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Background: Societal changes have led to greater isolation and higher levels of loneliness particularly for older generations. Loneliness is a significant public health challenge leading to increased levels of poor mental health. Depression and anxiety are also increasing in prevalence amongst children and young people. Intergenerational activities are interventions designed to bring together older and younger generations with the purpose of allowing participants to utilise their experiences and skills, and to give participants a chance to experience the pleasure and excitement that occurs with the transmission of knowledge and skills from one generation to another. Intergenerational activities are therefore potential interventions that can address the growing problems associated with loneliness and lack of wellbeing. Objectives: This systematic review aims to examine the impact of intergenerational interventions on the wellbeing and mental health in children and adolescents, and potential harmful effects. It also aims to identify areas for future research as well as key messages for service commissioners. Search Methods: We searched an evidence and gap map published in 2022 (comprehensive searches conducted July 2021 and updated June 2023) to identify randomised controlled trials of intergenerational interventions that report mental health and wellbeing outcomes for children and young people. Selection Criteria: Randomised controlled trials of intergenerational interventions that involved unrelated younger and older people with at least one skipped generation between them and reported mental health or wellbeing outcomes for children and young people were included in this review. Data Collection and Analysis: We used standard methodological procedures expected by The Campbell Collaboration. We conducted data extraction and Cochrane risk of bias assessments in EPPI reviewer. Main Results: While we identified 500 evaluations of intergenerational interventions, where the impact on participating children and/or young people was evaluated this was most often limited to assessing their impact on attitudes to aging. We identified five studies evaluating five different types of intergenerational interventions which included one‐off sessions to ones that spanned a year measuring their impact on the mental health and wellbeing of children and/or young people. The purposes of the interventions differed, which included promoting social skills, preventing harmful behaviour and promoting learning. The ages of children also varied across the five studies, with one targeting younger children, two targeting younger teenagers and two targeting older teenagers. One study included socioeconomically disadvantaged children, and in the other studies the socioeconomic backgrounds of the children and young people were not described. The outcome measures used to evaluate the interventions varied with none of the studies measuring the same outcomes. One study showed improvements in wellbeing measures, and this was an intervention delivered to children in deprived neighbourhoods, where the intervention duration was for a year allowing the development of a greater depth of relationship between the younger and older participants. Four studies found no....... The included studies were at high risk of bias therefore raising uncertainty in the reliability of the findings. Underpinning theories that supported the development of the interventions and explained the mechanisms of effect were poorly described. Authors' Conclusions: The evidence for the effectiveness of intergenerational interventions on the mental health and wellbeing of children and young people is limited and inconclusive. Few evaluations have sought to measure how intergenerational interventions impact children and young people and where this impact is measured the focus is usually limited to attitudes to aging. The evidence that has been collected is too heterogenous to allow synthesis of the findings. The underpinning theories to support their development are poorly described with no follow‐up data to ascertain if benefits are maintained. Intergenerational interventions show promise but researchers have failed to measure how they impact on the mental health and wellbeing of children and young people. This is a serious limitation of the evidence base that needs to be addressed in robust and rigorous evaluations. [ABSTRACT FROM AUTHOR]

Summary: Background: Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic review and qualitative evidence synthesis of factors affecting adolescent and caregiver decision‐making processes around such interventions, as well as post‐surgery demands and challenges, so that their experiences might be better understood and improved support given. No previous qualitative evidence synthesis has been published on this topic. Methods and findings: We searched 10 bibliographic databases and followed‐up gray literature and citations sources. We performed a qualitative evidence synthesis on 19 primary qualitative research studies in adolescents aged 13 years or older. They reported diverse motivations and incentives for considering these interventions, including the physical and social problems resulting from living with obesity, and an awareness of the benefits and limitations of interventions. They reported that they need: information, physical and emotional support and, in some cases, financial assistance. There was high confidence in a majority of these findings (GRADE CERQual). Conclusions: We found that supportive interventions accompanying bariatric surgery should be in place to offer: practical help; address anxieties and uncertainties; and facilitate both appropriate decision‐making and the achievement of young people's desired outcomes. [ABSTRACT FROM AUTHOR]

