Search

Additional file 1. Mixed Methods Appraisal Tool

Additional file 3. Organisation A’s outcome measure

Additional file 2. Organisation B’s outcome measure

Additional file 1.

An evaluation of a third sector delivered support service in partnership with primary care to support primary care patients with mental health issues who require alternative support.

Background There is increasing interest in using Patient Reported Outcome Measures (PROMs) within organisations delivering health related services. However, organisations have had mixed success in implementing PROMs and there is little understanding about why this may be. Thus, the purpose of this study was to identify the facilitators and barriers to implementing PROMs in organisations. Method A systematic review of reviews was undertaken. Searches were conducted of five electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews, during the week of the 20th February 2017. Additional search methods included website searching and reference checking. To be included, a publication had to be a review of the literature, describe its methods and include information related to implementing PROMs. The reviews were extracted using a standardised form and assessed for their risk of bias using the Risk of Bias in Systematic Reviews tool. The findings were synthesised using the Consolidated Framework for Implementation Research. The protocol was registered on the International Prospective Register of Systematic Reviews database (PROSPERO) (CRD42017057491). Results Initially 2047 records were identified. After assessing eligibility, six reviews were included. These reviews varied in their review type and focus. Different issues arose at distinct stages of the implementation process. Organisations needed to invest time and resources in two key stages early in the implementation process: ‘designing’ the processes for using PROMs within an organisation; and ‘preparing’ an organisation and its staff. The ‘designing’ stage involved organisations planning not just which PROMs to use and how to administer them, but also how the data would be used for clinical purposes. The ‘preparing’ stage involved getting an organisation and its staff ready to use PROMs, particularly persuading clinicians of the validity and value of PROMs, delivering training, and developing electronic systems. Having an implementation lead overseeing the process and developing the process based on feedback were also identified as facilitating implementation. Conclusion Organisations implementing PROMs need to invest time and resources in ‘designing’ the PROMs strategy and ‘preparing’ the organisation to use PROMs. Focusing on these earlier stages may prevent problems arising when PROMs are used in practice. Electronic supplementary material The online version of this article (10.1186/s41687-018-0072-3) contains supplementary material, which is available to authorized users.

This evaluation assesses the first stages of creating a social movement to normalise conversations about cancer, raise awareness of cancer risks, support people to consult their doctor about signs and symptoms, and take up invitations to be screened. Findings indicate that local workers based in voluntary and community sector organisations can effectively use peer support to recruit cancer champions, develop understanding of key messages about common cancers, and trigger interest across neighbourhoods, businesses and local groups in becoming part of a social movement to increase cancer health literacy.

Objective: This paper updates previous guidance on developing a protocol, with a specific focus on question formulation and searching, reflecting recent developments in methods for conducting qualitative evidence syntheses (QES). Study design and setting: Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry, and mapping the information available to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. Results: The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility and implementation to construct a set of questions that can produce a useful information set to inform decisions. Conclusion: Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Further, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route-map, particularly in reviews that ask more exploratory and open ended questions. ispartof: Journal of Clinical Epidemiology vol:97 issue:97 pages:79-85 ispartof: location:United States status: published

This poster describes how a review of wellbeing tools conducted by community organisations in Sheffield led to the collaborative development of a more relevant measurement tool.

PRISMA checklist. (DOC 58 kb)

MEDLINE search terms. (DOCX 13 kb)

Table S1. The facilitators and barriers to implementing PROMs [22â 24, 35â 37]. (DOCX 47 kb)

status: published

Applying the iCAT_SR â example B: systematic review of the effects of interventions aimed at communities to inform and/or educate about early childhood vaccination and qualitative evidence synthesis of parentsâ and informal caregiversâ views and experiences of routine early childhood vaccination communication. (PDF 371Â kb)

Applying the iCAT_SR â example B: systematic review of the effects of interventions aimed at communities to inform and/or educate about early childhood vaccination and qualitative evidence synthesis of parentsâ and informal caregiversâ views and experiences of routine early childhood vaccination communication. (PDF 371Â kb)

iCAT dimensions for assessing the complexity of interventions in the context of randomised trials (PDF 420Â kb)

Dimensions considered and excluded from the iCAT for assessing the complexity of interventions in the context of randomised trials (PDF 241Â kb)

Guidance for using the iCAT_SR tool: intervention Complexity Assessment Tool for Systematic Reviews, version 1.0 (PDF 362Â kb)

Development of a tool to describe and assess the complexity of interventions in randomised trials (PDF 338Â kb)

iCAT dimensions for assessing the complexity of interventions in the context of randomised trials (PDF 420Â kb)

Dimensions considered and excluded from the iCAT for assessing the complexity of interventions in the context of randomised trials (PDF 241Â kb)

