data-Review Citations), Embase and Cochrane databases (n=5, inception to Feb 2022) and a grey literature search of international genomics websites (n=64; inception to May 2022). Key inclusion criteria include: guidance produced by health organisations, bioethics committees and professional associations, outlining recommendations for: (1) SF identification, (2) SF analysis or (3) SF management. Non-English language articles and conference abstracts will be excluded. Guidance will be critically appraised with the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE) II tool. We will interpret our findings by process and across populations using a qualitative descriptive approach.

ETHICS AND DISSEMINATION

Our systematic review evaluates published data and does not require ethics review. Our findings will be disseminated through peer-reviewed publications, conference presentations and workshops with precision medicine stakeholders.

PROSPERO REGISTRATION NUMBER

CRD42022316079.

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

INTRODUCTION

Digital interventions are considered as a potential solution to loneliness in older adults. However, this type of intervention has had limited acceptance among older adults (aged ≥60 years). To ensure the use of digital interventions in older adults, possible barriers and facilitating factors should be better understood from the user's perspective. We aim to systematically examine the barriers and facilitators to the implementation of digital interventions designed to reduce loneliness in older adults by identifying, evaluating and synthesising qualitative studies.

METHODS AND ANALYSIS

A comprehensive search of qualitative studies for barriers and facilitators for use of digital interventions will be conducted in the following databases: PubMed, MEDLINE, CINAHL, Embase, Scopus, Cochrane Library and Web of Science. Studies reported in English will be considered for this review. Grey literature will not be included. Two reviewers (HZ and XL) will independently screen the literatures, and any differences will be solved by turning to the third reviewer (JN). The Joanna Briggs Institute (JBI) Qualitative Research Critical Appraisal Checklist will be used by two reviewers to independently assess the validity of the methods used. Relevant data about the populations, context, culture, geographical location, study methods and barriers and facilitators to the implementation of digital interventions will be extracted using the JBI standardised data extraction tool. JBI meta-aggregation methods will be implemented to synthesise the data, which will generate themes and categories based on the data. The final synthesis will establish confidence levels using the JBI ConQual approach.

ETHICS AND DISSEMINATION

The protocol does not require ethical approval. The data are based on published scientific databases. The results will be disseminated through journal articles and scientific conference presentations (if feasible).

PROSPERO REGISTRATION NUMBER

CRD42022328609.

Fetal alcohol spectrum disorder resources for health professionals: a scoping review protocol

INTRODUCTION

People with fetal alcohol spectrum disorder (FASD) encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. Not all health professionals possess the knowledge or expertise required for the identification, assessment, referral and management of FASD. Accessible resources for understanding and managing FASD can help create awareness in health professionals and ensure patients receive the correct diagnosis and timely access to the necessary supports and services. The aim of this scoping review is to identify and analyse FASD resources for health professionals.

METHODS AND ANALYSIS

A comprehensive search of eight databases (MEDLINE, Scopus, PsycINFO, CINAHL, PubMED, EMBASE, Web of Science and Trip Medical Database) and nine grey literature databases (FASD Hub, NOFASD Australia, National Organisation for FASD, FASD United, HealthInfoNet, Proof Alliance, Child Family Community Australia, Foundation for Alcohol Research & Education and the Australian Department of Health websites) will be conducted using three search engines including PubMed, Ovid and Google advanced search (search dates: October 2021 to May 2022). Consultations will also be carried out with international and national experts in the diagnosis/management of FASD to obtain any additional relevant published or unpublished resources. Inclusion criteria were developed to guide the selection of resources that are publicly available, primarily focused on FASD and curated for health professionals for the identification, management or referral of FASD. Critical appraisal process will be executed using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) tool to assess the quality of selected resources.

ETHICS AND DISSEMINATION

Ethical approval is not required for the scoping review. Scoping review results will be presented at relevant national and international conferences and published in peer-reviewed journals. Search results will be made available to ensure reproducibility and transparency.