Given that much of the data required to answer SWAR research questions is either generated during a review or can be collected with little effort, SWARs offer a potentially cost-effective approach to improving review processes. A resource-efficient way of conducting these evaluations is to undertake a Study Within A Review (SWAR). Where appropriate, the outcome of a SWAR may inform decisions within its host systematic review(s) A SWAR need not be prohibitively expensive. Keywords: study within a review; SWAR; systematic review; evidence synthesis EN study within a review SWAR systematic review evidence synthesis 328 332 5 01/03/23 20221201 NES 221201 Systematic reviews and other evidence syntheses bring together information from multiple studies to help inform policy and practice decisions. [Extracted from the article]

The purpose of the current article is to define critical appraisal, identify its benefits, discuss conceptual issues influencing the adequacy of a critical appraisal, and detail procedures to help reviewers undertake critical appraisals. A critical appraisal involves a careful and systematic assessment of a study's trustworthiness or methodological rigour, and contributes to assessing how confident people can be in the findings of a set of studies. To help reviewers include high quality critical appraisals in their articles, they can consider differences between quality and bias, the value of total quality scores, the advantages and disadvantages of standardized checklists, the relevance of the experimental hierarchy of evidence, the differences between critical appraisal tools and reporting standards, and the challenges involved in appraising qualitative research. The steps involved in a sound critical appraisal include: (a) identifying the study type(s) of the individual paper(s), (b) identifying appropriate criteria and checklist(s), (c) selecting an appropriate set of criteria and checklist, (d) performing the appraisal, and (e) summarizing and using the results. Although these steps apply to critical appraisals of both quantitative and qualitative research, they require reviewers to make and defend a number of decisions resulting from the subjective features involved in assessing research. [ABSTRACT FROM AUTHOR]

Background: Electroencephalographic (EEG) neurofeedback has been utilized to regulate abnormal brain activity associated with chronic pain. Methods: In this systematic review, we synthesized the evidence from randomized controlled trials (RCTs) to evaluate the effect of EEG neurofeedback on chronic pain using random effects meta‐analyses. Additionally, we performed a narrative review to explore the results of non‐randomized studies. The quality of included studies was assessed using Cochrane risk of bias tools, and the GRADE system was used to rate the certainty of evidence. Results: Ten RCTs and 13 non‐randomized studies were included. The primary meta‐analysis on nine eligible RCTs indicated that although there is low confidence, EEG neurofeedback may have a clinically meaningful effect on pain intensity in short‐term. Removing the studies with high risk of bias from the primary meta‐analysis resulted in moderate confidence that there remained a clinically meaningful effect on pain intensity. We could not draw any conclusion from the findings of non‐randomized studies, as they were mostly non‐comparative trials or explorative case series. However, the extracted data indicated that the neurofeedback protocols in both RCTs and non‐randomized studies mainly involved the conventional EEG neurofeedback approach, which targeted reinforcing either alpha or sensorimotor rhythms and suppressing theta and/or beta bands on one brain region at a time. A posthoc analysis of RCTs utilizing the conventional approach resulted in a clinically meaningful effect estimate for pain intensity. Conclusion: Although there is promising evidence on the analgesic effect of EEG neurofeedback, further studies with larger sample sizes and higher quality of evidence are required. [ABSTRACT FROM AUTHOR]

Background: Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. Methods: A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. Results: A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. Conclusions: The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way. [ABSTRACT FROM AUTHOR]

Aim To review published literature to identify when and how patients and healthcare practitioners have been involved in knowledge mobilization activity and the impact this may have had on their care. Background Improving patient outcomes, satisfaction and quality of care is increasingly reliant on shared decision-making between health professionals and patients. Knowledge mobilization, at its simplest: 'moving knowledge to where it can be most useful' is a growing field of academic study. To date, it appears that much effort has focused on moving knowledge from researchers to healthcare practitioners. Knowledge mobilization to patients is currently under-researched. Design Integrative review. Review Methods Methods of integrative review will be used to address the review problem. PRISMA guidelines were used as a general framework to guide structuring and reporting the review. Elements of method-specific reporting guidelines for specific streams of evidence will be used as required. Discussion This review will aim to provide a broad and deep understanding of patient-practitioner-researcher engagement in knowledge mobilization activity. This synthesis of the extant literature should offer insights into the optimum characteristics of methods for bridging patient-practitioner-researcher boundaries in knowledge mobilization action. [ABSTRACT FROM AUTHOR]

