Developing a search filter for ‘upstream’ public health interventions

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Kavanagh J, Stansfield C, Lorenc T, Harden A, Weightman A, Doyle J, Waters E

Background: In 2008, the Cochrane Health Promotion and Public Health (HPPH) Field submitted a proposal for a new Public Health Review Group (PHRG). The need for this new group reflects global concern with evidence that supports action on the social determinants of health, and in particular evidence for public health policy making that includes regulation, legislation and population health interventions. The topic scope of the study register for the PHRG is upstream public health interventions targeted at populations or specific groups. The authors are not aware of any existing search filters for identifying upstream interventions. Populating a new PHRG register will be challenging in the absence of such a filter. Objectives: To develop and conduct preliminary testing of a suggestive search filter, to aid identification of upstream public health interventions in MEDLINE and The Cochrane Library. Methods: Studies included in a sample of Cochrane reviews of upstream public health interventions, and relevant studies from the current HPPH field register TRoPHI (Trials Register of Promoting Health Interventions) were identified. Search strategies for reviews and the PubMed record for studies were analysed for MeSH and free text phrases that might identify upstream interventions. The utility of identified terms and MeSH will be explored before being combined in a search filter, which will be tested for sensitivity and specificity. Results: Ninety-six PubMed or CENTRAL records for 112 studies included in 10 Cochrane reviews were identified. Scoping searches identified a further 30 studies from TRoPHI. Preliminary findings confirm that there are few intuitive MeSH terms available to researchers looking for upstream interventions. Some records lack free text or MeSH terms that directly relate to public health or health promotion. Analysis of 68% of records and search strategies revealed: over 150 free text terms and phrases; and 68 MeSH terms for further exploration. These ranged from generic terms to those specific to particular types of interventions. The search filter will be presented with data on its effectiveness for identifying ‘upstream’ interventions. Conclusions: This study will provide a helpful base on which to develop a search for identifying upstream public health interventions.