Physiotherapy interventions for head and trunk control in children with developmental disabilities: A scoping review protocol

Background: Head and trunk control is prerequisite skill that maximizes engagement and participation in one's environment by integrating vision, oromotor skill, arm control and respiration. Various physiotherapy and technology-based interventions have been utilized to facilitate head and trunk control in children with developmental disabilities. This scoping review is planned to map and summarize existing studies from the scientific literature on physiotherapy and technology-based interventions for head and trunk control in children with developmental disabilities. Methods: The scoping review will utilize the Joanna Briggs Institute scoping review methodology. The review will cover studies including children and adolescents aged between six months and 17 years 11 months 29 days, with developmental disabilities where in child finds difficulty in lifting its head and aligning head and trunk. We will include randomized controlled trial (RCT), non-RCT, quasi-experimental trial, and systematic reviews that have employed physiotherapy and technology-based interventions. Database-specific search strategy will be used to search records in Medline (PubMed and Web of Science), Embase, Scopus, CINAHL, PEDro, and Cochrane Library. Additionally, various grey literatures and clinical-trial registries will be searched. Two reviewers, independently, will screen and extract the data. Tables and visual representations will be utilized to present the extracted data. Registration details: The protocol has been registered in Open Science Framework, DOI:  10.17605/OSF.IO/B3RSU (22 ^nd August 2022).

Can the palaeoepidemiology of rickets during the industrialisation period in France be studied through bioarchaeological grey literature and French medico-historical literature of the 18th-early 20th centuries? Preliminary examination of a complex topic

OBJECTIVE

This study explores whether data relating to rickets from the French medico-historical literature (FMHL) and bioarchaeological grey literature are useful in evaluating its epidemiology during the industrialisation of France. Unlike other European countries such as England, industrialisation in France was a slow and continuous process with two phases: the first in 1830-1870 and the second in 1870-1914.

MATERIALS AND METHODS

A bibliographical analysis of 2800 FMHL sources from the 18th to the early 20th centuries and 50 archaeological excavation reports from the last 21 years was undertaken.

RESULTS

The FMHL data is very heterogeneous and predominantly dates to the second phase of industrialisation. The bioarchaeological data is very incomplete and predominantly relates to the period before industrialisation. At the same time, knowledge improvement and institutional changes to protect children could explain more systematic registration of cases of rickets.

CONCLUSIONS

No solid conclusions can be made regarding the prevalence of rickets at present, however these data hold great potential.

SIGNIFICANCE

In comparison to England, no systematic investigation of rickets prevalence during the period of industrialisation in France has been undertaken to date.

LIMITATIONS

The lack of archaeological excavations from this period and the limited paleopathological analysis of the sites excavated have contributed to our current lack of understanding regarding the impact of industrialization on the prevalence of rickets on the French population.

SUGGESTIONS FOR FURTHER WORK

The FMHL data needs to be homogenized and osteoarchaeological collections need to be restudied with a common protocol focusing on signs of vitamin D deficiency.

Methods for evaluating the benefits and harms of antenatal and newborn screening programmes adopted by health economic assessments: protocol for a systematic review

INTRODUCTION

Complex organisational arrangements are required to deliver antenatal and newborn screening programmes. Decision-makers consider the benefits and harms of screening when reviewing the evidence about these programmes. Economic evaluations contribute one important part of this assessment process. However, it is not fully understood what approaches health economic assessments have adopted to measure and value benefits and harms. This study aims to systematically review and critique the published and grey literature on methods for identifying, measuring and valuing the benefits and harms of antenatal and newborn screening adopted by health economic assessments.

METHODS AND ANALYSIS

Nine bibliographic databases will be searched from 2000 onwards. These search strategies will be supplemented by manual reference searching of bibliographies, forward citation searching, contacts with experts, author searching and web searching for grey literature. Studies will be selected for review if they report health economic assessments of an antenatal or newborn screening programme. Assessments of title and abstracts and full reports will be undertaken independently with disagreements resolved through discussion. Data extraction will include fields to assess the reporting quality of the studies using the Consolidated Health Economic Evaluation Reporting Standards statement and a bespoke ancillary form to assess how benefits and harms have been accounted for.

ETHICS AND DISSEMINATION

This is an evidence synthesis review from already published materials and hence ethics committee approval or written informed consent will not be required. Our results will be disseminated by publishing in high-impact peer-review journals and presenting at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42020165236.

Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature

The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the "community infrastructure" domain within the built environment, and the "community capacity" domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities.

National primary care responses to COVID-19: a rapid review of the literature

OBJECTIVE

The aim of this review, conducted in April 2020, is to examine available national primary care guidelines for COVID-19 and to explore the ways in which these guidelines support primary care facilities in responding to the demands of the COVID-19 pandemic.

