Driven by necessity in our own complex review, we developed alternative systematic ways of identi... more Driven by necessity in our own complex review, we developed alternative systematic ways of identifying relevant evidence where the key concepts are generally not focal to the primary studies' aims and are found across multiple disciplines-that is, hard-to-detect evidence. Specifically, we sought to identify evidence on community engagement in public health interventions that aim to reduce health inequalities. Our initial search strategy used text mining to identify synonyms for the concept 'community engagement'. We conducted a systematic search for reviews on public health interventions, supplemented by searches of trials databases. We then used information in the reviews' evidence tables to gather more information about the included studies than was evident in the primary…
Background Community engagement has been advanced as a promising way of improving health and redu... more Background Community engagement has been advanced as a promising way of improving health and reducing health inequalities; however, the approach is not yet supported by a strong evidence base. Objectives To undertake a multimethod systematic review which builds on the evidence that underpins the current UK guidance on community engagement; to identify theoretical models underpinning community engagement; to explore mechanisms and contexts through which communities are engaged; to identify community engagement approaches that are effective in reducing health inequalities, under what circumstances and for whom; and to determine the processes and costs associated with their implementation. Data sources Databases including the Cochrane Database of Systematic Reviews (CDSR), The Campbell Library, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) database, the NHS Economic Evaluation Database (NHS EED) and EPPI-Centre’s Trials Register of Promoting Health Interventions (TRoPHI) and Database of Promoting Health Effectiveness Reviews (DoPHER) were searched from 1990 to August 2011 for systematic reviews and primary studies. Trials evaluating community engagement interventions reporting health outcomes were included. Review methods Study eligibility criteria: published after 1990; outcome, economic, or process evaluation; intervention relevant to community engagement; written in English; measured and reported health or community outcomes, or presents cost, resource, or implementation data characterises study populations or reports differential impacts in terms of social determinants of health; conducted in an Organisation for Economic Co-operation and Development (OECD) country. Study appraisal: risk of bias for outcome evaluations; assessment of validity and relevance for process evaluations; comparison against an economic evaluation checklist for economic evaluations. Synthesis methods: four synthesis approaches were adopted for the different evidence types: theoretical, quantitative, process, and economic evidence. Results The theoretical synthesis identified key models of community engagement that are underpinned by different theories of changes. Results from 131 studies included in a meta-analysis indicate that there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. There is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. There are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours. There is weak evidence from the effectiveness and process evaluations that certain implementation factors may affect intervention success. From the economic analysis, there is weak but inconsistent evidence that community engagement interventions are cost-effective. By combining findings across the syntheses, we produced a new conceptual framework. Limitations Differences in the populations, intervention approaches and health outcomes made it difficult to pinpoint specific strategies for intervention effectiveness. The syntheses of process and economic evidence were limited by the small (generally not rigorous) evidence base. Conclusions Community engagement interventions are effective across a wide range of contexts and using a variety of mechanisms. Public health initiatives should incorporate community engagement into intervention design. Evaluations should place greater emphasis on long-term outcomes, outcomes for indirect beneficiaries, process evaluation, and reporting costs and resources data. The theories of change identified and the newly developed conceptual framework are useful tools for researchers and practitioners. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation. Funding The National Institute for Health Research Public Health Research programme.
To explore which conditions of community engagement are implicated in effective interventions tar... more To explore which conditions of community engagement are implicated in effective interventions targeting disadvantaged pregnant women and new mothers. Adaptive experiences during pregnancy and the early years are key to reducing health inequalities in women and children worldwide. Public health nurses, health visitors and community midwives are well placed to address such disadvantage, often using community engagement strategies. Such interventions are complex; however, and we need to better understand which aspects of community engagement are aligned with effectiveness. Qualitative comparative analysis conducted in 2013, of trials data included in a recently published systematic review. Two reviewers agreed on relevant conditions from 24 maternity or early years intervention studies examining four models of community engagement. Effect size estimates were converted into 'fuzzy' effectiveness categories and truth tables were constructed. Using fsQCA software, Boolean minimiza...
