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Qualitative comparative analysis (QCA) is a hybrid method designed to bridge the gap between qualitative and quantitative research in a case-sensitive approach that considers each case holistically as a complex configuration of conditions and outcomes. QCA allows for multiple conjunctural causation, implying that it is often a combination of conditions that produces an outcome, that multiple pathways may lead to the same outcome, and that in different contexts, the same condition may have a different impact on the outcome. This approach to complexity allows QCA to provide a practical understanding for complex, real-world situations, and the context of implementing interventions. There are guides for conducting QCA in primary research and quantitative systematic reviews yet, to our knowledge, no guidance for conducting QCA in systematic mixed studies reviews (SMSRs). Thus, the specific objectives of this paper are to (1) describe a step-by-step approach for novice researchers for using QCA to integrate qualitative and quantitative evidence, including guidance on how to use software; (2) highlight specific challenges; (3) propose potential solutions from a worked example; and (4) provide recommendations for reporting. [ABSTRACT FROM AUTHOR]

Background: Almost two-thirds of the North American population have searched for health information on the web, and the majority report searching on behalf of someone else in their social circle, a phenomenon referred to as proxy seeking. Little is known about how proxy seekers use web-based health information and the outcomes they experience. Objective: The main aim of this study was to explore why proxy seekers used a parenting website on behalf of parents in their social circle and the outcomes they reported. Methods: A qualitative descriptive study was conducted in the context of a partnership with a web-based parenting resource to explore the contexts and motivations for proxy web-based health information seeking, use of information, and subsequent outcomes. A total of 14 participants who self-identified as family members, friends of parents of young children, or professionals who worked with young children were interviewed, and a thematic analysis was conducted. Results: The following 4 reasons for proxy seeking were uncovered: for reassurance, out of personal curiosity, as part of a professional role, or following an explicit request from the parents. Information was used to provide informational support for parents or material support for a child. Positive outcomes of using the information and some of the resulting interpersonal tensions were described. Conclusions: This study provides an in-depth look at proxy seeking behavior and outcomes among users of a web-based parenting resource. [ABSTRACT FROM AUTHOR]

Background: In primary care, patients increasingly face difficult decisions related to complex care needs (multimorbidity, polypharmacy, mental health issues, social vulnerability and structural barriers). There is a need for a pragmatic conceptual model to understand decisional needs among patients with complex care needs and outcomes related to decision. We aimed to identify types of decisional needs among patients with complex care needs, and decisionmaking configurations of conditions associated with decision outcomes. Methods: We conducted a systematic mixed studies review. Two specialized librarians searched five bibliographic databases (Medline, Embase, PsycINFO, CINAHL and SSCI). The search strategy was conducted from inception to December 2017. A team of twenty crowd-reviewers selected empirical studies on: (1) patients with complex care needs; (2) decisional needs; (3) primary care. Two reviewers appraised the quality of included studies using the Mixed Methods Appraisal Tool. We conducted a 2-phase case-based qualitative synthesis framed by the Ottawa Decision Support Framework and Gregor's explicative-predictive theory type. A decisional need case involved: (a) a decision (what), (b) concerning a patient with complex care needs with bio-psycho-social characteristics (who), (c) made independently or in partnership (how), (d) in a specific place and time (where/when), (e) with communication and coordination barriers or facilitators (why), and that (f) influenced actions taken, health or well-being, or decision quality (outcomes). Results: We included 47 studies. Data sufficiency qualitative criterion was reached. We identified 69 cases (2997 participants across 13 countries) grouped into five types of decisional needs: 'prioritization' (n = 26), 'use of services' (n = 22), 'prescription' (n = 12), 'behavior change' (n = 4) and 'institutionalization' (n = 5). Many decisions were made between clinical encounters in situations of social vulnerability. Patterns of conditions associated with decision outcomes revealed four decision-making configurations: 'well-managed' (n = 13), 'asymmetric encounters' (n = 21), 'self-management by default' (n = 8), and 'chaotic' (n = 27). Shared decision-making was associated with positive outcomes. Negative outcomes were associated with independent decision-making. Conclusion: Our results could extend decision-making models in primary care settings and inform subsequent usercentered design of decision support tools for heterogenous patients with complex care needs. [ABSTRACT FROM AUTHOR]

Mixed methods (MM) involve combining qualitative (QUAL) and quantitative (QUAN) methods in program evaluation, primary research, and literature reviews. MM are being increasingly used in health and social sciences (in multiple fields and in an inter-field manner). Over the years, several strategies to integrate QUAL and QUAN phases, results, and data have been proposed. For MM teachers, one of the challenges is to explain specific MM strategies and their combinations, find current illustrative examples for trainees, and identify emerging innovative MM strategies. Our project is aimed at identifying and measuring the importance of facilitators and barriers associated with the implementation of an innovative cross-disciplinary monitoring of the research literature: the Collaborative eBibliography on Mixed Methods (CeBoMM). Results will facilitate CeBoMM implementation, and can contribute to MM teaching and learning, thereby, helping MM teachers and their trainees worldwide. Ultimately, CeBoMM can be adapted to be used by teachers in other academic areas and those interested in collaborative information monitoring. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which discusses topics within the issue including collective intelligence to monitor and filter research publications, called eSRAP; evaluating online health information sources; and development and sustainability of online academic reference books.

Context: Almost all parents search web-based information for their children. This study focuses on parents with low socioeconomic status (SES), a correlate of health literacy (determinants of child education/health); specifically, their experience of seeking information on the Naître et Grandir (N&G) website (trustworthy information on child development, education and health in clear language). Objectives: To measure the influence of a health literacy intervention on (a) the frequency of the utilization of a questionnaire to understand the perceived outcomes of N&G information, and (b) parents' expected benefits of this information. Study design and Analysis: A 4-year prospective time series. Statistical analyses were descriptive and inferential. Setting: For each N&G webpage, parents are invited to complete a questionnaire (Information Assessment Method, IAM) to report their intention to use and expected benefits of the webpage information. Population studied: Quebec parents of 0-8-year-old children who completed at least one IAM questionnaire. Intervention: An improved version of the IAM, the IAM+ was developed with low SES parents and implemented in January 2019. Main outcome measures: IAM data were collected in the pre-intervention (2017-2018) and the postintervention (2019-2020) periods. Results: Participants completed 10,362 IAM questionnaires. The proportion of responses and reported benefits from low SES participants increased post-intervention. Low SES participants and particularly low SES fathers expected greater benefits from the accessed web information compared to other participants and mothers. Conclusions: Results suggest (a) family physicians recommend trustworthy easy-to-read information resources to all patients when needed, including patients with a low literacy level; (b) web content that incorporates international health literacy standards is associated with greater expected benefits among low SES parents; (c) increasing father awareness and father-inclusive content can lead to greater expected benefits; and (d) the IAM questionnaire that is accessible on all devices, including smartphones, can help low SES parents provide feedback to web editors regarding the outcomes of their content. [ABSTRACT FROM AUTHOR]