DESIGN

Rapid review and narrative synthesis.

DATA SOURCES

PubMed, Embase and Google, as well as the websites of relevant national health departments, were searched from 1 January 2020 to 24 April 2020.

ELIGIBILITY CRITERIA

Documents included must be issued by a national health authority, must be specific to COVID-19 care, directed at healthcare workers or managers, and must refer to the role of primary care in the COVID-19 response.

RESULTS

We identified 17 documents from 14 countries. An adapted framework on primary care challenges and responses to pandemic influenza framed our analysis. Guidelines generally reported on COVID-19 service delivery and mostly made specific recommendations for ensuring continued delivery of essential primary care services through telehealth or other virtual care modalities. Few offered guidance to support surveillance as a public health function. All offered guidance on implementing outbreak control measures, largely through flexible and coordinated organisational models with partners from various sectors. There was a lack of guidance to support supply chain management and practice resilience in primary care, and lack of personal protective equipment represents a serious threat to the provision of quality care during the pandemic.

CONCLUSIONS

Current national primary care guidelines for COVID-19 provide guidance on infection control and minimising the risk of spread in primary care practices, while supporting the use of new technology and coordinated partnerships. However, to ensure primary care practice resilience and quality of care are upheld, guidelines must offer recommendations on supply chain management and operational continuity, supported by adequate resources.

Prone cardiopulmonary resuscitation: A scoping and expanded grey literature review for the COVID-19 pandemic

AIM

To identify and summarize the available science on prone resuscitation. To determine the value of undertaking a systematic review on this topic; and to identify knowledge gaps to aid future research, education and guidelines.

METHODS

This review was guided by specific methodological framework and reporting items (PRISMA-ScR). We included studies, cases and grey literature regarding prone position and CPR/cardiac arrest. The databases searched were MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Scopus and Google Scholar. Expanded grey literature searching included internet search engine, targeted websites and social media.

RESULTS

Of 453 identified studies, 24 (5%) studies met our inclusion criteria. There were four prone resuscitation-relevant studies examining: blood and tidal volumes generated by prone compressions; prone compression quality metrics on a manikin; and chest computed tomography scans for compression landmarking. Twenty case reports/series described the resuscitation of 25 prone patients. Prone compression quality was assessed by invasive blood pressure monitoring, exhaled carbon dioxide and pulse palpation. Recommended compression location was zero-to-two vertebral segments below the scapulae. Twenty of 25 cases (80%) survived prone resuscitation, although few cases reported long term outcome (neurological status at hospital discharge). Seven cases described full neurological recovery.

CONCLUSION

This scoping review did not identify sufficient evidence to justify a systematic review or modified resuscitation guidelines. It remains reasonable to initiate resuscitation in the prone position if turning the patient supine would lead to delays or risk to providers or patients. Prone resuscitation quality can be judged using end-tidal CO₂, and arterial pressure tracing, with patients turned supine if insufficient.

What guidance is there on portion size for feeding preschool-aged children (1 to 5 years) in the United Kingdom and Ireland? A systematic grey literature review

Large portion sizes of food can lead to excessive energy intake and weight gain in young children. Although portion size guidance is available, parents are often unaware it exists. Our systematic grey literature review aimed to identify the portion size guidance resources in the United Kingdom and Ireland, aimed at users (e.g., parents and childcare providers) responsible for feeding preschool-aged children. We describe who the resources are aimed at, how they are informed and whether the recommended portion sizes are consistent across resources. Resources were identified via advanced Google searches, searching reference lists and contacting experts. Resources that provided quantifiable portion size information (e.g., grammes) were included. Portion sizes (g) were extracted and energy equivalents (kcal) were calculated. Portion sizes were analysed by food group and by eating occasion. Twenty-two resources were identified. Median portion sizes were consistent across resources for fruit (40 g [IQR = 40-50]) and vegetables (40 g [IQR = 30-40]). Variability was observed in portion size and/or energy content for dairy (60 g [IQR = 25-93]), protein (72 kcal [IQR = 44-106]) and starchy (41 g/71 kcal [IQR = 25-80/56-106]) food groups. The range in size of an average eating occasion was large (90-292 g). This review identifies resources that could help caregivers to choose appropriate portion sizes for preschool-aged children but also highlights how future resources could be improved.