Background: Systematic reviews (SRs) of broad topics, especially in public health, can cover many... more Background: Systematic reviews (SRs) of broad topics, especially in public health, can cover many discipline areas. Exhaustive searching for such widely dispersed evidence can be costly, and different terminology used across disciplines hampers identification. A further complication arises when the review question’s focus is peripheral to the aims of the primary research, and therefore might not be referred to in the titles and abstracts of the primary studies. Such evidence is likely to be missed by conventional review methods, but there are no clear guidelines for systematic alternatives. Objectives: To demonstrate alternative systematic ways of identifying relevant evidence where the key concepts are of interest across various disciplines and are generally not focal to the primary studies’ aims. Specifically, we sought to identify evidence on community engagement in public health interventions to reduce health inequalities. <<Winner of the Thomas Chalmers Award for the best poster presentation addressing methodological issues related to systematic reviews presented by an early career researcher at the 20th Cochrane Colloquium.>>
BACKGROUND: The presence of health inequalities is one of the largest issues currently facing pub... more BACKGROUND: The presence of health inequalities is one of the largest issues currently facing public health policy making in developed countries. Interventions that engage the community in their design or delivery are thought more likely to address the specific needs of disadvantaged populations, and community engagement has consequently become central to guidance and strategies for promoting public health. We aimed to map the evidence on community engagement approaches to address health inequalities, with a focus on the ...
Systematic reviews of public health interventions are fraught with challenges. Complexity is inhe... more Systematic reviews of public health interventions are fraught with challenges. Complexity is inherent; this may be due to multi-component interventions, diverse study populations, multiple outcomes measured, mixed study designs utilized and the effect of context on intervention design, implementation and effectiveness. For policy makers and practitioners to use systematic reviews to implement effective public health programmes, systematic reviews must include this information, which seeks to answer the questions posed by decision makers, including recipients of programmes. This necessitates expanding the traditional evaluation of evidence to incorporate the assessment of theory, integrity of interventions, context and sustainability of the interventions and outcomes.
Journal of Epidemiology and Community Health, Jan 1, 2008
BACKGROUND:
Promoting walking and cycling as a part of everyday activity is seen as a strategy... more BACKGROUND:
Promoting walking and cycling as a part of everyday activity is seen as a strategy for tackling obesity and chronic disease. Policy needs to be based on evidence about people's views of walking and cycling as well as effects of interventions.
METHODS:
Studies of the views of children, young people and parents about walking and cycling were searched for systematically, and a framework analysis applied. The findings were synthesised and compared with the findings of an effectiveness review of interventions for encouraging walking and cycling as an alternative to motorised transport.
RESULTS:
The synthesis of views described a culture of car use, fed by a fear and dislike of local environments and parental responses that emphasised children's safety at the expense of developing their independence, despite children expressing responsible attitudes towards transport choices. Comparison with effectiveness literature found that most evaluated interventions targeted only the public's fear and dislike of local environments.
CONCLUSION:
Interventions need to address pedestrian and cyclist safety, perceptions of risk, and parental norms regarding children's independence.
... Thomas, James and Sutcliffe, Katy and Harden, Angela and Oakley, Ann and Oliver, Sandy and Re... more ... Thomas, James and Sutcliffe, Katy and Harden, Angela and Oakley, Ann and Oliver, Sandy and Rees, Rebecca and Brunton, Ginny and Kavanagh, Josephine (2005) The barriers to, and the facilitators of, healthy eating among children: findings from a systematic review. ...
Rees, Rebecca and Oliver, Sandy and Harden, Angela and Shepherd, Jonathan and Kavanagh, Josephine... more Rees, Rebecca and Oliver, Sandy and Harden, Angela and Shepherd, Jonathan and Kavanagh, Josephine and Burchett, Helen (2004) Use of an advisory group to ensure relevance: reflections on participation of stakeholders in a review of sexual health promotion for men who have sex with men (MSM). In: 12th Cochrane Colloquium: Bridging the gaps, 2-6 October 2004, Ottawa, Canada. ... Full text not available from this repository. ... Official URL: http://www.imbi.uni-freiburg.de/OJS/cca/index.php/... ... IOE EPrints is powered by ...
... Shepherd, Jonathan and Garcia, Jo and Oliver, Sandy and Harden, Angela and Rees, Rebecca and ... more ... Shepherd, Jonathan and Garcia, Jo and Oliver, Sandy and Harden, Angela and Rees, Rebecca and Brunton, Ginny and Oakley, Ann (2002) Barriers to, and facilitators of, the health of young people: a systematic review of evidence on young people's views and ... ID Code: 3713. ...
