Article type
Year
Abstract
Background: There is increasing interest in addressing multiple questions in systematic reviews using a wider range of evidence, particularly in relation to broad and multi-faceted interventions such as those typically implemented within public health.
Objectives: This study explores how diverse types of evidence including trials, process evaluations, theory, 'non-intervention’ quantitative and qualitative studies can be combined using a review on the effects of schools and school environment interventions on health as a case example.
Methods: Exhaustive searches were conducted and the results screened to identify relevant studies. Each study type underwent separate critical appraisal, data extraction and synthesis using specially developed tools tailored to each type of study. All five syntheses were integrated to draw conclusions and make recommendations.
Results: Each type of study was used to address a different question within the review. Trials were used to estimate the effectiveness of interventions and process evaluations to address questions about intervention acceptability, feasibility and context. The quantitative non-intervention studies were used to examine the range of school-level factors which influence health and might form the focus of future intervention studies (these studies examined whether differences in health between schools could be explained by school level factors). The qualitative studies examined how students viewed the impact of schools on their health.
Conclusions: This approach to combining diverse types of evidence in a single review proved especially valuable here as the interventions under study - those which aim to change the school environment - are at a relatively early stage of development. Current intervention studies have not addressed the full range of potential determinants of school health. Findings from the different study types were integrated to: build new theory for how schools affect health; suggest potential new avenues for intervention research; and refine logic models for interventions.
Objectives: This study explores how diverse types of evidence including trials, process evaluations, theory, 'non-intervention’ quantitative and qualitative studies can be combined using a review on the effects of schools and school environment interventions on health as a case example.
Methods: Exhaustive searches were conducted and the results screened to identify relevant studies. Each study type underwent separate critical appraisal, data extraction and synthesis using specially developed tools tailored to each type of study. All five syntheses were integrated to draw conclusions and make recommendations.
Results: Each type of study was used to address a different question within the review. Trials were used to estimate the effectiveness of interventions and process evaluations to address questions about intervention acceptability, feasibility and context. The quantitative non-intervention studies were used to examine the range of school-level factors which influence health and might form the focus of future intervention studies (these studies examined whether differences in health between schools could be explained by school level factors). The qualitative studies examined how students viewed the impact of schools on their health.
Conclusions: This approach to combining diverse types of evidence in a single review proved especially valuable here as the interventions under study - those which aim to change the school environment - are at a relatively early stage of development. Current intervention studies have not addressed the full range of potential determinants of school health. Findings from the different study types were integrated to: build new theory for how schools affect health; suggest potential new avenues for intervention research; and refine logic models for interventions.