The Internet has become the first source of consumer health information. Most theoretical and empirical studies are centered on information needs and seeking, rather than on information outcomes. This review's purpose is to explore and explain health outcomes of Online Consumer Health Information (OCHI) in primary care. A participatory systematic mixed studies review with a framework synthesis was undertaken. Starting from an initial conceptual framework, our specific objectives were to (a) identify types of OCHI outcomes in primary care, (b) identify factors associated with these outcomes, and (c) integrate these factors and outcomes into a comprehensive revised framework combining an information theory and a psychosocial theory of behavior. The results of 65 included studies were synthesized using a qualitative thematic data analysis. The themes derived from the literature underwent a harmonization process that produced a comprehensive typology of OCHI outcomes. The revised conceptual framework specifies four individual and one organizational level of OCHI outcomes, while including factors such as consumers' information needs and four interdependent contextual factors. It contributes to theoretical knowledge about OCHI health outcomes, and informs future research, information assessment methods, and tools to help consumers find and use health information. [ABSTRACT FROM AUTHOR]

Online consumer health information (OCHI) is being used at an unprecedented rate, and this trend is expected to continue. Most people have used OCHI, and many may have seen the outcomes of this use (either positive or negative or both). Education and income, as indicators of socioeconomic status, are important contextual factors influencing OCHI outcomes. Much of the literature states that individuals with higher income and education are more likely to access OCHI and with this, experience better health outcomes. On the other hand, our research shows that when OCHI websites offer high-quality information that is accessible to those with low literacy levels, individuals with low socioeconomic status report as many benefits as those with higher income and education. In this commentary, we will describe the context of our research and present our findings. This work is relevant to information professionals (librarians) working with health professionals and the public, those teaching information literacy and health literacy, as well as researchers interested in information literacy and information use. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various topics within the issue including Evidence Based Medicine (EBM), role of health science librarians in EBM, and ways to improve of teaching, learning, and professional practices.

A mixed studies review (MSR) is a type of literature review that includes qualitative, quantitative, and mixed methods studies. This form of literature review is popular since it can provide a rich understanding of complex health interventions and programs. However, conducting a MSR can be challenging since it combines several study designs. A wiki toolkit was developed to provide MSR-specific guidance and suggest tips and tools for planning, conducting and reporting MSR. The toolkit is structured according to eight stages for conducting a systematic review: (1) formulate a review question, (2) define eligibility criteria, (3) select sources of information, (4) identify potentially relevant studies, (5) select relevant studies, (6) appraise the quality of studies, (7) extract data, and (8) synthesize included studies. The toolkit includes examples, tips for searching studies with diverse designs, existing tools for searching, selecting and appraising, synthesis designs, and a template for proposals and reports. This toolkit is presented as a wiki, which allows users to collaboratively modify the content and provides continuous updates on the science of MSR. It is hoped that this wiki toolkit will be useful to all users and contribute to creating a network of people interested in MSR. [ABSTRACT FROM AUTHOR]

Literature reviews, and more particularly systematic reviews, are increasingly being produced and published. The past 40 years have been marked by considerable development of methodologies and methods in literature reviews. This paper aims to provide a brief historical overview of systematic reviews which will help to have a better understanding of what, why, when, and how they were developed. The paper is structured in three parts. The first part will provide a definition of systematic reviews and their main characteristics. The second part will present three main periods of the evolution of systematic reviews: foundation period (1970–1989), institutionalization period (1990–2000), and diversification period (2001–). These periods can be distinguished by the users of scientific evidence, the methodological influence, and the technological development. The last part will summarize the main elements in the history of the systematic reviews and present some direction for future research. [ABSTRACT FROM AUTHOR]

Background: In health, organizational participatory research (OPR) refers to health organization members participating in research decisions, with university researchers, throughout a study. This non-academic partner contribution to the research may take the form of consultation or co-construction. A drawback of OPR is that it requires more time from all those involved, compared to non-participatory research approaches; thus, understanding the added value of OPR, if any, is important. Thus, we sought to assess whether the OPR approach leads to benefits beyond what could be achieved through traditional research.Methods: We identified, selected, and appraised OPR health literature, and at each stage, two team members independently reviewed and coded the literature. We used quantitative content analysis to transform textual data into reliable numerical codes and conducted a logistic regression to test the hypothesis that a co-construction type OPR study yields extra benefits with a greater likelihood than consultation-type OPR studies.Results: From 8873 abstracts and 992 full text papers, we distilled a sample of 107 OPR studies. We found no difference between the type of organization members' participation and the likelihood of exhibiting an extra benefit. However, the likelihood of an OPR study exhibiting at least one extra benefit is quadrupled when the impetus for the study comes from the organization, rather than the university researcher(s), or the organization and the university researcher(s) together (OR = 4.11, CI = 1.12-14.01). We also defined five types of extra benefits.Conclusions: This review describes the types of extra benefits OPR can yield and suggests these benefits may occur if the organization initiates the OPR. Further, this review exposes a need for OPR authors to more clearly describe the type of non-academic partner participation in key research decisions throughout the study. Detailed descriptions will benefit others conducting OPR and allow for a re-examination of the relationship between participation and extra benefits in future reviews. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews of qualitative and quantitative evidence can provide a rich understanding of complex phenomena. This type of review is increasingly popular, has been used to provide a landscape of existing knowledge, and addresses the types of questions not usually covered in reviews relying solely on either quantitative or qualitative evidence. Although several typologies of synthesis designs have been developed, none have been tested on a large sample of reviews. The aim of this review of reviews was to identify and develop a typology of synthesis designs and methods that have been used and to propose strategies for synthesizing qualitative and quantitative evidence. Methods: A review of systematic reviews combining qualitative and quantitative evidence was performed. Six databases were searched from inception to December 2014. Reviews were included if they were systematic reviews combining qualitative and quantitative evidence. The included reviews were analyzed according to three concepts of synthesis processes: (a) synthesis methods, (b) sequence of data synthesis, and (c) integration of data and synthesis results. Results: A total of 459 reviews were included. The analysis of this literature highlighted a lack of transparency in reporting how evidence was synthesized and a lack of consistency in the terminology used. Two main types of synthesis designs were identified: convergent and sequential synthesis designs. Within the convergent synthesis design, three subtypes were found: (a) data-based convergent synthesis design, where qualitative and quantitative evidence is analyzed together using the same synthesis method, (b) results-based convergent synthesis design, where qualitative and quantitative evidence is analyzed separately using different synthesis methods and results of both syntheses are integrated during a final synthesis, and (c) parallel-results convergent synthesis design consisting of independent syntheses of qualitative and quantitative evidence and an interpretation of the results in the discussion. Conclusions: Performing systematic reviews of qualitative and quantitative evidence is challenging because of the multiple synthesis options. The findings provide guidance on how to combine qualitative and quantitative evidence. Also, recommendations are made to improve the conducting and reporting of this type of review. [ABSTRACT FROM AUTHOR]

Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations. Scoping review followed an iterative process. Eligibility criteria: organizational interventions in Organisation for Economic Cooperation and Development (OECD) countries; aiming to improve access to primary care for vulnerable populations; all study designs; published from 2000 in English or French; reporting at least one outcome (avoidable hospitalization, emergency department admission, or unmet health care needs). Sources: Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. Study selection: One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes of access to primary care), and (ii) the classification of interventions of the Cochrane Effective Practice and Organization of Care. Using pattern analysis, interventions were mapped in accordance with the presence/absence of 'dimension-outcome' patterns. Out of 8,694 records (title/abstract), 39 studies with varying designs were included. The analysis revealed the following pattern. Results of 10 studies on interventions classified as 'Formal integration of services' suggested that these interventions were associated with three dimensions of access (approachability, availability and affordability) and reduction of hospitalizations (four/four studies), emergency department admissions (six/six studies), and unmet healthcare needs (five/six studies). These 10 studies included seven non-randomized studies, one randomized controlled trial, one quantitative descriptive study, and one mixed methods study. Our results suggest the limited breadth of research in this area, and that it will be feasible to conduct a full systematic review of studies on the effectiveness of the formal integration of services to improve access to primary care services for vulnerable populations. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including health information services, health literacy, and online information services.

Objective: Mixed studies reviews include empirical studies with diverse designs. Given that identifying relevant studies for such reviews is time consuming, a mixed filter was developed. Methods: The filter was used for six journals from three disciplines. For each journal, database records were coded "empirical" (relevant) when they mentioned a research question or objective, data collection, analysis, and results. We measured precision (proportion of retrieved documents being relevant), sensitivity (proportion of relevant documents retrieved), and specificity (proportion of nonrelevant documents not retrieved). Results: Records were coded with and without the filter, and descriptive statistics were performed, suggesting the mixed filter has high sensitivity. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarettes (e-cigarettes) have been steadily increasing in popularity since their introduction to US markets in 2007. Debates surrounding the proper regulatory mechanisms needed to mitigate potential harms associated with their use have focused on youth access, their potential for nicotine addiction, and the renormalization of a smoking culture. The objective of this study was to describe the enacted and planned regulations addressing this novel public health concern in the US. Methods: We searched LexisNexis Academic under Federal Regulations and Registers, as well as State Administrative Codes and Registers. This same database was also used to find information about planned regulations in secondary sources. The search was restricted to US documents produced between January 1st, 2004, and July 14th, 2014. Results: We found two planned regulations at the federal level, and 74 enacted and planned regulations in 44 states. We identified six state-based regulation types, including i) access, ii) usage, iii) marketing and advertisement, iv) packaging, v) taxation, and vi) licensure. These were further classified into 10 restriction subtypes: sales, sale to minors, use in indoor public places, use in limited venues, use by minors, licensure, marketing and advertising, packaging, and taxation. Most enacted restrictions aimed primarily to limit youth access, while few regulations enforced comprehensive restrictions on product use and availability. Conclusions: Current regulations targeting e-cigarettes in the US are varied in nature and scope. There is greater consensus surrounding youth protection (access by minors and/or use by minors, and/or use in limited venues), with little consensus on multi-level regulations, including comprehensive use bans in public spaces. [ABSTRACT FROM AUTHOR]

Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on our application experience, organized in seven areas. These are the following: (1) the challenge of identifying middle range theory; (2) addressing heterogeneity and lack of conceptual clarity; (3) the challenge of appraising the quality of complex evidence; (4) the relevance of capturing unintended outcomes; (5) understanding the process of context, mechanism, and outcome (CMO) configuring; (6) incorporating middle-range theory in the CMO configuration process; and (7) using middle range theory to advance the conceptualization of outcomes - both visible and seemingly 'hidden'. One conclusion from our experience is that the degree of heterogeneity of the evidence base will determine whether theory can drive the development of review protocols from the outset, or will follow only after an intense period of data immersion. We hope that presenting a critical reflection on customizing realist review will convey how the methodology can be tailored to the often complex and idiosyncratic features of health research, leading to innovative evidence syntheses. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article provides an overview of mixed methods research and mixed studies reviews. These two approaches are used to combine the strengths of quantitative and qualitative methods and to compensate for their respective limitations. This article is structured in three main parts. First, the epistemological background for mixed methods will be presented. Afterward, we present the main types of mixed methods research designs and techniques as well as guidance for planning, conducting, and appraising mixed methods research. In the last part, we describe the main types of mixed studies reviews and provide a tool kit and examples. Future research needs to offer guidance for assessing mixed methods research and reporting mixed studies reviews, among other challenges. [ABSTRACT FROM AUTHOR]

This article provides an overview of mixed methods research and mixed studies reviews. These two approaches are used to combine the strengths of quantitative and qualitative methods and to compensate for their respective limitations. This article is structured in three main parts. First, the epistemological background for mixed methods will be presented. Afterward, we present the main types of mixed methods research designs and techniques as well as guidance for planning, conducting, and appraising mixed methods research. In the last part, we describe the main types of mixed studies reviews and provide a tool kit and examples. Future research needs to offer guidance for assessing mixed methods research and reporting mixed studies reviews, among other challenges. [ABSTRACT FROM AUTHOR]

PURPOSE We wanted to describe family physicians' use of information from an electronic knowledge resource for answering clinical questions, and their perception of subsequent patient health outcomes; and to estimate the number needed to benefit from information (NNBI), defined as the number of patients for whom clinical information was retrieved for 1 to benefit. METHODS We undertook a mixed methods research study, combining quantitative longitudinal and qualitative research studies. Participants were 41 family physicians from primary care clinics across Canada. Physicians were given access to 1 electronic knowledge resource on handheld computer in 2008-2009. For the outcome assessment, participants rated their searches using a validated method. Rated searches were examined during interviews guided by log reports that included ratings. Cases were defined as clearly described searches where clinical information was used for a specific patient. For each case, interviewees described information-related patient health outcomes. For the mixed methods data analysis, quantitative and qualitative data were merged into clinical vignettes (each vignette describing a case). We then estimated the NNBI. RESULTS In 715 of 1,193 searches for information conducted during an average of 86 days, the search objective was directly linked to a patient. Of those searches, 188 were considered to be cases. In 53 cases, participants associated the use of information with at least 1 patient health benefit. This finding suggested an NNBI of 14 (715/53). CONCLUSION The NNBI may be used in further experimental research to compare electronic knowledge resources. A low NNBI can encourage clinicians to search for information more frequently. If all searches had benefits, the NNBI would be 1. In addition to patient benefits, learning and knowledge reinforcement outcomes are frequently reported. [ABSTRACT FROM AUTHOR]