... This approach ignores the role of other factors associated with teenage pregnancy such as soc... more ... This approach ignores the role of other factors associated with teenage pregnancy such as social disadvantage and a lack of educational ... Young people, pregnancy and social exclusion: A systematic synthesis of research evidence to identify effective, appropriate and ...
Driven by necessity in our own complex review, we developed alternative systematic ways of identi... more Driven by necessity in our own complex review, we developed alternative systematic ways of identifying relevant evidence where the key concepts are generally not focal to the primary studies' aims and are found across multiple disciplines-that is, hard-to-detect evidence. Specifically, we sought to identify evidence on community engagement in public health interventions that aim to reduce health inequalities. Our initial search strategy used text mining to identify synonyms for the concept 'community engagement'. We conducted a systematic search for reviews on public health interventions, supplemented by searches of trials databases. We then used information in the reviews' evidence tables to gather more information about the included studies than was evident in the primary…
Background Community engagement has been advanced as a promising way of improving health and redu... more Background Community engagement has been advanced as a promising way of improving health and reducing health inequalities; however, the approach is not yet supported by a strong evidence base. Objectives To undertake a multimethod systematic review which builds on the evidence that underpins the current UK guidance on community engagement; to identify theoretical models underpinning community engagement; to explore mechanisms and contexts through which communities are engaged; to identify community engagement approaches that are effective in reducing health inequalities, under what circumstances and for whom; and to determine the processes and costs associated with their implementation. Data sources Databases including the Cochrane Database of Systematic Reviews (CDSR), The Campbell Library, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) database, the NHS Economic Evaluation Database (NHS EED) and EPPI-Centre’s Trials Register of Promoting Health Interventions (TRoPHI) and Database of Promoting Health Effectiveness Reviews (DoPHER) were searched from 1990 to August 2011 for systematic reviews and primary studies. Trials evaluating community engagement interventions reporting health outcomes were included. Review methods Study eligibility criteria: published after 1990; outcome, economic, or process evaluation; intervention relevant to community engagement; written in English; measured and reported health or community outcomes, or presents cost, resource, or implementation data characterises study populations or reports differential impacts in terms of social determinants of health; conducted in an Organisation for Economic Co-operation and Development (OECD) country. Study appraisal: risk of bias for outcome evaluations; assessment of validity and relevance for process evaluations; comparison against an economic evaluation checklist for economic evaluations. Synthesis methods: four synthesis approaches were adopted for the different evidence types: theoretical, quantitative, process, and economic evidence. Results The theoretical synthesis identified key models of community engagement that are underpinned by different theories of changes. Results from 131 studies included in a meta-analysis indicate that there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. There is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. There are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours. There is weak evidence from the effectiveness and process evaluations that certain implementation factors may affect intervention success. From the economic analysis, there is weak but inconsistent evidence that community engagement interventions are cost-effective. By combining findings across the syntheses, we produced a new conceptual framework. Limitations Differences in the populations, intervention approaches and health outcomes made it difficult to pinpoint specific strategies for intervention effectiveness. The syntheses of process and economic evidence were limited by the small (generally not rigorous) evidence base. Conclusions Community engagement interventions are effective across a wide range of contexts and using a variety of mechanisms. Public health initiatives should incorporate community engagement into intervention design. Evaluations should place greater emphasis on long-term outcomes, outcomes for indirect beneficiaries, process evaluation, and reporting costs and resources data. The theories of change identified and the newly developed conceptual framework are useful tools for researchers and practitioners. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation. Funding The National Institute for Health Research Public Health Research programme.
To explore which conditions of community engagement are implicated in effective interventions tar... more To explore which conditions of community engagement are implicated in effective interventions targeting disadvantaged pregnant women and new mothers. Adaptive experiences during pregnancy and the early years are key to reducing health inequalities in women and children worldwide. Public health nurses, health visitors and community midwives are well placed to address such disadvantage, often using community engagement strategies. Such interventions are complex; however, and we need to better understand which aspects of community engagement are aligned with effectiveness. Qualitative comparative analysis conducted in 2013, of trials data included in a recently published systematic review. Two reviewers agreed on relevant conditions from 24 maternity or early years intervention studies examining four models of community engagement. Effect size estimates were converted into 'fuzzy' effectiveness categories and truth tables were constructed. Using fsQCA software, Boolean minimiza...