Background: More women experience depressive symptoms antenatally than postnatally. Supporting women through the antenatal period is recognised as important in mitigating negative outcomes and in preventing postnatal depression (PND). A systematic review was conducted which aimed to provide a detailed service user and service provider perspective on the uptake, acceptability, and perception of harms of antenatal interventions and postnatal interventions for preventing PND.Methods: A comprehensive literature search was conducted in 12 major bibliographic databases in November 2012 and updated in December 2014. Studies were included if they contained qualitative evidence on the perspectives and attitudes of pregnant women and postnatal women who had taken part in, or healthcare professionals (HCPs) involved in delivering, preventive interventions for PND.Results: Twenty-two studies were included. Support and empowerment through education were identified as particularly helpful to women as intervention components, across all intervention types. Implications for accessing the service, understanding the remit of the service and women's preferences for group and individual care also emerged.Limitations: The majority of the included studies were of moderate or low quality, which may result in a lack of rich data consistently across all studies, limiting to some degree interpretations that can be made.Conclusion: The synthesis demonstrated important considerations for devising new interventions or adapting existing interventions. Specifically, it is important that individual or group interventions are carefully tailored to women's needs or preferences and women are aware of the remit of the HCPs role to ensure they feel able to access the support required. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of complex interventions, as well as their success in reaching relevant populations, is critically influenced by their implementation in a given context. Current conceptual frameworks often fail to address context and implementation in an integrated way and, where addressed, they tend to focus on organisational context and are mostly concerned with specific health fields. Our objective was to develop a framework to facilitate the structured and comprehensive conceptualisation and assessment of context and implementation of complex interventions.Methods: The Context and Implementation of Complex Interventions (CICI) framework was developed in an iterative manner and underwent extensive application. An initial framework based on a scoping review was tested in rapid assessments, revealing inconsistencies with respect to the underlying concepts. Thus, pragmatic utility concept analysis was undertaken to advance the concepts of context and implementation. Based on these findings, the framework was revised and applied in several systematic reviews, one health technology assessment (HTA) and one applicability assessment of very different complex interventions. Lessons learnt from these applications and from peer review were incorporated, resulting in the CICI framework.Results: The CICI framework comprises three dimensions-context, implementation and setting-which interact with one another and with the intervention dimension. Context comprises seven domains (i.e., geographical, epidemiological, socio-cultural, socio-economic, ethical, legal, political); implementation consists of five domains (i.e., implementation theory, process, strategies, agents and outcomes); setting refers to the specific physical location, in which the intervention is put into practise. The intervention and the way it is implemented in a given setting and context can occur on a micro, meso and macro level. Tools to operationalise the framework comprise a checklist, data extraction tools for qualitative and quantitative reviews and a consultation guide for applicability assessments.Conclusions: The CICI framework addresses and graphically presents context, implementation and setting in an integrated way. It aims at simplifying and structuring complexity in order to advance our understanding of whether and how interventions work. The framework can be applied in systematic reviews and HTA as well as primary research and facilitate communication among teams of researchers and with various stakeholders. [ABSTRACT FROM AUTHOR]

The critical appraisal and quality assessment of primary research are key stages in systematic review and evidence synthesis. These processes are driven by the need to determine how far the primary research evidence, singly and collectively, should inform findings and, potentially, practice recommendations. Quality assessment of primary qualitative research remains a contested area. This article reviews recent developments in the field charting a perceptible shift from whether such quality assessment should be conducted to how it might be performed. It discusses the criteria that are used in the assessment of quality and how the findings of the process are used in synthesis. It argues that recent research indicates that sensitivity analysis offers one potentially useful means for advancing this controversial issue. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. This review sought to answer two questions: ‘Is the KTA Framework used in practice? And if so, how?’ Methods: This study is a citation analysis and systematic review. The index citation for the original paper was identified on three databases—Web of Science, Scopus and Google Scholar—with the facility for citation searching. Limitations of English language and year of publication 2006-June 2013 were set. A taxonomy categorising the continuum of usage was developed. Only studies applying the framework to implementation projects were included. Data were extracted and mapped against each phase of the framework for studies where it was integral to the implementation project. Results: The citation search yielded 1,787 records. A total of 1,057 titles and abstracts were screened. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. All ten described using the Action Cycle and seven referred to Knowledge Creation. The KTA Framework was enacted in different health care and academic settings with projects targeted at patients, the public, and nursing and allied health professionals. Conclusions: The KTA Framework is being used in practice with varying degrees of completeness. It is frequently cited, with usage ranging from simple attribution via a reference, through informing planning, to making an intellectual contribution. When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. Prevailing wisdom encourages the use of theories, models and conceptual frameworks, yet their application is less evident in practice. This may be an artefact of reporting, indicating that prospective, primary research is needed to explore the real value of the KTA Framework and similar tools. [ABSTRACT FROM AUTHOR]