Primary health care practitioners routinely search for information within electronic knowledge resources. We proposed four levels of outcomes of information-seeking: situational relevance, cognitive impact, information use, and patient health outcomes. Our objective was to produce clinical vignettes for describing and testing these levels. We conducted a mixed methods study combining a quantitative longitudinal study and a qualitative multiple case study. Participants were 10 nurses, 10 medical residents, and 10 pharmacists. They had access to an online resource, and did 793 searches for treatment recommendations. Using the Information Assessment Method ( IAM), participants rated their searches for each of the four levels. Rated searches were examined in interviews guided by log reports and a think-aloud protocol. Cases were defined as clearly described searches where clinical information was used for a specific patient. For each case, interviewees described the four levels of outcomes. Quantitative and qualitative data were merged into clinical vignettes. We produced 130 clinical vignettes. Specifically, 46 vignettes (35.4%) corresponded to clinical situations where information use was associated with one or more than one type of positive patient health outcome: increased patient knowledge ( n = 28), avoidance of unnecessary or inappropriate intervention ( n = 25), prevention of disease or health deterioration ( n = 9), health improvement ( n = 6), and increased patient satisfaction ( n = 3). Results suggested information use was associated with perceived benefits for patients. This may encourage clinicians to search for information more often when they feel the need. Results supported the four proposed levels of outcomes, which can be transferable to other information-seeking contexts. [ABSTRACT FROM AUTHOR]

Introduction: Systematic literature reviews provide best evidence, but are underused by clinicians. Thus, integrating Cochrane reviews into continuing medical education (CME) is challenging. We designed a pilot CME program where summaries of Cochrane reviews (Courriels Cochrane) were disseminated by e-mail. Program participants automatically received CME credit for each Courriel Cochrane they rated. The feasibility of this program is reported (delivery, participation, and participant evaluation). Method: We recruited French-speaking physicians through the Canadian Medical Association. Program delivery and participation were documented. Participants rated the informational value of Courriels Cochrane using the Information Assessment Method (IAM), which documented their reflective learning (relevance, cognitive impact, use for a patient, expected health benefits). IAM responses were aggregated and analyzed. Results: The program was delivered as planned. Thirty Courriels Cochrane were delivered to 985 physicians, and 127 (12.9%) completed at least one IAM questionnaire. Out of 1109 Courriels Cochrane ratings, 973 (87.7%) conta-ined 1 or more types of positive cognitive impact, while 835 (75.3%) were clinically relevant. Participants reported the use of information for a patient and expected health benefits in 595 (53.7%) and 569 (51.3%) ratings, respectively. Discussion: Program delivery required partnering with 5 organizations. Participants valued Courriels Cochrane. IAM ratings documented their reflective learning. The aggregation of IAM ratings documented 3 levels of CME outcomes: participation, learning, and performance. This evaluation study demonstrates the feasibility of the Courriels Cochrane as an approach to further disseminate Cochrane systematic literature reviews to clinicians and document self-reported knowledge translation associated with Cochrane reviews. [ABSTRACT FROM AUTHOR]

Abstract: Background: Systematic literature reviews identify, select, appraise, and synthesize relevant literature on a particular topic. Typically, these reviews examine primary studies based on similar methods, e.g., experimental trials. In contrast, interest in a new form of review, known as mixed studies review (MSR), which includes qualitative, quantitative, and mixed methods studies, is growing. In MSRs, reviewers appraise studies that use different methods allowing them to obtain in-depth answers to complex research questions. However, appraising the quality of studies with different methods remains challenging. To facilitate systematic MSRs, a pilot Mixed Methods Appraisal Tool (MMAT) has been developed at McGill University (a checklist and a tutorial), which can be used to concurrently appraise the methodological quality of qualitative, quantitative, and mixed methods studies. Objectives: The purpose of the present study is to test the reliability and efficiency of a pilot version of the MMAT. Methods: The Center for Participatory Research at McGill conducted a systematic MSR on the benefits of Participatory Research (PR). Thirty-two PR evaluation studies were appraised by two independent reviewers using the pilot MMAT. Among these, 11 (34%) involved nurses as researchers or research partners. Appraisal time was measured to assess efficiency. Inter-rater reliability was assessed by calculating a kappa statistic based on dichotomized responses for each criterion. An appraisal score was determined for each study, which allowed the calculation of an overall intra-class correlation. Results: On average, it took 14min to appraise a study (excluding the initial reading of articles). Agreement between reviewers was moderate to perfect with regards to MMAT criteria, and substantial with respect to the overall quality score of appraised studies. Conclusion: The MMAT is unique, thus the reliability of the pilot MMAT is promising, and encourages further development. [Copyright &y& Elsevier]

Inspired by the acquisition-cognition-application model (T. Saracevic & K.B. Kantor, ), we developed a tool called the Information Assessment Method to more clearly understand how physicians use clinical information. In primary healthcare, we conducted a naturalistic and longitudinal study of searches for clinical information. Forty-one family physicians received a handheld computer with the Information Assessment Method linked to one commercial electronic knowledge resource. Over an average of 320 days, 83% of 2,131 searches for clinical information were rated using the Information Assessment Method. Searches to address a clinical question, as well as the retrieval of relevant clinical information, were positively associated with the use of that information for a specific patient. Searches done out of curiosity were negatively associated with the use of clinical information. We found significant associations between specific types of cognitive impact and information use for a specific patient. For example, when the physician reported 'My practice was changed and improved' as a result of this clinical information, the odds that information was used for a specific patient increased threefold. Our findings provide empirical data to support the applicability of the acquisition-cognition-application model, as operationalized through the Information Assessment Method, in primary healthcare. Capturing the use of research-based information in medicine opens the door to further study of the relationships between clinical information and health outcomes. [ABSTRACT FROM AUTHOR]

