Synthesising quantitative evidence in systematic reviews of complex health interventions

BMJ Global Health, Journal Year: 2019, Volume and Issue: 4(Suppl 1), P. e000858 - e000858

Published: Jan. 1, 2019

Public health and service interventions are typically complex: they multifaceted, with impacts at multiple levels on stakeholders. Systematic reviews evaluating the effects of complex can be challenging to conduct. This paper is part a special series papers considering these challenges particularly in context WHO guideline development. We outline established innovative methods for synthesising quantitative evidence within systematic review intervention, including considerations complexity system into which intervention introduced. describe three broad areas: non-quantitative approaches, tabulation, narrative graphical approaches; standard meta-analysis methods, meta-regression investigate study-level moderators effect; advanced synthesis models allow exploration components, investigation both mediators, examination mechanisms, complexities system. offer guidance choice approach that might taken by people collating support development, emphasise appropriate will depend purpose synthesis, similarity studies included review, level detail available from studies, nature results reported expertise team resources available.

Language: Английский

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Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries

Cochrane library, Journal Year: 2022, Volume and Issue: 2022(3)

Published: March 29, 2022

Language: Английский

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Series: Clinical Epidemiology in South Africa. Paper 3: Logic models help make sense of complexity in systematic reviews and health technology assessments

Journal of Clinical Epidemiology, Journal Year: 2016, Volume and Issue: 83, P. 37 - 47

Published: Aug. 4, 2016

Language: Английский

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Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review

Environmental Health, Journal Year: 2021, Volume and Issue: 20(1)

Published: April 10, 2021

Abstract Background Air pollution is one of the world’s leading mortality risk factors contributing to seven million deaths annually. COVID-19 pandemic has claimed about in less than a year. However, it unclear whether exposure acute and chronic air influences epidemiologic curve. Methods We searched for relevant studies listed six electronic databases between December 2019 September 2020. applied no language or publication status limits. Studies presented as original articles, that assessed risk, incidence, prevalence, lethality relation with either short-term long-term ambient were included. All patients regardless age, sex location diagnosed having any severity taken into consideration. synthesised results using harvest plots based on effect direction. Results Included cross-sectional ( n = 10), retrospective cohorts 9), ecological 6 which two time-series) hypothesis (n 1). Of these studies, 52 48% pollutant exposure, respectively evaluated both. Pollutants mostly studied PM 2.5 (64%), NO 2 (50%), 10 (43%) O 3 (29%) effects (85%), (39%) (23%) then (15%) effects. Most outcomes incidence rate. Acutely, pollutants independently associated first , (only incident cases). Chronically, similar relationships found . High overall bias judgments (86 39% respectively) was predominantly due failure adjust aggregated data important confounders, lesser extent because lack comparative analysis. Conclusion The body evidence indicates both can affect epidemiology. higher level existing compared moderate exposure. Public health interventions help minimize anthropogenic source socio-economic injustice/disparities may reduce planetary threat posed by pandemics.

Language: Английский

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What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years

The Lancet, Journal Year: 2022, Volume and Issue: 399(10337), P. 1810 - 1829

Published: April 27, 2022

Language: Английский

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The effect of nutrition-specific and nutrition-sensitive interventions on the double burden of malnutrition in low-income and middle-income countries: a systematic review

The Lancet Global Health, Journal Year: 2024, Volume and Issue: 12(3), P. e419 - e432

Published: Jan. 30, 2024

BackgroundLow-income and middle-income countries (LMICs) experiencing nutrition transition face an increasing double burden of malnutrition (DBM). WHO has urged the identification risks opportunities in interventions to mitigate DBM, but robust evidence is missing. This review summarises effect nutrition-specific nutrition-sensitive on undernutrition overnutrition LMICs.MethodsWe searched four major databases grey literature for publications English, French, Portuguese, Spanish from Jan 1, 2000, Aug 14, 2023. Eligible studies evaluated or both overnutrition, employing study designs (individually randomised, cluster non-randomised trials; interrupted time series; controlled before–after; prospective cohort studies). Studies were synthesised narratively, classified as DBM-beneficial, potentially DBM-neutral, DBM-harmful, using vote counting. registered with PROSPERO (CRD42022320131).FindingsWe identified 26 evaluating 20 (maternal child health [MCH] school-based programmes) six (conditional cash transfers other social policies) interventions. Seven eight MCH providing food-based nutritional supplements indicated possible DBM-harmful effects, associated increased maternal overweight. Most programmes that target behavioural change considered DBM-beneficial. Two conditional suggested DBM-beneficial effects children, whereas one harmful A a family planning service education reform revealed long-term obesity.InterpretationThere considerable scope repurpose existing reduce growing DBM LMICs. In settings undergoing rapid transition, specific policy attention required ensure supplement-based do not unintentionally increase Consistent reporting outcomes all essential expand base identify promote maximising benefits minimising harms DBM.FundingPresident's Scholarship (Imperial College London) National Institute Health Care Research.TranslationsFor French translations abstract see Supplementary Materials section.