Measuring the outcome and impact of research capacity strengthening initiatives: A review of indicators used or described in the published and grey literature

Background: Development partners and research councils are increasingly investing in research capacity strengthening initiatives in low- and middle-income countries to support sustainable research systems. However, there are few reported evaluations of research capacity strengthening initiatives and no agreed evaluation metrics. Methods: To advance progress towards a standardised set of outcome and impact indicators, this paper presents a structured review of research capacity strengthening indicators described in the published and grey literature. Results: We identified a total of 668 indicators of which 40% measured output, 59.5% outcome and 0.5% impact. Only 1% of outcome and impact indicators met all four quality criteria applied. A majority (63%) of reported outcome indicators clustered in four focal areas, including: research management and support (97/400), the attainment and application of new research skills and knowledge (62/400), research collaboration (53/400), and knowledge transfer (39/400). Conclusions: Whilst this review identified few examples of quality research capacity strengthening indicators, it has identified priority focal areas in which outcome and impact indicators could be developed as well as a small set of 'candidate' indicators that could form the basis of development efforts.

Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever

A rapid review of gray literature from 2015 to 2016 was conducted to identify the lessons learned for emergency risk communication from recent outbreaks of Ebola, Zika, and yellow fever. Gray literature databases and key websites were searched and requests for documents were posted to expert networks. A total of 83 documents met inclusion criteria, 68 of which are cited in this report. This article focuses on the 3 questions, out of 12 posed by World Health Organization as part of a Guideline development process, dealing most directly with communicating risk during health emergencies: community engagement, trust building, and social media. Documents were evaluated for credibility using an Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist? and if the document contained a study, a method-specific tool was applied. A rapid content analysis of included sources was undertaken with relevant text either extracted verbatim or summarized and mapped against the questions. A database subset was created for each question and citations were assigned to the subset(s) for which they contained relevant information. Multiple designations per document were common. Database subsets were used to synthesize the results into a coherent narrative. The gray literature strongly underlines the central importance of local communities. A one-size-fits-all approach does not work. For maximum effectiveness, local communities need to be involved with and own emergency risk communication processes, preferably well before an emergency occurs. Social media can open new avenues for communication, but is not a general panacea and should not be viewed as a replacement for traditional modes of communication. In general, the gray literature indicates movement toward greater recognition of emergency risk communication as a vitally important element of public health.

Towards sustainable healthcare system performance in the 21st century in high-income countries: a protocol for a systematic review of the grey literature

INTRODUCTION

There is wide recognition that, if healthcare systems continue along current trajectories, they will become harder to sustain. Ageing populations, accelerating rates of chronic disease, increasing costs, inefficiencies, wasteful spending and low-value care pose significant challenges to healthcare system durability. Sustainable healthcare systems are important to patients, society, policy-makers, public and private funders, the healthcare workforce and researchers. To capture current thinking about improving healthcare system sustainability, we present a protocol for the systematic review of grey literature to capture the current state-of-knowledge and to compliment a review of peer-reviewed literature.

METHODS AND ANALYSIS

The proposed search strategy, based on the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, includes Google Advanced Search, snowballing techniques and targeted hand searching of websites of lead organisations such as WHO, Organisation for Economic Cooperation and Development, governments, public policy institutes, universities and non-government organisations. Documents will be selected after reviewing document summaries. Included documents will undergo full-text review. The following criteria will be used: grey literature document; English language; published January 2013-March 2018; relevant to the healthcare delivery system; the content has international or national scope in high-income countries. Documents will be assessed for quality, credibility and objectivity using validated checklists. Descriptive data elements will be extracted: identified sustainability threats, definitions of sustainability, attributes of sustainable healthcare systems, solutions for improvement and outcome measures of sustainability. Data will be analysed using novel text-mining methods to identify common concept themes and meanings. This will be triangulated with the more traditional analysis and concept theming by the researchers.

ETHICS AND DISSEMINATION

No primary data will be collected, therefore ethical approval will not be sought. The results will be disseminated in peer-reviewed literature, as conference presentations and as condensed summaries for policy-makers and health system partners.

PROSPERO REGISTRATION NUMBER

CRD42018103076.