Background: Participatory Research (PR) entails the co-governance of research by academic researchers and end-users. End-users are those who are affected by issues under study (e.g., community groups or populations affected by illness), or those positioned to act on the knowledge generated by research (e.g., clinicians, community leaders, health managers, patients, and policy makers). Systematic reviews assessing the generalizable benefits of PR must address: the diversity of research topics, methods, and intervention designs that involve a PR approach; varying degrees of end-user involvement in research co-governance, both within and between projects; and the complexity of outcomes arising from long-term partnerships. Methods: We addressed the above mentioned challenges by adapting realist review methodology to PR assessment, specifically by developing inductively-driven identification, selection, appraisal, and synthesis procedures. This approach allowed us to address the non-uniformity and complexity of the PR literature. Each stage of the review involved two independent reviewers and followed a reproducible, systematic coding and retention procedure. Retained studies were completed participatory health interventions, demonstrated high levels of participation by non-academic stakeholders (i.e., excluding studies in which end-users were not involved in co-governing throughout the stages of research) and contained detailed descriptions of the participatory process and context. Retained sets are being mapped and analyzed using realist review methods. Results: The librarian-guided search string yielded 7,167 citations. A total of 594 citations were retained after the identification process. Eighty-three papers remained after selection. Principle Investigators (PIs) were contacted to solicit all companion papers. Twenty-three sets of papers (23 PR studies), comprising 276 publications, passed appraisal and are being synthesized using realist review methods. Discussion: The systematic and stage-based procedure addressed challenges to PR assessment and generated our robust understanding of complex and heterogeneous PR practices. To date, realist reviews have focussed on evaluations of relatively uniform interventions. In contrast our PR search yielded a wide diversity of partnerships and research topics. We therefore developed tools to achieve conceptual clarity on the PR field, as a beneficial precursor to our theoretically-driven synthesis using realist methods. Findings from the ongoing review will be provided in forthcoming publications. [ABSTRACT FROM AUTHOR]

Methods to systematically assess electronic knowledge resources by health professionals may enhance evaluation of these resources, knowledge exchange between information users and providers, and continuing professional development. We developed the Information Assessment Method (IAM) to document health professional perspectives on the relevance, cognitive impact, potential use and expected health outcomes of information delivered by (push) or retrieved from (pull) electronic knowledge resources. However, little is known about push communication in health sciences, and what we propose to call clinical emailing channels (CECs). CECs can be understood as a communication infrastructure that channels clinically relevant research knowledge, email alerts, from information providers to the inboxes of individual practitioners. In two companion papers, our objectives are to (part 1) explore CEC evaluation in routine practice, and (part 2) examine the content validity of the cognitive component of IAM. The present paper (part 1) critically reviews the literature in health sciences and four disciplines: communication, information studies, education and knowledge translation. Our review addresses the following questions. What are CECs? How are they assessed? The review contributes to better define CECs, and proposes a 'push-pull-acquisition-cognition-application' evaluation framework, which is operationalized by IAM. Compared with existing evaluation tools, our review suggests IAM is comprehensive, generic and systematic. [ABSTRACT FROM AUTHOR]

Introduction: The importance of reflective practice is recognized by the adoption of a reflective learning model in continuing medical education (CME), but little is known about how to evaluate reflective learning in CME. Reflective learning seldom is defined in terms of specific cognitive processes or observable performances. Competency-based evaluation rarely is used for evaluating CME effects. To bridge this gap, reflective learning was defined operationally in a reflective learning framework (RLF). The operationalization supports observations, documentation, and evaluation of reflective learning performances in CME, and in clinical practice. In this study, the RLF was refined and validated as physician performance was evaluated in a CME e-learning activity. Methods: Qualitative multiple-case study wherein 473 practicing family physicians commented on research-based synopses after reading and rating them as an on-line CME learning activity. These comments formed 2029 cases from which cognitive tasks were extracted as defined by the RLF with the use of a thematic analysis. Frequencies of cognitive tasks were compared in a cross-case analysis. Results: Four RLF cognitive processes and 12 tasks were supported. Reflective learning was defined as 4 interrelated cognitive processes: Interpretation, Validation, Generalization, and Change, which were specified by 3 observable cognitive tasks, respectively. These 12 tasks and related characteristics were described in an RLF codebook for future use. Discussion: Reflective learning performances of family physicians were evaluated. The RLF and its codebook can be used for integrating reflective learning into CME curricula and for developing competency-based assessment. Future research on potential uses of the RLF should involve participation of CME stakeholders. [ABSTRACT FROM AUTHOR]

Background In a prospective study to explore connections between clinical information delivery and information retrieval, 41 Canadian family physicians searched an electronic knowledge resource (EKR) as needed for practice. Research software, called the Information Assessment Method (IAM), prompted family physicians to report on the situational relevance, perceived cognitive impact and application of their retrieved information hits. Both the IAM and the EKR needed periodic updating to properly address our research questions. Objective To determine the frequency of software updating when manual or semi-automatic approaches are used by family physicians. Methods Each family physician received a handheld computer (PDA) that ran the Windows Mobile 6 operating system. For technical reasons, both the IAM and the EKR were accessed offline on PDA. To update the EKR and the IAM, family physicians were asked to synchronise their PDA to their PC. Updating the IAM was a manual process, whereas updating the EKR was semi-automatic. Results We found: (1) about 25% of family physicians never or rarely updated PDA software on their own, (2) a large number of software updates were never installed and (3) the semi-automatic method was associated with a small increase in the proportion of installed software updates (58.9% versus 48.6% for the manual method). Conclusions When a wireless internet connection is not used to update PDA software, sociotechnical issues complicate mobile data collection and data transfer. [ABSTRACT FROM AUTHOR]

Abstract: A new form of literature review has emerged, Mixed Studies Review (MSR). These reviews include qualitative, quantitative and mixed methods studies. In the present paper, we examine MSRs in health sciences, and provide guidance on processes that should be included and reported. However, there are no valid and usable criteria for concomitantly appraising the methodological quality of the qualitative, quantitative and mixed methods studies. Objective: To propose criteria for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies or study components. Design: A three-step critical review was conducted. Data sources: 2322 references were identified in MEDLINE, and their titles and abstracts were screened; 149 potentially relevant references were selected and the full-text papers were examined; 59 MSRs were retained and scrutinized using a deductive–inductive qualitative thematic data analysis. This revealed three types of MSR: convenience, reproducible, and systematic. Review methods: Guided by a proposal, we conducted a qualitative thematic data analysis of the quality appraisal procedures used in the 17 systematic MSRs (SMSRs). Results: Of 17 SMSRs, 12 showed clear quality appraisal procedures with explicit criteria but no SMSR used valid checklists to concomitantly appraise qualitative, quantitative and mixed methods studies. In two SMSRs, criteria were developed following a specific procedure. Checklists usually contained more criteria than needed. In four SMSRs, a reliability assessment was described or mentioned. While criteria for quality appraisal were usually based on descriptors that require specific methodological expertise (e.g., appropriateness), no SMSR described the fit between reviewers’ expertise and appraised studies. Quality appraisal usually resulted in studies being ranked by methodological quality. Conclusion: A scoring system is proposed for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies for SMSRs. This scoring system may also be used to appraise the methodological quality of qualitative, quantitative and mixed methods components of mixed methods research. [Copyright &y& Elsevier]

