Article type
Year
Abstract
Background: Schools have been identified as effective sites for the delivery of asthma self-management education, as they are environments commonly associated with the learning of new skills. However, ‘school age’ spans a wide spectrum of child developmental stages, and represents different pedagogical needs, as well as responses to self-management education. Understanding the effectiveness and implementation processes of school-based interventions and their interaction with context is essential to develop mechanistic theories of whether and why interventions work.
Objectives: This review synthesises evidence from both effectiveness and implementation literature in order to produce meaningful evidence for the design of a future intervention.
Methods: We use a logic model to conceptualise components of implementation and indicators of effectiveness simultaneously. We examine the results from process evaluation studies to understand the factors associated with successful interventions using Qualitative Comparative Analysis (QCA). Analyses of intervention effectiveness are undertaken using standard meta-analysis techniques. We bridge the gap between implementation and effectiveness using the evidence from QCA to conduct further subgroup analyses in our meta-analysis.
Results: We structure the results of this presentation through focussing on four main areas of reflection around: 1) the utility of logic models in bridging diverse bodies of literature; 2) the challenges of identifying and engaging with process evaluation literature in systematic reviews; 3) the methods employed for integrating findings from QCA data into meta-analysis; and 4) the added value of the approach in providing evidence for the design of an asthma education trial.
Conclusions: Mixed-methods reviews are a necessary development in order to address questions arising from decision-makers beyond ‘what works’. The results of this review demonstrate the feasibility of the approach and methods employed, but also highlight areas lacking methodological guidance, particularly around the identification and appraisal of process evaluation literature.
Objectives: This review synthesises evidence from both effectiveness and implementation literature in order to produce meaningful evidence for the design of a future intervention.
Methods: We use a logic model to conceptualise components of implementation and indicators of effectiveness simultaneously. We examine the results from process evaluation studies to understand the factors associated with successful interventions using Qualitative Comparative Analysis (QCA). Analyses of intervention effectiveness are undertaken using standard meta-analysis techniques. We bridge the gap between implementation and effectiveness using the evidence from QCA to conduct further subgroup analyses in our meta-analysis.
Results: We structure the results of this presentation through focussing on four main areas of reflection around: 1) the utility of logic models in bridging diverse bodies of literature; 2) the challenges of identifying and engaging with process evaluation literature in systematic reviews; 3) the methods employed for integrating findings from QCA data into meta-analysis; and 4) the added value of the approach in providing evidence for the design of an asthma education trial.
Conclusions: Mixed-methods reviews are a necessary development in order to address questions arising from decision-makers beyond ‘what works’. The results of this review demonstrate the feasibility of the approach and methods employed, but also highlight areas lacking methodological guidance, particularly around the identification and appraisal of process evaluation literature.