Background: Systematic reviews (SRs) of broad topics, especially in public health, can cover many... more Background: Systematic reviews (SRs) of broad topics, especially in public health, can cover many discipline areas. Exhaustive searching for such widely dispersed evidence can be costly, and different terminology used across disciplines hampers identification. A further complication arises when the review question’s focus is peripheral to the aims of the primary research, and therefore might not be referred to in the titles and abstracts of the primary studies. Such evidence is likely to be missed by conventional review methods, but there are no clear guidelines for systematic alternatives. Objectives: To demonstrate alternative systematic ways of identifying relevant evidence where the key concepts are of interest across various disciplines and are generally not focal to the primary studies’ aims. Specifically, we sought to identify evidence on community engagement in public health interventions to reduce health inequalities. <<Winner of the Thomas Chalmers Award for the best poster presentation addressing methodological issues related to systematic reviews presented by an early career researcher at the 20th Cochrane Colloquium.>>
BACKGROUND: The presence of health inequalities is one of the largest issues currently facing pub... more BACKGROUND: The presence of health inequalities is one of the largest issues currently facing public health policy making in developed countries. Interventions that engage the community in their design or delivery are thought more likely to address the specific needs of disadvantaged populations, and community engagement has consequently become central to guidance and strategies for promoting public health. We aimed to map the evidence on community engagement approaches to address health inequalities, with a focus on the ...
Systematic reviews of public health interventions are fraught with challenges. Complexity is inhe... more Systematic reviews of public health interventions are fraught with challenges. Complexity is inherent; this may be due to multi-component interventions, diverse study populations, multiple outcomes measured, mixed study designs utilized and the effect of context on intervention design, implementation and effectiveness. For policy makers and practitioners to use systematic reviews to implement effective public health programmes, systematic reviews must include this information, which seeks to answer the questions posed by decision makers, including recipients of programmes. This necessitates expanding the traditional evaluation of evidence to incorporate the assessment of theory, integrity of interventions, context and sustainability of the interventions and outcomes.
Journal of Epidemiology and Community Health, Jan 1, 2008
BACKGROUND:
Promoting walking and cycling as a part of everyday activity is seen as a strategy... more BACKGROUND:
Promoting walking and cycling as a part of everyday activity is seen as a strategy for tackling obesity and chronic disease. Policy needs to be based on evidence about people's views of walking and cycling as well as effects of interventions.
METHODS:
Studies of the views of children, young people and parents about walking and cycling were searched for systematically, and a framework analysis applied. The findings were synthesised and compared with the findings of an effectiveness review of interventions for encouraging walking and cycling as an alternative to motorised transport.
RESULTS:
The synthesis of views described a culture of car use, fed by a fear and dislike of local environments and parental responses that emphasised children's safety at the expense of developing their independence, despite children expressing responsible attitudes towards transport choices. Comparison with effectiveness literature found that most evaluated interventions targeted only the public's fear and dislike of local environments.
CONCLUSION:
Interventions need to address pedestrian and cyclist safety, perceptions of risk, and parental norms regarding children's independence.
... Thomas, James and Sutcliffe, Katy and Harden, Angela and Oakley, Ann and Oliver, Sandy and Re... more ... Thomas, James and Sutcliffe, Katy and Harden, Angela and Oakley, Ann and Oliver, Sandy and Rees, Rebecca and Brunton, Ginny and Kavanagh, Josephine (2005) The barriers to, and the facilitators of, healthy eating among children: findings from a systematic review. ...
Rees, Rebecca and Oliver, Sandy and Harden, Angela and Shepherd, Jonathan and Kavanagh, Josephine... more Rees, Rebecca and Oliver, Sandy and Harden, Angela and Shepherd, Jonathan and Kavanagh, Josephine and Burchett, Helen (2004) Use of an advisory group to ensure relevance: reflections on participation of stakeholders in a review of sexual health promotion for men who have sex with men (MSM). In: 12th Cochrane Colloquium: Bridging the gaps, 2-6 October 2004, Ottawa, Canada. ... Full text not available from this repository. ... Official URL: http://www.imbi.uni-freiburg.de/OJS/cca/index.php/... ... IOE EPrints is powered by ...