Background: The rationale for conducting mixed-method studies is usually based on the desire to combine the complementary strengths of qualitative and quantitative research. Typically, the former provides in-depth descriptions offering strong internal validity while the latter provides strong external validity. The exclusive use of quantitative methods in mental health research presents certain limitations which lie in the subjective nature of mental health problems and related behaviors, and the fact that these are mediated by cultural context. Aims and methods: This paper illustrates, along with the Pathway and Barriers to Mental Health project, the usefulness of using a mixed-method design to study mental health problems and related behaviors in a culturally diverse community. Results: The results show how the various quantitative and qualitative stages of the project were implemented in a Sequential Transformative Design that allows for a better identification and understanding of community mental health problems. This type of mixed design contributed to the development and evaluation of a regional cultural consultation service in mental health. Conclusion: A mixed-methods approach does not simply make positivist science stronger; rather, it contributes to do better research and tailored intervention. [ABSTRACT FROM AUTHOR]

Background Information retrieval in primary care is becoming more difficult as the volume of medical information held in electronic databases expands. The lexical structure of this information might permit automatic indexing and improved retrieval. Objective To determine the possibility of identifying the key elements of clinical studies, namely Patient-Population-Problem, Exposure-Intervention, Comparison, Outcome, Duration and Results (PECODR), from abstracts of medical journals. Methods We used a convenience sample of 20 synopses from the journal Evidence-Based Medicine (EBM) and their matching original journal article abstracts obtained from PubMed. Three independent primary care professionals identified PECODR-related extracts of text. Rules were developed to define each PECODR element and the selection process of characters, words, phrases and sentences. From the extracts of text related to PECODR elements, potential lexical patterns that might help identify those elements were proposed and assessed using NVivo software. Results A total of 835 PECODR-related text extracts containing 41 263 individual text characters were identified from 20 EBM journal synopses. There were 759 extracts in the corresponding PubMed abstracts containing 31 947 characters. PECODR elements were found in nearly all abstracts and synopses with the exception of duration. There was agreement on 86.6%of the extracts from the 20 EBM synopses and 85.0% on the corresponding PubMed abstracts. After consensus this rose to 98.4% and 96.9% respectively. We found potential text patterns in the Comparison, Outcome and Results elements of both EBM synopses and PubMed abstracts. Some phrases and words are used frequently and are specific for these elements in both synopses and abstracts. [ABSTRACT FROM AUTHOR]

Rationale and aim Clinical Information-Retrieval Technology (CIRT) is increasingly used, for example in accessing drug databases. However, no comprehensive framework exists to understand why health professionals search for information using CIRT. The present article aims to propose such organizational framework. Background Our literature review suggests six reasons, of which three refer to cognitive objectives (C1, C2, C3) and three to organizational objectives (O1, O2, O3): (C1) to answer-solve-support a clinical question-problem-decision; (C2) to fulfil an educational-research objective; (C3) to search in general or for curiosity; (O1) to share information with patients; (O2) to exchange information with other health professionals; (O3) to plan-manage-monitor tasks with other health professionals. Methods The case study examined the use and impact of the InfoRetriever software on handheld computers in a Canadian family practice centre. Using the Critical Incident Technique, six family doctors were interviewed on specific events. A thematic analysis assigned extracts of interviews to reasons for use. Findings and conclusion Findings illustrate the six reasons, and suggest a seventh reason that refers to a cognitive objective, namely (C4) to overcome the limits of health professional memory. These seven reasons are interpreted according to the literature on information science and organization studies, which suggest ordering reasons at three levels of stimulation of learning and knowledge: none (objective not achieved), moderate (cognitive objective achieved), and high (organizational objective achieved). This paves the way toward a new evaluation of relevance of CIRT in everyday practice (judgement based on professionals’ objective achievement) using an organizational model of information-retrieving processes. [ABSTRACT FROM AUTHOR]

Rationale and objective Evidence-based sources of information do not integrate self-assessment tools to assess the impact of a users’ search for clinical information. We present a method to evaluate evidence-based sources of information, by systematically assessing the impact of searches for clinical information in everyday practice. Methods We integrated an information management tool ( InfoRetriever 2003) with an educational intervention in a cohort of 26 family medicine residents. An electronic impact assessment scale was used by these doctors to report the perceived impact of each item of information (each hit) retrieved on hand-held computer. We compared the types of impact associated with hits in two distinct categories: clinical decision support systems (CDSS) vs. clinical information-retrieval technology (CIRT). Information hits in CDSS were defined as any hit in the following InfoRetriever databases: Clinical Prediction Rules, History and Physical Exam diagnostic calculator and Diagnostic Test calculator. CIRT information hits were defined as any hit in: Abstracts of Cochrane Reviews, InfoPOEMs, evidence-based practice guideline summaries and the Griffith's 5 Minute Clinical Consult . Results The impact assessment questionnaire was linked to 5160 information hits. 4946 impact assessment questionnaires were answered (95.9%), and 2495 contained reports of impact (48.4%). Reports of positive impact on doctors were most frequently in the areas of learning and practice improvement. In comparison to CDSS, CIRT hits were more frequently associated with learning and recall. CDSS hits were more frequently associated with reports of practice improvement. Conclusions Our new method permits systematic and comparative assessment of impact associated with distinct categories of information. [ABSTRACT FROM AUTHOR]

Summary: Purpose:: This paper appraises empirical studies examining the impact of clinical information-retrieval technology on physicians and medical students. Methods:: The world literature was reviewed up to February 2004. Two reviewers independently identified studies by scrutinising 3368 and 3249 references from bibliographic databases. Additional studies were retrieved by hand searches, and by searching ISI Web of Science for citations of articles. Six hundred and five paper-based articles were assessed for relevance. Of those, 40 (6.6%) were independently appraised by two reviewers for relevance and methodological quality. These articles were quantitative, qualitative or of mixed methods, and 26 (4.3%) were retained for further analysis. For each retained article, two teams used content analysis to review extracted textual material (quantitative results and qualitative findings). Results:: Observational studies suggest that nearly one-third of searches using information-retrieval technology may have a positive impact on physicians. Two experimental and three laboratory studies do not reach consensus in support of a greater impact of this technology compared with other sources of information, notably printed educational material. Clinical information-retrieval technology may affect physicians, and further research is needed to examine its impact in everyday practice. [Copyright &y& Elsevier]

Disseminating health and medical information on the Internet can improve knowledge transfer from health professionals to the population, and help individuals to maintain and improve their health. There are currently several medical information websites that directly target the general population with the aim of providing information about health problems, self-care and prevention. However, this new technology also hides several shortcomings, such as: (i) uneven quality of medical information available on the Internet: (ii) difficulties in finding, understanding and using this information; (iii) lack of access for the unconnected population; and (iv) the potential for harm and risks of overconsumption. To be able to overcome these dangers, it is important that public health practitioners and health professionals be involved in the design, dissemination and evaluation of Web-based health and medical information. [ABSTRACT FROM AUTHOR]

The article discusses the use of continuing medical education (CME) module in searching for clinical information in their electronic medical record (EMR) and evidence-based medicine (EBM). It mentions that the U.S. organizations offering CME programs encourage physicians to retrieve clinical information that helps in decision-making. It states that research in EBM is encouraged by incorporating CME module in EMR.

