Article type
Year
Abstract
Objectives: To identify the contributions of observational and qualitative research to a systematic review.
Methods: We systematically reviewed the effectiveness of smoking cessation interventions implemented during pregnancy. This review integrated process indicators and views of service users and practitioners. We examined the completed review to identify what types of observational and qualitative research it drew on; where this research was incorporated into the review; how it influenced the review; and its added value.
Results: The review background drew on routinely collected state and national data, epidemiological surveys, surveys of professional practice, formative intervention studies, in-depth interviews and critical reviews. It was also informed by consultations with health promotion specialists attending a training workshop and maternity service users in a rapid appraisal exercise. These sources led to the extraction of additional types of data from randomised trials and their linked studies to describe the interventions (theoretical basis and intensity of interventions, process indicators, biochemical validation of smoking status) and additional outcomes (e.g. length of labour, method of delivery, breastfeeding, anxiety, depression and maternal health, participants views and measures of family functioning). Additional qualitative data was extracted systematically from included RCTs to answer questions about how the design of interventions and recommendations arising from their evaluation related to the views of services users.
Discussion: Prior observational and qualitative research and consultations can (a) influence the criteria by which interventions' effectiveness is judged, and (b) reveal to what extent these criteria are adopted in services. Process indicators contribute to understanding heterogeneity in outcomes. Poor implementation of complex interventions (masked in the absence of process indicators) may undermine excellent design, power and recruitment. Thus, recommendations for current practice and research most usefully draw on process indicators, qualitative data and outcome measures, all extracted systematically from primary studies.
Methods: We systematically reviewed the effectiveness of smoking cessation interventions implemented during pregnancy. This review integrated process indicators and views of service users and practitioners. We examined the completed review to identify what types of observational and qualitative research it drew on; where this research was incorporated into the review; how it influenced the review; and its added value.
Results: The review background drew on routinely collected state and national data, epidemiological surveys, surveys of professional practice, formative intervention studies, in-depth interviews and critical reviews. It was also informed by consultations with health promotion specialists attending a training workshop and maternity service users in a rapid appraisal exercise. These sources led to the extraction of additional types of data from randomised trials and their linked studies to describe the interventions (theoretical basis and intensity of interventions, process indicators, biochemical validation of smoking status) and additional outcomes (e.g. length of labour, method of delivery, breastfeeding, anxiety, depression and maternal health, participants views and measures of family functioning). Additional qualitative data was extracted systematically from included RCTs to answer questions about how the design of interventions and recommendations arising from their evaluation related to the views of services users.
Discussion: Prior observational and qualitative research and consultations can (a) influence the criteria by which interventions' effectiveness is judged, and (b) reveal to what extent these criteria are adopted in services. Process indicators contribute to understanding heterogeneity in outcomes. Poor implementation of complex interventions (masked in the absence of process indicators) may undermine excellent design, power and recruitment. Thus, recommendations for current practice and research most usefully draw on process indicators, qualitative data and outcome measures, all extracted systematically from primary studies.