Evidence from qualitative studies can play an important role in adding value to systematic reviews for policy, practice and consumer decision-making.  Cochrane Intervention reviews now include qualitative and implementation research embedded within, or associated with, the trials.  There are five primary roles for qualitative evidence syntheses within the context of Cochrane Intervention reviews: o Scoping review: Qualitative research, either as individual studies or within a synthesis, may be used to inform Cochrane intervention reviews by helping define and refine the question, and to address all important outcomes; o Integrated review: Integration of both quantitative and qualitative evidence within a single coherent Cochrane review product; o Qualitative review of trial sibling studies: Conduct of a qualitative evidence synthesis alongside a Cochrane intervention review using qualitative studies informing the intervention that are directly related to included trials and thus share a common context; o Qualitative review of unrelated qualitative evidence: Conduct of a qualitative evidence synthesis that includes qualitative studies of the intervention but not necessarily related to included trials; and o Qualitative review of wider relevant issues: Conduct of a qualitative evidence synthesis that includes qualitative data beyond that relating to the intervention e.g. attitudes of patients, staff members or carers to the experience of a disease or health condition.  Many methods of qualitative evidence synthesis are appropriate to the aims and scope of Cochrane Intervention reviews.  The synthesis of qualitative research is an area of debate and evolution. The Cochrane Qualitative and Implementation Methods Group provides a forum for discussion and further development of methodology in this area. Available from http://qim.cochrane.org/supplemental-handbook-guidance ispartof: Cochrane Handbook for Systematic Reviews of Interventions pages:1-26 edition:version ispartof: pages:1-26 edition:version edition: version status: published

Framework for successful consumer involvement (Telford et al. [ 12 ]). Framework for patient and service user involvement (Shippee et al. [ 17 ]). Levels of participation (Popay [ 23 ]).

The checklist is known as the Consolidated Criteria for Reporting Qualitative Studies (COREQ) (1). Although many qualitative research methods are used to understand complex meanings and interpretations of health, disease or interventions, the COREQ guideline’s focus is targeted on the reporting of studies using interviews and focus groups. Tong and colleagues (1) developed the 32-item checklist by reviewing and identifying items published from qualitative studies. COREQ can be used by peer reviewers and editors reviewing a primary qualitative research submission. COREQ can also be used by readers wishing to gauge the validity of the results of a published report of qualitative research. ispartof: Guidelines for reporting health research: a user's manual pages:1-320 edition:1 ispartof: BMJ books pages:1-320 edition:1 edition: 1 status: published

The objective of this study was to investigate the relationship between the characteristics of home-care contracts, as indicators of employment relationships, and nurses'job satisfaction and perceived job security. A cross-sectional design was used to collect data on the study variables.The setting was 11 Community Care Access Centres and 11 nursing provider agencies in the Canadian province of Ontario. The sample included 700 nurses. A mailed survey was used to collect data from CCACs on length of contract awarded to provider agencies, potential for renewal, volume of service awarded, and profit status of the agency. Data were collected, via a mailed survey, on nurses' age, gender, work status, and years of employment in the community and at the current agency. The Nursing Job Satisfaction Scale was used to collect data on nurses'job satisfaction. Perceived job security was assessed using a single item measured on a 5-point Likert scale. Significant differences were found among provider agencies in nurses' perception of the quality of care, work enjoyment, satisfaction with time for care, and job security. Older nurses rated work enjoyment higher than younger nurses. Nurses paid on an hourly basis were more satisfied with their time for care than those paid on a per-visit basis. Nurses employed on a casual basis were less satisfied with job security than those employed on a full-time basis. Differences in nurse outcomes were observed among nursing provider agencies, but these were not related to the profit status of the agency. Further research is needed on the best practices within agencies that result in more satisfied staff.

This study looks at the dominant discourses in the news and documentary coverage\ud of the British military in the occupation of Iraq. It is in these discourses that the\ud justification for the war and occupation rests and in this justification lies the\ud interpretation of the function, efficacy and cost of the military. To do this I have\ud examined the genres of news, news and current affairs documentaries and traditional\ud documentaries to see how these genres favour certain discourses and circumstances\ud which allow certain questions to be asked, but resist others. Evidence from the\ud Chilcot Inquiry is used to illustrate what themes and questions have been silenced in\ud the television coverage. The dominant discourse of coverage is that of the suffering, heroic soldier, taking\ud part in a ‘humanitarian’ war, although what this actually entails is not examined in\ud depth. In this study it is the news and NCA documentaries and not traditional\ud documentaries which provide a deeper context, a wider range of voices, and a more\ud critical view of the military’s role and strategy in Iraq. The nature of the occupation\ud is confused, the junior nature of the British military’s relationship with the\ud Americans is not explained, the financial cost of the occupation is ignored in the\ud elision with the moral cost of death, and the political and governing role of a military\ud occupation is not considered. Although all genres describe the soldiers’ role as\ud humanitarian, there is little visual evidence to illustrate it, and the paradox of\ud soldiers who fight, but can have no enemy as they are there to ‘help’ the Iraqis\ud becomes apparent. The footage of fighting soldiers therefore becomes a representation of soldiers, and where the footage is specific, individual soldiers talk\ud about their betrayal or suffering where the enemy is the British government. The\ud emotional discourse of the suffering soldier inhabits this space between the\ud represented and the reproduced and represses any questions about the military’s\ud responsibility for their actions in Iraq, and hence curtails the civic function of\ud documentary and news to inform.