Researchers examining the influence of the built environment on health are increasingly using mixed methods approaches. The use of more than one type of methodology to address a single research question is compelling in this field because researchers investigating the impact of the built environment on health have been faced with proposing solutions to a complex societal problem involving interacting systems and social uncertainties. Mixed methods studies can help researchers to gain a better understanding of the relationships that exist between humans and their environment by drawing on qualitative and quantitative methods. Mixed methods studies could also be instrumental for providing effective policy solutions. This is because they allow researchers to identify built environment determinants of health in a population of interest and to understand the social and cultural factors that might influence the uptake of an intervention by this population. The objective of this paper is to assist those conducting research on the built environment and health who may have little background in mixed methods. We provide an overview of mixed methods research designs and provide concrete techniques for the integration of diverse methods. We also discuss the recommendations for mixed methods research in the field of built environment - health research, drawing on specific examples from published studies. Reporting a research design and an integration strategy in mixed methods studies could help to strengthen our ability to gain new insights into the multidimensional nature of the relationship between the built environment and health. [ABSTRACT FROM AUTHOR]

Background: Organizational Participatory Research (OPR) seeks organizational learning and/or practice improvement. Previous systematic literature reviews described some OPR processes and outcomes, but the link between these processes and outcomes is unknown. We sought to identify and sequence the key processes of OPR taking place with and within healthcare organizations and the main outcomes to which they contribute, and to define ideal-types of OPR.Methods: This article reports a participatory systematic mixed studies review with qualitative synthesis A specialized health librarian searched MEDLINE, CINAHL, Embase Classic + Embase, PsycINFO, the Cochrane Library, Social Work Abstracts and Business Source Complete, together with grey literature data bases were searched from inception to November 29, 2012. This search was updated using forward citation tracking up to June 2014. Reporting quality was appraised and unclear articles were excluded. Included studies clearly reported OPR where the main research related decisions were co-constructed among the academic and healthcare organization partners. Included studies were distilled into summaries of their OPR processes and outcomes, which were subsequently analysed using deductive and inductive thematic analysis. All summaries were analysed; that is, data analysis continued beyond saturation.Results: Eighty-three studies were included from the 8873 records retrieved. Eight key OPR processes were identified. Four follow the phases of research: 1) form a work group and hold meetings, 2) collectively determine research objectives, 3) collectively analyse data, and 4) collectively interpret results and decide how to use them. Four are present throughout OPR: 1) communication, 2) relationships; 3) commitment; 4) collective reflection. These processes contribute to extra benefits at the individual and organizational levels. Four ideal-types of OPR were defined. Basic OPR consists of OPR processes leading to achieving the study objectives. This ideal-type and may be combined with any of the following three ideal-types: OPR resulting in random additional benefits for the individuals or organization involved, OPR spreading to other sectors of the organization and beyond, or OPR leading to subsequent initiatives. These results are illustrated with a novel conceptual model.Conclusion: The model provides operational guidance to help OPR stakeholders collaboratively address organizational issues and achieve desired outcomes and more.Review Registration: As per PROSPERO inclusion criteria, this review is not registered. [ABSTRACT FROM AUTHOR]

Information monitoring and keeping abreast of research trends is essential for researchers. However, as the volume of information and the number of tools for staying up to date continue to grow, researchers struggle to continuously monitor and filter scholarly articles. This is particularly true for researchers working in complex multidisciplinary fields like Patient Oriented Research, who need to cast their nets wide to identify relevant high-quality studies. The proposed multiple case study will explore and analyze the use and user perceptions regarding a collaborative research trend monitoring system, called eSRAP. This research will advance knowledge on processes and outcomes of collaborative monitoring of research publications. The findings will be significant to those providing monitoring services, studying collaborative information behaviour, training future researchers and information professionals, as well as to system designers. [ABSTRACT FROM AUTHOR]

Spaced education (SE) is a learning strategy that can improve long-term knowledge retention. Inspired by the concept of SE, we conducted a mixed methods study of a smartphone application (app) as a platform of SE. Objectives were to: (phase 1 quantitative) estimate the extent to which weekly alerts on the app can stimulate medical residents to visit the app, (connection of phases) identify participants for a second qualitative phase, and (phase 2 qualitative) describe factors, from the resident perspective, which influence sustainable participation in SE, and describe strategies for improvement of the app. Methodology and methods: phase-1 design was pre-experimental, phase-2 design was qualitative descriptive (deductive-inductive thematic analysis). Results: We observed a stimulating effect of weekly alerts for the first two months of the one-year study. Per participant, alert visits varied from 0 to 34 (mean = 1.7, SD = 4.5) and total page visits varied from 1 to 442 (mean = 28.3, SD = 61.4). Barriers and facilitators to sustainable participation in SE fell into five dimensions: user-related factors, information content factors, mobile app design factors, alert system factors, and service factors. Four strategies for app improvement were described. In conclusion, we propose five dimensions pertaining to potential predictors of sustainable participation in SE to deliver clinical information. [ABSTRACT FROM AUTHOR]

Purpose: Case management (CM) interventions are effective for frequent users of health care services, but little is known about which intervention characteristics lead to positive outcomes. We sought to identify characteristics of CM that yield positive outcomes among frequent users with chronic disease in primary care.Methods: For this systematic review of both quantitative and qualitative studies, we searched MEDLINE, CINAHL, Embase, and PsycINFO (1996 to September 2017) and included articles meeting the following criteria: (1)population: adult frequent users with chronic disease, (2)intervention: CM in a primary care setting with a postintervention evaluation, and (3)primary outcomes: integration of services, health care system use, cost, and patient outcome measures. Independent reviewers screened abstracts, read full texts, appraised methodologic quality (Mixed Methods Appraisal Tool), and extracted data from the included studies. Sufficient and necessary CM intervention characteristics were identified using configurational comparative methods.Results: Of the 10,687 records retrieved, 20 studies were included; 17 quantitative, 2 qualitative, and 1 mixed methods study. Analyses revealed that it is necessary to identify patients most likely to benefit from a CM intervention for CM to produce positive outcomes. High-intensity intervention or the presence of a multidisciplinary/interorganizational care plan was also associated with positive outcomes.Conclusions: Policy makers and clinicians should focus on their case-finding processes because this is the essential characteristic of CM effectiveness. In addition, value should be placed on high-intensity CM interventions and developing care plans with multiple types of care providers to help improve patient outcomes. [ABSTRACT FROM AUTHOR]

