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This study employed insider research and reflective practice to investigate exchanges across the research-policy interface to understand the practice of producing policy-relevant systematic reviews. Interviewees came from 11 systematic reviews or review programmes which spanned four models of policy-relevant reviews and between them provided evidence for understanding policy problems, comparing policy options, or implementing policy decisions. No review methodology was found to be uniquely appropriate for policy-relevant systematic reviews. It was the mutual engagement across the research-policy interface that made the reviews policy-relevant. This involved thinking about the issues and seeing them from multiple viewpoints to identify and shape questions; this prompted implicit or explicit value-driven debates. The intellectual work to shape a policy-relevant systematic review is an iterative, collective endeavour that requires partners from either side of the policy-research interface to engage with the unfamiliar, listen, challenge and co-construct questions and answers.

Why you should read this article: • To understand a collaborative learning model for developing 'training the trainer' courses • To develop training programmes on indigenising systematic reviews to local contexts • To gain insights into adult learning and teaching strategies Background: Developing a workforce with the skills to produce and make judicious use of evidence for policy and practice decisions requires trainers who can tailor evidence and training to policy and practice priorities. Aim: To describe how a collaborative learning model adapted a systematic review course to suit Indian nurse educators and research scholars in the conduct and use of systematic reviews. Discussion: A collaborative learning team of academics and research scholars brought together expertise in nursing education in India, and evidence synthesis in India and the UK. Participants found the course was highly beneficial, enhanced independent and critical thinking, and instilled them with the confidence and skills to deliver such courses to Indian researchers, nurses and other healthcare professionals. Conclusion: Contextualising materials and methods to participants' experiences made learning more relatable. The use of adult learning approaches enabled participants to apply the same approaches when leading training in their own institutions and underpinned long-term sustainable working relationships between facilitators and learners, leading to new studies and new resources to support evidence-informed decision-making. Implications for practice: An educational intervention on 'indigenising systematic reviews' with online collaborative learning can produce improvements in the knowledge and skills of participants. Advantages of this educational approach include its flexibility, active involvement of participants and sustainable partnership building. The principles and methods used could be replicated in any setting to train trainers. [ABSTRACT FROM AUTHOR]

Support for producing systematic reviews about health systems is less well developed than for those about clinical practice. From interviewing policy makers and systematic reviewers we identified institutional mechanisms which bring systematic reviews and policy priorities closer by harnessing organisational and individual motivations, emphasising engagement between policy and research, embedding efforts in conducive structures and supporting them with formalised procedures. Four models combine mechanisms appropriately to suit the initial degree of clarity and consensus of key issues underpinning the policy problem or research question, and whether the review is for a specific decision or widespread use.

When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the reviews of reviews (RoR) method in order to advance understanding of this important tool for policy makers. Drawing on our experiences, we present, where possible, potential solutions to these challenges to demonstrate that RoRs, despite their limitations, can be useful for mediating policy-relevant evidence at speed.

Realist synthesis is often offered as a useful strategy to understand intervention complexity. Its unique selling point is its basis in a critical realist philosophy of science. However, we argue that the philosophical basis of current approaches to realist synthesis is closer to positivism, notably the focus on bringing a theoretical reduction to complex problems, a strategy eschewed in critical realism's concern with complex independent ontology. We critique three recently published reviews to illustrate our arguments and apply an analytic strategy to findings from a realist review that, we argue, is more in line with critical realism. [ABSTRACT FROM AUTHOR]