Background: Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes.Method: This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work.Results: Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles.Conclusions: We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate. [ABSTRACT FROM AUTHOR]

Background: Following publication of the first worked example of the "best fit" method of evidence synthesis for the systematic review of qualitative evidence in this journal, the originators of the method identified a need to specify more fully some aspects of this particular derivative of framework synthesis. Methods and Results: We therefore present a second such worked example in which all techniques are defined and explained, and their appropriateness is assessed. Specified features of the method include the development of new techniques to identify theories in a systematic manner; the creation of an a priori framework for the synthesis; and the "testing" of the synthesis. An innovative combination of existing methods of quality assessment, analysis and synthesis is used to complete the process. This second worked example was a qualitative evidence synthesis of employees' views of workplace smoking cessation interventions, in which the "best fit"method was found to be practical and fit for purpose. Conclusions: The method is suited to producing context-specific conceptual models for describing or explaining the decision-making and health behaviours of patients and other groups. It offers a pragmatic means of conducting rapid qualitative evidence synthesis and generating programme theories relating to intervention effectiveness, which might be of relevance both to researchers and policy-makers. [ABSTRACT FROM AUTHOR]

scope a., booth a. & sutcliffe p. (2012) Women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression: a qualitative synthesis. Journal of Advanced Nursing 68(9), 1909-1919. Abstract Aim. This paper is a report of a systematic review that aimed to synthesize qualitative evidence relating to women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression. Background. Postnatal depression may occur in women following childbirth, resulting in a range of distressing symptoms such as sadness, fatigue, and feelings of inability to look after their baby. Women tend to prefer psychological interventions. However, access to individual psychological therapy is limited by cost, waiting times, and availability of therapists. Data sources. A comprehensive literature search was conducted in 17 major psychological, medical, health-related and health economics electronic bibliographic databases. Design. A qualitative evidence synthesis was conducted using thematic synthesis. Review methods. Databases were searched from 1966-January 2008. A total of 116 full papers were screened against the inclusion criteria. Included papers were quality assessed. The original review protocol was restricted to evidence on group cognitive behaviour therapy. However, due to the paucity of evidence, the inclusion criteria were broadened to include other group interventions. A thematic synthesis was undertaken of the data extracted from the included papers. Results. Six studies were included. Specific benefits were that treatment enabled women to develop better relationships with their baby and understand postnatal depression. Negative aspects of treatment included difficulties in applying cognitive behavioural techniques, and unfavourable social comparisons with other group members. Conclusions. Women have contrasting perceptions and experiences of group treatment. This suggests that greater attention should be focused on identifying those most likely to benefit from these treatments in a group environment. [ABSTRACT FROM AUTHOR]

Rationale Men have poorer health status and are less likely to attend health screening compared to women. Objective This systematic review presents current evidence on the barriers and facilitators to engaging men in health screening. Methods We included qualitative, quantitative and mixed-method studies identified through five electronic databases, contact with experts and reference mining. Two researchers selected and appraised the studies independently. Data extraction and synthesis were conducted using the ‘best fit’ framework synthesis method. Results 53 qualitative, 44 quantitative and 6 mixed-method studies were included. Factors influencing health screening uptake in men can be categorized into five domains: individual, social, health system, healthcare professional and screening procedure. The most commonly reported barriers are fear of getting the disease and low risk perception; for facilitators, they are perceived risk and benefits of screening. Male-dominant barriers include heterosexual -self-presentation, avoidance of femininity and lack of time. The partner's role is the most common male-dominant facilitator to screening. Conclusions This systematic review provides a comprehensive overview of barriers and facilitators to health screening in men including the male-dominant factors. The findings are particularly useful for clinicians, researchers and policy makers who are developing interventions and policies to increase screening uptake in men. [ABSTRACT FROM AUTHOR]