Background Patient and public involvement in diabetes research is now actively encouraged in different countries because it is believed that involving people with experience of the condition will improve the quality and relevance of the research. However, reviews of patient involvement have noted that inadequate resources, patients’ and communities’ lack of research knowledge, and researchers’ lack of skills to involve patients and communities in research may present significant contextual barriers. Little is known about the extent of patient/community involvement in designing or delivering interventions for people with diabetes. A realist review of involvement will contribute to assessing when, how and why involvement works, or does not work, to produce better diabetes interventions. Methods/design This protocol outlines the process for conducting a realist review to map how patients and the public have been involved in diabetes research to date. The review questions ask the following: How have people with diabetes and the wider community been involved in diabetes research? What are the characteristics of the process that appear to explain the relative success or failure of involvement? How has involvement (or lack of involvement) in diabetes research influenced the development and conduct of diabetes research? The degree of support in the surrounding context will be assessed alongside the ways in which people interact in different settings to identify patterns of interaction between context, mechanisms and outcomes in different research projects. The level and extent of the involvement will be described for each stage of the research project. The descriptions will be critically reviewed by the people with diabetes on our review team. In addition, researchers and patients in diabetes research will be asked to comment. Information from researcher-patient experiences and documents will be compared to theories of involvement across a range of disciplines to create a mid-range theory describing how involvement (or lack of involvement) in diabetes research influences the development and conduct of diabetes research.

Objectives: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Study Design and Setting: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Results: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Conclusion: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches. Refereed/Peer-reviewed

The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Refereed/Peer-reviewed

Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized health care resources for use in a decision-making process.1 Cochrane works collaboratively with contributors around the world to produce authoritative, relevant, and reliable reviews. Cochrane reviews are commonly used in a guideline development process to determine recommendations for practice. The Cochrane Qualitative and Implementation Methods Group provide methodological advice and guidance to Cochrane as well as leading methodological development to benefit the wider qualitative evidence synthesis community. In this introductory paper 1 we briefly outline the evolution of qualitative and mixed-method synthesis methods, the role of qualitative and mixedmethod syntheses in a decision-making process, and the contribution of qualitative and mixed-method syntheses to understanding complexity in complex intervention reviews. We then introduce a series of papers that provide Cochrane guidance on conducting qualitative and mixed-method evidence syntheses for a decision-making context. ispartof: Journal of Clinical Epidemiology vol:97 issue:97 pages:35-38 ispartof: location:United States status: published

• Critical appraisal of qualitative studies is an essential step within a Cochrane Intervention review that incorporates qualitative evidence. • The overarching goal of critical appraisal in the context of including qualitative research in a Cochrane Intervention Review is to assess whether the studies actually address questions under meaning, process and context in relation to the intervention and outcomes under review. • Review teams should use a critical appraisal instrument that is underpinned by a multi-dimensional concept of quality in research and hence includes items to assess quality according to several domains including quality of reporting, methodological rigour and conceptual depth and bread. • Critical appraisal involves (i) filtering against minimum criteria, involving adequacy of reporting detail on the data sampling, -collection and-analysis, (ii) technical rigour of the study elements indicating methodological soundness and (iii) paradigmatic sufficiency, referring to researchers’ responsiveness to data and theoretical consistency. • When choosing an appraisal instrument a Review teams should consider the available expertise in qualitative research within the team and should ensure that the critical appraisal instrument they choose is appropriate given the review question and the type of studies to be included. • Reviewers need to clarify how the outcome of their critical appraisal exercise is used with respect to the presentation of their findings. The inclusion of a sensitivity analysis is recommended to evaluate the magnitude of methodological flaws or the extent to which it has a small rather than a big impact on the findings and conclusions. Available from URL http://cqrmg.cochrane.org/supplemental-handbook-guidance ispartof: Supplementary guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions edition:Version ispartof: edition:Version edition: Version status: published