Users’ experience of frameworks to support evidence-informed
decision-making in public health is positive, but still limited

Poster
2024 Prague [Global Evidence Summit]
Bracchiglione J1, Song Y2, Meneses-Echávez J3, De Carvalho Gomes H4, Albiger B4, Solà I5, Rigau D5, Alonso-Coello P1
1Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (ir Sant Pau), Ciberesp, Barcelona, Spain, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
2Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (ir Sant Pau), Ciberesp, Barcelona, Spain, Barcelona, Spain; School of Medicine, Chinese University of Hong Kong, Shenzhen, China
3Facultad de Cultura Física, Deporte, y Recreación. Universidad Santo Tomás, Bogotá, Colombia; Norwegian Institute of Public Health, Oslo, Norway
4European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
5Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (ir Sant Pau), Ciberesp, Barcelona, Spain, Barcelona, Spain

Background:

Evidence-informed decision-making (EIDM) in public health (PH) is a complex process. Evidence-to-decision (EtD) frameworks are structured processes aiming to improve decision-making by explicitly considering critical criteria, but their use has not been systematically synthesised.

Objectives:

To summarise users’ experiences of EtD frameworks for PH decisions.

Methods:

As part of a scoping review, we identified 15 EtD frameworks for PH decision-making. We searched MEDLINE and Health Systems Evidence, conducted a hand-search and citation search for documents reporting the experience of EtD frameworks’ users. Two reviewers conducted selection of studies and data extraction. We also surveyed key stakeholders regarding their experience with any of the identified frameworks. We conducted a descriptive thematic synthesis, identifying main barriers and facilitators.

Results:

We identified 12 studies reporting users’ experience for only two of the 15 previously identified frameworks: GRADE-EtD (n=9) and WHO-INTEGRATE (n=3). Both frameworks were perceived as structured approaches that enhanced the use of evidence, the consideration of contextual factors, and consensus-building processes. Main barriers were related to lack of high quality evidence for the effectiveness of PH interventions, limitations of the terminology or unclear boundaries between specific criteria, perceptions of missing criteria, and insuficient guidance. Survey responders (n=13) expressed concerns about the appropriateness of the framework for the PH field, mainly due to the challenge of dealing with a lack of evidence, a mismatch between the framework’s criteria and panel discussions, and the knowledge and resources needed.

Conclusions:

Users of GRADE-EtD and WHO-INTEGRATE frameworks have an overall positive perception of these frameworks, but several barriers remain. These experiences may change over time, as these frameworks continually evolve. There is an important evidence gap regarding users’ experience for other EtD frameworks.