Cyberbullying is associated with considerable negative mental and psychosocial consequences in children and young people, making it a serious public health concern. To review the highest level of available evidence, a systematic mapping review was conducted to identify systematic reviews that investigated the relationship between cyberbullying and mental and psychological outcomes in young people. Topic-relevant bibliographic databases and online resources were searched to identify reviews published since 2007. Data were extracted using a coding tool developed for this study. Methodological quality of included reviews was assessed using AMSTAR criteria. Nineteen systematic reviews satisfied the inclusion criteria and they reported a strong negative association between cyberbullying and mental health outcomes in young people. Meta-analysis was performed in 11 reviews and narrative synthesis in 8 reviews. Data were derived from predominantly cross-sectional studies and a clear causal relationship between cyberbullying and mental outcomes cannot be established. Two-third of the included reviews were classified to be of low or unclear quality, due to the lack of quality assessment of the primary studies included in individual reviews. This systematic map consolidates available evidence at review level and confirms the existing gaps in longitudinal and qualitative evidence synthesis. Closer examination of the moderating factors influencing cyberbullying behaviors in future research can advance our understanding and inform the development of tailored programs of intervention to mitigate the negative impact of this phenomenon. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We examined the feasibility and benefit of integrating occupational therapy into a long-term services and supports (LTSS) care coordination program for aging in place. METHOD. Clients referred to occupational therapy during a 16-wk trial were evaluated with the In-Home Occupational Performance Evaluation and received education on strategies for aging in place. Clients who indicated readiness for change were assisted in setting personalized goals with goal attainment scaling and received four additional occupational therapy visits. RESULTS. Of the program's feasibility benchmarks, 87% were met. Twenty-three clients were referred, and 16 clients were evaluated; 37.5% of those evaluated indicated readiness for change, establishing 18 goals with 100% goal attainment. CONCLUSION. Integration of occupational therapy into an LTSS care coordination program was feasible. Benefits of adding occupational therapy included a performance-based evaluation that revealed personal factors as barriers to aging in place and gave access to a client-centered service to maximize independence. [ABSTRACT FROM AUTHOR]

Objective: Positive youth development (PYD) often aims to prevent tobacco, alcohol, and drugs use and violence. We systematically reviewed PYD interventions, synthesizing process, and outcomes evidence. Synthesis of outcomes, published elsewhere, found no overall evidence of reducing substance use or violence but notable variability of fidelity. Our synthesis of process evaluations examined how implementation varied and was influenced by context.Data Source: Process evaluations of PYD aiming to reduce substance use and violence. Study Inclusion Criteria: Overall review published since 1985; written in English; focused on youth aged 11 to 18 years; focused on interventions addressing multiple positive assets; reported on theory, process, or outcomes; and concerned with reducing substance use or violence. Synthesis of process evaluations examined how implementation varies with or is influenced by context.Data Extraction: Two reviewers in parallel.Data Synthesis: Thematic synthesis.Results: We identified 12 reports. Community engagement enhanced program appeal. Collaboration with other agencies could broaden the activities offered. Calm but authoritative staff increased acceptability. Staff continuity underpinned diverse activities and durable relationships. Empowering participants were sometimes in tension with requiring them to engage in diverse activities.Conclusion: Our systematic review identified factors that might help improve the fidelity and acceptability of PYD interventions. Addressing these might enable PYD to fulfill its potential as a means of promoting health. [ABSTRACT FROM AUTHOR]

Background. Humanitarian emergencies can impact people's psychosocial well-being and mental health. Providing mental health and psychosocial support (MHPSS) is an essential component of humanitarian aid responses. However, factors influencing the delivery MHPSS programmes have yet to be synthesised. We undertook a systematic review on the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies in low- and middle-income countries. Methods. A comprehensive search of 12 bibliographic databases, 25 websites and citation checking was undertaken. Studies published in English from 1980 onwards were included if they contained evidence on the perspectives of adults or children who had engaged in or programmes providers involved in delivering, MHPSS programmes in humanitarian settings. Thirteen studies were critically appraised and analysed thematically. Results. Community engagement was a key mechanism to support the successful implementation and uptake of MHPSS programmes. Establishing good relationships with parents may also be important when there is a need to communicate the value of children and young people's participation in programmes. Sufficient numbers of trained providers were essential in ensuring a range of MHPSS programmes were delivered as planned but could be challenging in resource-limited settings. Programmes need to be socially and culturally meaningful to ensure they remain appealing. Recipients also valued engagement with peers in group-based programmes and trusting and supportive relationships with providers. Conclusion. The synthesis identified important factors that could improve MHPSS programme reach and appeal. Taking these factors into consideration could support future MHPSS programmes achieve their intended aims. [ABSTRACT FROM AUTHOR]

