Guidelines for systematic reviews of health promotion and public health interventions

Article type
Authors
Jackson N, Waters E, Doyle J, Howes F
Abstract
Background: Training resources currently available to systematic reviewers are mostly targeted towards reviews of clinical interventions. Clinical reviews may differ in many respects to reviews of health promotion and public health interventions, which are often very complex and context-dependent. Largely in response to the needs of health promotion and public health reviewers, the Cochrane Health Promotion and Public Health (HP/PH) Field has developed a set of guidelines for Cochrane reviewers and Review Groups in order to increase the quality and quantity of health promotion and public health reviews on The Cochrane Library.

Objectives: To develop a set of practical and user-friendly guidelines which are methodologically sound, fulfil the needs of systematic reviewers, and address the requirements of policy and decision-makers in developed and developing countries.

Methods: A range of key individuals with expertise and experience in conducting reviews relevant to health promotion and public health were located and invited to participate in an international Guidelines taskforce. The purpose of the taskforce was to identify issues that confront reviewers and address these by producing reviewer guidelines. Although the issues were raised as being particularly important in the context of completing HP/PH reviews, the issues are not necessarily unique to HP/PH reviews, and therefore, could have wider applicability.

Results: Through implementation of a number of strategies the taskforce identified and addressed a number of issues relevant to the conduct of HP/PH systematic reviews. Topics addressed in the guidelines are; 1) planning the review to ensure policy and practice-relevant review questions, 2) selecting study designs, 3) searching for health promotion and public health studies, 4) quality appraisal of health promotion and public health studies, 5) assessing the theoretical framework, 6) assessing the integrity of the intervention, 7) assessing the heterogeneity of health promotion and public health studies, 7) narrative synthesis, 8) inclusion, appraisal and synthesis of qualitative research, 9) incorporating issues of equity and ethics, 10) sustainability of interventions, 11) assessment of context, 12) applicability of the findings of the review.

The guidelines supplement and signpost existing systematic review resources. They will be regularly updated as results of relevant methodological work become available. Feedback will be sought from users about the usefulness and user-friendliness to evaluate and update the guidelines.

The guidelines have been submitted to the Handbook Advisory Group (March 2004) for comment and inclusion as an Appendix in the Cochrane Reviewers Handbook and Open Learning Materials for Reviewers.

Conclusions: Best-practice guidelines, which tackle/address issues that confront reviewers of HP/PH interventions will improve the quality and quantity of HP/PH reviews. They will also ensure that the reviews meet the needs of users.