... Shepherd, Jonathan and Garcia, Jo and Oliver, Sandy and Harden, Angela and Rees, Rebecca and ... more ... Shepherd, Jonathan and Garcia, Jo and Oliver, Sandy and Harden, Angela and Rees, Rebecca and Brunton, Ginny and Oakley, Ann (2002) Barriers to, and facilitators of, the health of young people: a systematic review of evidence on young people's views and ... ID Code: 3713. ...
... This approach ignores the role of other factors associated with teenage pregnancy such as soc... more ... This approach ignores the role of other factors associated with teenage pregnancy such as social disadvantage and a lack of educational ... Young people, pregnancy and social exclusion: A systematic synthesis of research evidence to identify effective, appropriate and ...
... Brunton, Ginny and Oliver, Sandy and Oliver, Kathryn and Lorenc, Theo (2006) A synthesis of r... more ... Brunton, Ginny and Oliver, Sandy and Oliver, Kathryn and Lorenc, Theo (2006) A synthesis of research addressing children's young people's and parents' views of walking and cycling for transport. ... Departments: Departments > Social Science Research Unit. ID Code: 5113. ...
Background: Scoping reviews differ from systematic reviews in that they are limited to a prelimin... more Background: Scoping reviews differ from systematic reviews in that they are limited to a preliminary assessment of the potential scope and size of the relevant research literature, and indicate potential research gaps. They are often conducted on the title and abstract level, and describe different aspects of the research literature, for example, study design, population, intervention elements and outcomes. The EPPI-Centre conducted two such scoping reviews for the Department of Health in England. Objectives: To assess the value of automated clustering using text mining to provide rapid descriptive codes across a range of study characteristics in order to generate themes across research records. Methods: Studies included in two public health-related systematic scoping reviews that have previously been coded by researchers across a range of characteristics at the title and abstract level were uploaded to the text mining software. The clustering function was employed to generate descriptive codes for all research records. Comparisons were made between the automated and researcher-assigned codes. Results: Preliminary results indicate clustering can be useful in describing literature for scoping reviews thematically in terms of topic focus, population groups and well-described study designs. Researcher input and knowledge of the literature enhances the usefulness in application. Optimal use of the function is a combination of researcher checking and reassigning ambiguous codes, variation of the minimum word length for clustering (longer descriptive labels result in smaller, more focused clusters) and undertaking manual free-text searches in conjunction with cluster-assigned codes. Conclusions: Clustering is a promising tool in contributing to rapid scoping reviews, although there are limitations owing to the diverse terminology used in describing public health literature.
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Papers by Ginny Brunton
Promoting walking and cycling as a part of everyday activity is seen as a strategy for tackling obesity and chronic disease. Policy needs to be based on evidence about people's views of walking and cycling as well as effects of interventions.
METHODS:
Studies of the views of children, young people and parents about walking and cycling were searched for systematically, and a framework analysis applied. The findings were synthesised and compared with the findings of an effectiveness review of interventions for encouraging walking and cycling as an alternative to motorised transport.
RESULTS:
The synthesis of views described a culture of car use, fed by a fear and dislike of local environments and parental responses that emphasised children's safety at the expense of developing their independence, despite children expressing responsible attitudes towards transport choices. Comparison with effectiveness literature found that most evaluated interventions targeted only the public's fear and dislike of local environments.
CONCLUSION:
Interventions need to address pedestrian and cyclist safety, perceptions of risk, and parental norms regarding children's independence.
Promoting walking and cycling as a part of everyday activity is seen as a strategy for tackling obesity and chronic disease. Policy needs to be based on evidence about people's views of walking and cycling as well as effects of interventions.
METHODS:
Studies of the views of children, young people and parents about walking and cycling were searched for systematically, and a framework analysis applied. The findings were synthesised and compared with the findings of an effectiveness review of interventions for encouraging walking and cycling as an alternative to motorised transport.
RESULTS:
The synthesis of views described a culture of car use, fed by a fear and dislike of local environments and parental responses that emphasised children's safety at the expense of developing their independence, despite children expressing responsible attitudes towards transport choices. Comparison with effectiveness literature found that most evaluated interventions targeted only the public's fear and dislike of local environments.
CONCLUSION:
Interventions need to address pedestrian and cyclist safety, perceptions of risk, and parental norms regarding children's independence.