Discrepancies in findings from effectiveness reviews: the case of health promotion interventions to change cholesterol levels

Peersman, Greet; Harden, Angela; Oliver, Sandy; Oakley, Ann

doi:10.1177/001789699905800210

Cited by 11 publications

(10 citation statements)

References 31 publications

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“…Realist reviews of evidence have been categorised as one of the “narrative approaches” [78] to systematic reviews suited to integrating a heterogeneity of quantitative and qualitative evidence [70]. Methods to integrate intervention studies and the views of immigrants in this review of evidence drew on reviews carried out by the EPPI-Centre in the UK [75,80-82]. Finally, the focus in this review of evidence was on group- and community-level interventions to address the growing recognition of the limitations of individual-level interventions, particularly in preventing the sexual transmission of HIV [2,3,42].…”

Section: Methodsmentioning

confidence: 99%

“…Developing search terms is often defined in terms of a trade-off between sensitivity and specificity [78,84,85]. With this in mind we followed the methods reported by others in a review of sexual health promotion interventions [82]. The starting point was to bring together two ‘known sets’ of primary studies of relevance to the review question ([82] p. 47).…”

Section: Methodsmentioning

confidence: 99%

“…With this in mind we followed the methods reported by others in a review of sexual health promotion interventions [82]. The starting point was to bring together two ‘known sets’ of primary studies of relevance to the review question ([82] p. 47). These ‘known sets’ were comprised of studies known to the lead author and studies found in preliminary searches of databases in the initial stages of the review.…”

Section: Methodsmentioning

confidence: 99%

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HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

McMahon

Ward

2012

Syst Rev

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BackgroundImmigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention.MethodsWe undertook a realist review to answer the research question: ‘How are HIV prevention interventions in high-income countries adapted to suit immigrants’ needs?’ A key goal was to uncover underlying theories or mechanisms operating in behavioural HIV prevention interventions with immigrants, to uncover explanations as how and why they work (or not) for particular groups in particular contexts, and thus to refine the underlying theories. The realist review mapped seven initial mechanisms underlying culturally appropriate HIV prevention with immigrants. Evidence from intervention studies and qualitative studies found in systematic searches was then used to test and refine these seven mechanisms.ResultsThirty-four intervention studies and 40 qualitative studies contributed to the analysis and synthesis of evidence. The strongest evidence supported the role of ‘consonance’ mechanisms, indicating the pivotal need to incorporate cultural values into the intervention content. Moderate evidence was found to support the role of three other mechanisms – ‘understanding’, ‘specificity’ and ‘embeddedness’ – which indicated that using the language of immigrants, usually the ‘mother tongue’, targeting (in terms of ethnicity) and the use of settings were also critical elements in culturally appropriate HIV prevention. There was mixed evidence for the roles of ‘authenticity’ and ‘framing’ mechanisms and only partial evidence to support role of ‘endorsement’ mechanisms.ConclusionsThis realist review contributes to the explanatory framework of behavioural HIV prevention among immigrants living in high-income countries and, in particular, builds a greater understanding of the suite of mechanisms that underpin adaptations of interventions by the cultural context and population being targeted.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

McMahon

Ward

2012

Syst Rev

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“…For systematic reviews to be relevant to policy and practice, the involvement of potential users in the review process is of value 7 8. User involvement in this review was sought through an advisory group, including policy specialists, practitioners and researchers, representing a number of organisations.…”

Section: Methodsmentioning

confidence: 99%

Attitudes to walking and cycling among children, young people and parents: a systematic review

Lorenc¹,

Brunton²,

Oliver³

et al. 2008

Journal of Epidemiology & Community Health

128

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“…26 We do not, of course, suggest that reviewers should incorporate the results of less robust studies uncritically in their synthesis of evidence of effectiveness, because doing so can significantly change the resulting recommendations about what interventions are labelled ''effective''. 27 However, our sensitivity analysis shows that our excluded but relevant studies could make an additional valuable contribution to the larger mosaic, even though we seemed to have been justified in excluding them from the primary synthesis of evidence of effectiveness. Indeed, the preliminary mapping of all available evidence has been an explicit part of the process of some systematic reviews.…”

Section: Category Of Interventionmentioning

confidence: 98%

Systematic reviews of health effects of social interventions: 2. Best available evidence: how low should you go?

Ogilvie

Egan²,

Hamilton³

et al. 2005

Journal of Epidemiology & Community Health

136

104

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Study objective: There is little guidance on how to select the best available evidence of health effects of social interventions. The aim of this paper was to assess the implications of setting particular inclusion criteria for evidence synthesis. Design: Analysis of all relevant studies for one systematic review, followed by sensitivity analysis of the effects of selecting studies based on a two dimensional hierarchy of study design and study population. Setting: Case study of a systematic review of the effectiveness of interventions in promoting a population shift from using cars towards walking and cycling. Main results: The distribution of available evidence was skewed. Population level interventions were less likely than individual level interventions to have been studied using the most rigorous study designs; nearly all of the population level evidence would have been missed if only randomised controlled trials had been included. Examining the studies that were excluded did not change the overall conclusions about effectiveness, but did identify additional categories of intervention such as health walks and parking charges that merit further research, and provided evidence to challenge assumptions about the actual effects of progressive urban transport policies. Conclusions: Unthinking adherence to a hierarchy of study design as a means of selecting studies may reduce the value of evidence synthesis and reinforce an ''inverse evidence law'' whereby the least is known about the effects of interventions most likely to influence whole populations. Producing generalisable estimates of effect sizes is only one possible objective of evidence synthesis. Mapping the available evidence and uncertainty about effects may also be important. D espite increasing calls for systematic reviews of health effects of social interventions, there is little methodological research or even guidance on how such reviews should be done. We have lifted the lid on the ''private life'' of the input side of one such systematic review to expose some of our methodological processes and decisions to critical analysis.1 In a companion paper, we set the scene and examined one phase of the review, the search for evidence. 2In this paper, we examine another phase of the review: the selection of evidence for inclusion. We investigate the effect of varying our inclusion criteria on the findings and overall value of the review. SELECTING EVIDENCE FOR INCLUSIONResearchers designing systematic reviews of intervention studies are advised to specify their research questions in terms of four facets: the intervention, the population receiving the intervention, the outcome of interest, and the study designs deemed worthy of inclusion.3 This approach is undoubtedly helpful for structuring research questions and protocols, but we aimed to synthesise population level evidence in a cross disciplinary field where comparatively little empirical intervention research has been done. A broad understanding of population health and its wider determinants implied a...

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Discrepancies in findings from effectiveness reviews: the case of health promotion interventions to change cholesterol levels

Cited by 11 publications

References 31 publications

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

Attitudes to walking and cycling among children, young people and parents: a systematic review

Systematic reviews of health effects of social interventions: 2. Best available evidence: how low should you go?

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