Language: Английский

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Community-based supplementary feeding for food insecure, vulnerable and malnourished populations - an overview of systematic reviews

Cochrane library, Journal Year: 2018, Volume and Issue: 2018(11)

Published: Nov. 9, 2018

Language: Английский

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Community-level interventions for improving access to food in low- and middle-income countries

Cochrane library, Journal Year: 2020, Volume and Issue: 2020(8)

Published: Aug. 5, 2020

Language: Английский

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Community-level interventions for improving access to food in low- and middle-income countries

Cochrane library, Journal Year: 2020, Volume and Issue: unknown

Published: July 28, 2020

Language: Английский

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Impact of social protection on gender equality in low‐ and middle‐income countries: A systematic review of reviews

Campbell Systematic Reviews, Journal Year: 2022, Volume and Issue: 18(2)

Published: May 25, 2022

Background More than half of the global population is not effectively covered by any type social protection benefit and women's coverage lags behind. Most girls boys living in low-resource settings have no effective coverage. Interest these essential programmes low middle-income rising context COVID-19 pandemic value for all has been undoubtedly confirmed. However, evidence on whether impact different (social assistance, insurance care services labour market programmes) differs gender consistently analysed. Evidence needed structural contextual factors that determine differential impacts. Questions remain as to programme outcomes vary according intervention implementation design. Objectives This systematic review aims collect, appraise, synthesise from available reviews impacts countries. It answers following questions: 1. What known gender-differentiated countries? 2. about impacts? 3. existing design features their association with outcomes? Search Methods We searched published grey literature 19 bibliographic databases libraries. The search techniques used were subject searching, reference list checking, citation searching expert consultations. All searches conducted between 10 February 1 March 2021 retrieve within last years language restrictions. Selection Criteria included synthesised qualitative, quantitative or mixed-methods studies analysed women, men, girls, age investigated one more types effects interventions six core outcome areas equality: economic security empowerment, health, education, mental health psychosocial wellbeing, safety voice agency. Data Collection Analysis A total 6265 records identified. After removing duplicates, 5250 screened independently simultaneously two reviewers based title abstract 298 full texts assessed eligibility. Another 48 records, identified through initial scoping exercise, consultations experts also screened. includes 70 high moderate quality reviews, representing a 3289 121 extracted data interest: population, intervention, methodology, appraisal, findings each research question. pooled effect sizes equality meta-analyses. methodological was assessed, framework synthesis method. To estimate degree overlap, we created matrices calculated corrected area. Main Results examined programme. majority assistance (77%, N = 54), 40% (N 28) programmes, 11% 8) focused 9% 6) interventions. Health most researched (e.g., maternal health; 70%, 49) area, followed empowerment savings; 39%, 27) education school enrolment attendance; 24%, 17). Five key consistent across areas: (1) Although pre-existing differences should be considered, tend report higher women comparison men boys; (2) Women are likely save, invest share benefits but lack family support barrier participation retention programmes; (3) Social explicit objectives demonstrate without broad objectives; (4) While point negative adverse unintended attributed features. there one-size-fits-all approaches need gender-responsive adapted; (5) Direct investment individuals families' needs accompanied efforts strengthen child systems. may increase participation, savings, investments, utilisation contraception use among attendance girls. They reduce pregnancies young risky sexual behaviour, symptoms sexually transmitted infections women. sexual, reproductive, services, knowledge reproductive improve changes attitudes towards planning; rates inclusive early initiation breastfeeding decrease poor physical wellbeing mothers. Labour receiving benefits, ownership assets, earning capacity infections, self-reported condom nutrition overall household dietary intake, subjective needed. Authors' Conclusions effectiveness gaps remain, current programmatic interests matched rigorous base demonstrating how appropriately implement Advancing entails moving beyond test packages combinations equality. Systematic investigating old pensions parental leave Voice agency under-researched areas.

Language: Английский

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