Important policy questions tend to span a range of academic disciplines, and the relevant research is often carried out in a variety of social, economic and geographic contexts. In efforts to synthesise research to help inform decisions arising from the policy questions, systematic reviews need conceptual frameworks and ways of thinking that combine knowledge drawn from different academic traditions and contexts; in other words, transdisciplinary research. This paper considers how transdisciplinary working can be achieved with: conceptual frameworks that span traditional academic boundaries; methods for shaping review questions and conceptual frameworks; and methods for interpreting the relevance of findings to different contexts. It also discusses the practical challenges and ultimate benefits of transdisciplinary working for systematic reviews. [ABSTRACT FROM AUTHOR]

Adult social care continues to be a central policy concern in the UK. The Adult Social Care Outcomes Framework (ASCOF) is a range of measures nationally available to drive forward improvement on outcomes and quality in local councils. While there is an emphasis on improving transparency, quality and outcomes, drawing on research evidence to achieve these aims is often difficult because the evidence is not easily identifiable, is disparate or of variable quality. We conducted a metareview to analyse and summarise systematic review-level evidence on the impact of interventions on the four outcomes set out in the ASCOF: quality of life, delaying and reducing the need for services, satisfaction with services and safeguarding of vulnerable adults. This paper focuses on the availability of review-level evidence and the presence of significant gaps in this evidence base. A range of health and social care databases were searched, including MEDLINE, ASSIA and The Cochrane Library in January and February 2012. All systematic reviews evaluating the efficacy of social care interventions for improving ASCOF outcomes for older people, people with long-term conditions, mental health problems or physical and/or learning disabilities were eligible. Two reviewers independently screened systematic reviews for quality and relevance and extracted data; 43 systematic reviews were included, the majority of which examined the impact of interventions on quality of life (n = 34) and delaying and reducing the need for support (n = 25). Limited systematic review-level evidence was found regarding satisfaction with services and safeguarding. There were also significant gaps in relation to key social care interventions and population groups. Research priorities include addressing these gaps and the collation of data on interventions, outcomes and populations more closely related to social care. Overall, a more relevant, comprehensive and robust evidence base is required to support improvement of outcomes for recipients of adult social care. [ABSTRACT FROM AUTHOR]

Websites and online resources outside academic bibliographic databases can be significant sources for identifying literature, though there are challenges in searching and managing the results. These are pertinent to systematic reviews that are underpinned by principles of transparency, accountability and reproducibility. We consider how the conduct of searching these resources can be compatible with the principles of a systematic search. We present an approach to address some of the challenges. This is particularly relevant when websites are relied upon to identify important literature for a review. We recommend considering the process as three stages and having a considered rationale and sufficient recordkeeping at each stage that balances transparency with practicality of purpose. Advances in technology and recommendations for website providers are briefly discussed. [ABSTRACT FROM AUTHOR]

Background: Preventing adolescent substance use and youth violence are public health priorities. Positive youth development interventions are widely deployed often with the aim of preventing both. However, the theorised mechanisms by which PYD is intended to reduce substance use and violence are not clear and existing evaluated interventions are under-theorised. Using innovative methods, we systematically searched for and synthesised published theoretical literature describing what is meant by positive youth development and how it might reduce substance use and violence, as part of a broader systematic review examining process and outcomes of PYD interventions.Methods: We searched 19 electronic databases, review topic websites, and contacted experts between October 2013 and January 2014. We included studies written in English, published since 1985 that reported a theory of change for positive youth development focused on prevention of smoking, alcohol consumption, drug use or violence in out-of-school settings. Studies were independently coded and quality-assessed by two reviewers.Results: We identified 16 studies that met our inclusion criteria. Our synthesis suggests that positive youth development aims to provide youth with affective relationships and diverse experiences which enable their development of intentional self-regulation and multiple positive assets. These in turn buffer against or compensate for involvement in substance use and violence. Existing literature is not clear on how intentional self-regulation is developed and which specific positive assets buffer against substance use or violence.Conclusions: Our synthesis provides: an example of a rigorous systematic synthesis of theory literature innovatively applying methods of qualitative synthesis to theoretical literature; a clearer understanding of how PYD might reduce substance use and violence to inform future interventions and empirical evaluations. [ABSTRACT FROM AUTHOR]