A global systematic scoping review of studies analysing indicators, development, and content of national-level physical activity and sedentary behaviour policies

BACKGROUND

National policy approaches to physical activity (PA) promotion and sedentary behaviour (SB) reduction are needed to address rising rates of non-communicable diseases. Understanding the policy process and impact through robust research and evaluation is crucial for facilitating successful reforms in national health policy. This scoping review, therefore, aimed to map the evidence on indicators, development, and content of national PA and/or SB policies globally.

METHODS

A systematic search of academic and grey literature was conducted through six bibliographic databases, Google, and websites of three large organisations for PA promotion.

RESULTS

Out of 24,872 screened documents, 203 publications from 163 studies were selected. The selected studies investigated PA/SB policies in 168 countries worldwide, and we provided summary results for each of the countries. Overall, 69, 29, and 2% of the analyses of national PA/SB policies were conducted for high-, middle-, and low-income countries, respectively. Twenty-two percent of the studies mentioned SB policies as part of their analysis, with only one study focusing solely on assessing SB policies. Operational definitions of policy were found in only 13% of publications. Only 15% of the studies used a conceptual or theoretical framework. A large variety of methods were used for data collection and analysis of PA/SB policy.

CONCLUSIONS

We found that PA policy research is much more developed than it was considered several years ago. Research around SB policies is still in its infancy, but it seems to have experienced some positive progress in the last few years. Three key issues were identified that should be addressed in further research: [i] there is a lack of PA/SB policy research in low- and middle-income countries, which is an important limitation of the current body of evidence; [ii] the definition of policy varied significantly across studies, and most studies did not rely on any theoretical framework, which may impede cross-study comparisons; and [iii] studies have used a variety of methods to analyse policy, which may also cause problems with comparability. Future PA/SB policy research should aim towards a clearer conceptualisation of policy, greater reliance on existing theoretical frameworks, and the use and further development of standardised methods for PA/SB policy analysis.

Campus Sexual Assault: A Systematic Review of Prevalence Research From 2000 to 2015

Sexual assault is a pervasive problem on university and college campuses in the United States that has garnered growing national attention, particularly in the past year. This is the first study to systematically review and synthesize prevalence findings from studies on campus sexual assault (CSA) published since 2000 ( n = 34). The range of prevalence findings for specific forms of sexual victimization on college campuses (i.e., forcible rape, unwanted sexual contact, incapacitated rape, sexual coercion, and studies' broad definitions of CSA/rape) is provided, and methodological strengths and limitations in the empirical body of research on CSA are discussed. Prevalence findings, research design, methodology, sampling techniques, and measures, including the forms of sexual victimization measured, are presented and evaluated across studies. Findings suggest that unwanted sexual contact appears to be most prevalent on college campuses, including sexual coercion, followed by incapacitated rape, and completed or attempted forcible rape. Additionally, several studies measured broad constructs of sexual assault that typically include combined forms of college-based sexual victimization (i.e., forcible completed or attempted rape, unwanted sexual contact, and/or sexual coercion). Extensive variability exists within findings for each type of sexual victimization measured, including those that broadly measure sexual assault, which is largely explained by differences in sampling strategies and overall study designs as well as measures of sexual assault used in studies. Implications for findings and recommendations for future research on the prevalence of college-based sexual victimization are provided.

Protective Factors Against Child Victimization in the School and Community: An Exploratory Systematic Review of Longitudinal Predictors and Interacting Variables

Protective factors against the victimization of children and young people within the school and community environments (extrafamilial victimization) have received less attention than risk factors. To date, there has been no systematic review on protective factors. This systematic review therefore aimed to synthesize the prospective longitudinal research findings on the protective factors against extrafamilial victimization. A systematic search of multiple sources led to the identification of 19,053 studies. Following application of a predefined inclusion and quality assessment criteria, 13 studies exploring protective factors against peer victimization and exposure to violence were included in this review. Across these studies, 19 protective factors were explored: 9 individual factors and 10 contextual factors. Four studies also explored the impact of mediating and moderating variables on the relationship between predictors and extrafamilial victimization. Findings highlight inconsistencies in the definition and measurement of victimization, along with bias in a number of areas. Nevertheless, a small number of variables (perceptions of social competence, physical strength, and aggression) were identified as potential protective factors against extrafamilial victimization. Additionally, mediating and moderating variables were identified, and the interaction between individual and contextual protective and risk factors were highlighted. These findings are explored under the theoretical framework of the ecological systems theory and their practical and research-based implications are discussed.