Context: Proxy online health information seekers informally seek online health information on behalf of or because of others without necessarily being asked to do so. Proxy information seekers in a person's social circle may help this person overcome information-seeking barriers (e.g., low level of e-health literacy) and illness challenges (e.g., when they are too physically weak to search themselves). However, little is known of the context, use, and reported outcomes of proxy online health information seeking. Objective: To explore the outcomes of proxy online health information seeking behaviour. Study Design: Mixed studies literature review with framework synthesis, then a convergent mixed methods study. Setting: In partnership with Naître et Grandir (an online parenting resource). Population: Members of the entourage of parents of 0- to 8-year-old children (grandparents, family members, friends, neighbours, or professionals working with children). Instrument: Validated 'Information Assessment Method' (IAM) questionnaire. Results: An initial theoretical model was developed using findings from the mixed studies review. IAM questionnaire responses showed that entourage members who actively seek online information were more likely to report that the information can help them be less worried, handle a problem, and decide what to do with someone else. In the interviews, entourage members reported proxy-seeking for reassurance, out of personal curiosity, as part of their professional role, or following an explicit request from the parents. They used the information to provide informational support (either by sharing the webpage directly or discussing its content), or to provide material support for a child in their care (e.g., playing games with a child), or to provide emotional support. In some cases, they did not share the information to avoid tensions with the parents in question. Positive outcomes included improvement in the relationship with others, and negative outcomes included interpersonal tensions when information was unsolicited. The initial model was revised to incorporate findings from the mixed methods study. Expected Outcomes: Findings from this study advance knowledge on proxy online health information seeking behaviour and outcomes. Health care practitioners can target patients' entourage with information for dissemination and use. Patients can be encouraged to turn to their entourage for support using online health information. [ABSTRACT FROM AUTHOR]

Context: Shared decision-making (SDM) is central to person-centred care and primary care nurses' practice. Our previous work showed the unmet educational needs of primary care nurses to engage in SDM with complex care needs patients. Objective: Using Kirkpatrick's four levels of learning, we sought to provide primary care nurses a continuing professional development (CPD) toolkit that meets their educational needs so they will engage in SDM with complex care needs patients. Study Design: One-group pre-post study to evaluate the CPD toolkit Setting: Primary care clinics in Quebec Population Studied: Primary care nurses Intervention: Cocreated CPD toolkit with a dissemination strategy using social media and the primary care nurses' virtual community of practice. Outcome measures: We used validated questionnaires using a 4-points Likert scale to measure Kirkpatrick's level 1 (reaction) and level 2 (learning) of primary care nurses after using the CPD toolkit. We collected qualitative data to document primary care nurses' perceptions of the CPD toolkit. Analysis: We used descriptive analyses to characterize the sample and student t-test for paired samples to evaluate the impact of the CPD toolkit. We used thematic analysis for qualitative data. Results: Our CPD toolkit was launched in the fall 2021. 165 primary care nurses completed it. From them, 69 completed pre-and post-training CPD questionnaires. Giving to Level 1, over 90% of the primary care nurses was satisfied with the CPD toolkit. For Level 2, the CPP toolkit significantly improved their confidence (p=0.001) and intention (p=0.01) to apply their knowledge in clinical settings. Comparative analyses show that the CDP toolkit appears to be most effective for primary care nurses practicing for 1 to 10 years. Qualitatively, as the most appreciated elements, primary care nurses identified the clarity and conciseness of the content disseminated and the access to concrete tools. After the CDP toolkit completion, primary care nurses perceived themselves as better able to assess patients' needs, support them in their SDM, and understand the nurse's and patient's roles in SDM. Conclusions: This project demonstrated that an innovative model of asynchronous CPD toolkit for SDM and primary care nurses is efficient to improve Kirkpatrick's Levels of learning 1 and 2 in primary care settings that match the educational needs expressed. This CDP toolkit could be exportable to other clinicians in primary care. [ABSTRACT FROM AUTHOR]

The questionnaires' origin (sources from which elements of the questionnaire are derived) and initial development (process of making a questionnaire from elements) should be assessed before their measurement properties. There is no Critical Appraisal Tool (CAT) that comprehensively assesses the origin and initial development of questionnaires therefore, our objective was to develop one. To develop the Questionnaire Origin and Development Appraisal (QODA) tool, we first developed QODA version-one from psychometric tool development guidelines, and pilot tested it, resulting in QODA version-two. Second, we performed a review that identified six CATs that evaluate origin and initial development. A pool of items was derived from these six CATs and QODA version-two. Using a nominal group method, this item pool was reduced and QODA version-three (20 items) was developed. The QODA may be useful to academic librarians who assist researchers and students from various disciplines. Information professionals including research trainees can learn how to use QODA and ensure sound questionnaire origin and initial development. This will improve the accuracy of data collected in research and professional practice (e.g., information service evaluation). Future research will study the QODA's measurement properties. [ABSTRACT FROM AUTHOR]

Systematic reviews (SR) typically focus on well-defined topics and homogeneous populations. In contrast, conducting a SR on patients with complex care needs (PCCN) presents two main challenges: a novel ill-defined topic and a heterogeneous population. This commentary summarizes the lessons learned from our experience using crowdsourcing to meet these challenges. PCCN often suffer from combinations of multiple issues (medical, interactional, sociocultural, psychological, related to healthcare services use), which can lead to difficult decision-making involving different stakeholders (themselves, caregivers, practitioners). The objective of our SR was to systematically assess decisional needs of PCCN reported in the literature. With the collaboration of librarians, we identified 8616 potentially relevant studies in five databases. A team of 20 crowdreviewers were trained and participated in the selection of 156 relevant studies, using specialised online software. The main benefit of crowdsourcing was the diversity of crowdreviewers' viewpoints which helped us establish an intersubjective knowledge classification of idiosyncratic concepts related to PCCN and their decisional needs. In line with other crowdsourced reviews, our experience confirms that crowdsourcing can be useful in SR with a large number of studies on ill-defined domains and with heterogeneous populations. [ABSTRACT FROM AUTHOR]

Background: Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants. Methods: This theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane's framework on health systems' responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers. Discussion: This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach—particularly in relation to the engagement of refugees and asylum seekers in the governance of our research. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Expanding the evidence within evidence-based healthcare: thinking about the context, acceptability and feasibility of interventions" by R.L. Shaw published in a 2014 issue of the journal.