When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the reviews of reviews (RoR) method in order to advance understanding of this important tool for policy makers. Drawing on our experiences, we present, where possible, potential solutions to these challenges to demonstrate that RoRs, despite their limitations, can be useful for mediating policy-relevant evidence at speed. [ABSTRACT FROM AUTHOR]

The prevalence of frailty was measured by the Survey of Health, Ageing, and Retirement in Europe Frailty Instrument (SHARE-FI) among older adults (N = 170) receiving occupational therapy services in a skilled nursing facility. Of these, 72.9% (n = 124) were frail upon evaluation. The results support occupational therapists' use of the SHARE-FI to distinguish frailty from other clinical conditions to provide effective services. [ABSTRACT FROM AUTHOR]

Displacement exerts an ongoing negative impact on people's mental health. The majority of displaced populations are hosted in the global south, yet there is a paucity of evidence synthesis on the implementation of mental health and psychosocial support (MHPSS) programmes in those contexts. We undertook a systematic review of factors influencing the delivery and receipt of MHPSS programmes for displaced populations in low- and middle-income countries to address this gap. A comprehensive search of 12 bibliographic databases, 25 websites and citation checking were undertaken. Studies published in English from 2013 onwards were included if they contained evidence on the perspectives of adults or children who had engaged in, or programmes providers involved in delivering, MHPSS programmes. Fifteen studies were critically appraised and synthesised. Studies considered programme safety as a proxy for acceptability. Other acceptability themes included stigma, culture and gender. Barriers to the accessibility of MHPSS programmes included language, lack of literacy of programme recipients and location of services. To enhance success, future delivery of MHPSS programmes should address gender and cultural norms to limit mental health stigma. Attention should also be given to designing flexible programmes that take into consideration location and language barriers to ensure they maximise accessibility., Competing Interests: The authors declare no competing interests exist., (© The Author(s) 2024.)

Humanitarian emergencies pose a significant global health challenge for children and young people's mental and psychological health. This systematic review investigates the effectiveness of mental health and psychosocial support (MHPSS) programmes delivered to children and young people affected by humanitarian emergencies in low- and middle-income countries (LMICs). Twelve electronic databases, key websites and citation checking were undertaken. Forty-three randomised controlled trials (RCTs) published in English between January 1980 and May 2023 were included in the review. Overall, the findings suggest that cognitive behavioural therapy may improve depression symptoms in children and young people affected by humanitarian emergencies. Narrative exposure therapy may reduce feelings of guilt. However, the impact of the other MHPSS modalities across outcomes is inconsistent. In some contexts, providing psychosocial programmes involving creative activities may increase the symptoms of depression in children and young people. These findings emphasise the need for the development of MHPSS programmes that can safely and effectively address the diverse needs of children and young people living in adversarial environments., Competing Interests: A.J. has a project funded by the National Institute for Health Research ARC North Thames. This report is independent research supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. A.J. has a studentship funded by the Economic Social research council via the London Interdisciplinary Social Science Doctoral Training Partnership. Grant award number: ES/P000703/1 – PR – 2,462,475., (© The Author(s) 2024.)

