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Lei R, Shen Q, Yang B, Hou T, Liu H, Luo X, Li Y, Zhang J, Norris SL, Chen Y. Core Outcome Sets in Child Health: A Systematic Review. JAMA Pediatr 2022; 176:1131-1141. [PMID: 36094597 DOI: 10.1001/jamapediatrics.2022.3181] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Developing core outcome sets is essential to ensure that results of clinical trials are comparable and useful. A number of core outcome sets in pediatrics have been published, but a comprehensive in-depth understanding of core outcome sets in this field is lacking. OBJECTIVE To systematically identify core outcome sets in child health, collate the diseases to which core outcome sets have been applied, describe the methods used for development and stakeholder participation, and evaluate the methodological quality of existing core outcome sets. EVIDENCE REVIEW MEDLINE, SCOPUS, Cochrane Library, and CINAHL were searched using relevant search terms, such as clinical trials, core outcome, and children, along with relevant websites, such as Core Outcome Measures in Effectiveness Trials (COMET). Four researchers worked in teams of 2, performed literature screening and data extraction, and evaluated the methodological quality of core outcome sets using the Core Outcome Set-Standards for Development (COS-STAD). FINDINGS A total of 77 pediatric core outcome sets were identified, mainly developed by organizations or researchers in Europe, North America, and Australia and mostly from the UK (22 [29%]) and the US (22 [29%]). A total of 77 conditions were addressed; the most frequent International Classification of Diseases, 11th Revision category was diseases of the digestive system (14 [18%]). Most of the outcomes in pediatric core outcome sets were unordered (34 [44%]) or presented in custom classifications (29 [38%]). Core outcome sets used 1 or more of 8 development methods; the most frequent combination of methods was systematic review/literature review/scoping review, together with the Delphi approach and consensus for decision-making (10 [14%]). Among the 6 main types of stakeholders, clinical experts were the most frequently involved (74 [100%]), while industry representatives were rarely involved (4 [5%]). Only 6 core outcome sets (8%) met the 12 criteria of COS-STAD. CONCLUSIONS AND RELEVANCE Future quality of pediatric core outcome sets should be improved based on the standards proposed by the COMET initiative, while core outcome sets methodology and reporting standards should be extended to pediatric populations to help improve the quality of core outcome sets in child health. In addition, the COMET outcome taxonomy should also add items applicable to children.
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Affiliation(s)
- Ruobing Lei
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Quan Shen
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Bo Yang
- Shapingba District Center for Disease Control and Prevention of Chongqing, Chongqing, China
| | - Tianchun Hou
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuehuan Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | | | - Yaolong Chen
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China.,Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
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Hoang HT, