Synthesizing diverse evidence: the use of primary qualitative data analysis methods and logic models in public health reviews

Abstract

ObjectivesThe nature of public health evidence presents challenges for conventional systematic review processes, with increasing recognition of the need to include a broader range of work including observational studies and qualitative research, yet with methods to combine diverse sources remaining underdeveloped. The objective of this paper is to report the application of a new approach for review of evidence in the public health sphere. The method enables a diverse range of evidence types to be synthesised in order to examine potential relationships between a public health environment and outcomes. Study designThe study draws on previous work by the National Institute for Health and Clinical Excellence on conceptual frameworks. It applied and further extended this work to the synthesis of evidence relating to one particular public health area, the enhancing of employee mental wellbeing in the workplace. MethodsThe approach utilised thematic analysis techniques from primary research together with conceptual modelling to explore potential relationships between factors and outcomes.

Cochrane Qualitative and Implementation Methods Group guidance series—paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis

“…Many quantitative and qualitative reviews now use theoretical frameworks or logic models to present relationships between problem, explanatory evidence, implementation and outcomes [24,46]. Theoretical frameworks explain the possible relationships between concepts in general terms; logic models are usually more pragmatic illustrations of how the components of a specific programme or intervention work together to produce the desired outcomes for a particular population in a given context [25][26][27] The protocol for a mixed method review on WASH Promotion Programmes [28] presents a logic model based on the RANAS theoretical model [29], the PROGRESS framework [30] and the Checklist for Implementation (Chimp) [31].…”

Contracting with General Dental Services: a mixed-methods study on factors influencing responses to contracts in English general dental practice

“…33 Logic models (also known as logical frameworks) originating from the field of programme evaluation are typically diagrams or flow charts that convey the logical relationship between different elements which make up a programme or intervention, explaining how these work together to influence the end result. The underlying purpose of logic models is to postulate the 'if-then' causal relationships between the various elements, which can then be tested.…”

“…This approach is particularly applicable to complex policy interventions, such as implementation of health-care contracts, where there are multifactorial outcomes, and the causal chain between the agent and the outcome is neither short nor simple. 33 Conceptual models (logic models) are thus useful in providing a structure for exploring the complex relationships between contextual factors, inputs, processes and outcomes. Figure 1 provides an aggregative synthesis in the form of a logic map of the various concepts and relationships we identified in our review of theory.…”

Systematic reviews: from ‘bare bones’ reviews to policy relevance

“…An increasing number of reviews are also adopting less traditional approaches to evidence synthesis, including different types of qualitative and mixed methods synthesis (Noyes 2010). A review of this literature, as well as the experience of 3ie's systematic reviews program and approach to impact evaluation (White 2009), suggests there are two key components to adapting the traditional approach to systematic reviews and producing more useful and higher quality reviews in international development, namely the use of theory (Petticrew and Roberts 2006, Gardner et al 2010, Tugwell et al 2010, Anderson et al 2011) and the need to include a broader range of evidence (Dixon-Woods et al 2005, Mays et al 2005, Oliver et al 2005, Popay 2005, Baxter et al 2010.…”

“…While it might be appropriate to not adopt a formal quality appraisal tool if the purpose of the review is building theory and explore potential relationships for future interventions and research (Baxter et al 2010), when research is being used as evidence for informing policy and practice transparent assessment of quality is important.…”