Background: Chronic peripheral joint pain due to osteoarthritis (OA) is extremely prevalent and a major cause of physical dysfunction and psychosocial distress. Exercise is recommended to reduce joint pain and improve physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) in this population is unknown., Objectives: To improve our understanding of the complex inter-relationship between pain, psychosocial effects, physical function and exercise., Search Methods: Review authors searched 23 clinical, public health, psychology and social care databases and 25 other relevant resources including trials registers up to March 2016. We checked reference lists of included studies for relevant studies. We contacted key experts about unpublished studies., Selection Criteria: To be included in the quantitative synthesis, studies had to be randomised controlled trials of land- or water-based exercise programmes compared with a control group consisting of no treatment or non-exercise intervention (such as medication, patient education) that measured either pain or function and at least one psychosocial outcome (self-efficacy, depression, anxiety, quality of life). Participants had to be aged 45 years or older, with a clinical diagnosis of OA (as defined by the study) or self-reported chronic hip or knee (or both) pain (defined as more than six months' duration).To be included in the qualitative synthesis, studies had to have reported people's opinions and experiences of exercise-based programmes (e.g. their views, understanding, experiences and beliefs about the utility of exercise in the management of chronic pain/OA)., Data Collection and Analysis: We used standard methodology recommended by Cochrane for the quantitative analysis. For the qualitative analysis, we extracted verbatim quotes from study participants and synthesised studies of patients' views using framework synthesis. We then conducted an integrative review, synthesising the quantitative and qualitative data together., Main Results: Twenty-one trials (2372 participants) met the inclusion criteria for quantitative synthesis. There were large variations in the exercise programme's content, mode of delivery, frequency and duration, participant's symptoms, duration of symptoms, outcomes measured, methodological quality and reporting. Comparator groups were varied and included normal care; education; and attention controls such as home visits, sham gel and wait list controls. Risk of bias was high in one and unclear risk in five studies regarding the randomisation process, high for 11 studies regarding allocation concealment, high for all 21 studies regarding blinding, and high for three studies and unclear for five studies regarding attrition. Studies did not provide information on adverse effects.There was moderate quality evidence that exercise reduced pain by an absolute percent reduction of 6% (95% confidence interval (CI) -9% to -4%, (9 studies, 1058 participants), equivalent to reducing (improving) pain by 1.25 points from 6.5 to 5.3 on a 0 to 20 scale and moderate quality evidence that exercise improved physical function by an absolute percent of 5.6% (95% CI -7.6% to 2.0%; standardised mean difference (SMD) -0.27, 95% CI -0.37 to -0.17, equivalent to reducing (improving) WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) function on a 0 to 100 scale from 49.9 to 44.3) (13 studies, 1599 participants)). Self-efficacy was increased by an absolute percent of 1.66% (95% CI 1.08% to 2.20%), although evidence was low quality (SMD 0.46, 95% CI 0.34 to 0.58, equivalent to improving the ExBeliefs score on a 17 to 85 scale from 64.3 to 65.4), with small benefits for depression from moderate quality evidence indicating an absolute percent reduction of 2.4% (95% CI -0.47% to 0.5%) (SMD -0.16, 95% CI -0.29 to -0.02, equivalent to improving depression measured using HADS (Hospital Anxiety and Depression Scale) on a 0 to 21 scale from 3.5 to 3.0) but no clinically or statistically significant effect on anxiety (SMD -0.11, 95% CI -0.26 to 0.05, 2% absolute improvement, 95% CI -5% to 1% equivalent to improving HADS anxiety on a 0 to 21 scale from 5.8 to 5.4; moderate quality evidence). Five studies measured the effect of exercise on health-related quality of life using the 36-item Short Form (SF-36) with statistically significant benefits for social function, increasing it by an absolute percent of 7.9% (95% CI 4.1% to 11.6%), equivalent to increasing SF-36 social function on a 0 to 100 scale from 73.6 to 81.5, although the evidence was low quality. Evidence was downgraded due to heterogeneity of measures, limitations with blinding and lack of detail regarding interventions. For 20/21 studies, there was a high risk of bias with blinding as participants self-reported and were not blinded to their participation in an exercise intervention.Twelve studies (with 6 to 29 participants) met inclusion criteria for qualitative synthesis. Their methodological rigour and quality was generally good. From the patients' perspectives, ways to improve the delivery of exercise interventions included: provide better information and advice about the safety and value of exercise; provide exercise tailored to individual's preferences, abilities and needs; challenge inappropriate health beliefs and provide better support.An integrative review, which compared the findings from quantitative trials with low risk of bias and the implications derived from the high-quality studies in the qualitative synthesis, confirmed the importance of these implications., Authors' Conclusions: Chronic hip and knee pain affects all domains of people's lives. People's beliefs about chronic pain shape their attitudes and behaviours about how to manage their pain. People are confused about the cause of their pain, and bewildered by its variability and randomness. Without adequate information and advice from healthcare professionals, people do not know what they should and should not do, and, as a consequence, avoid activity for fear of causing harm. Participation in exercise programmes may slightly improve physical function, depression and pain. It may slightly improve self-efficacy and social function, although there is probably little or no difference in anxiety. Providing reassurance and clear advice about the value of exercise in controlling symptoms, and opportunities to participate in exercise programmes that people regard as enjoyable and relevant, may encourage greater exercise participation, which brings a range of health benefits to a large population of people.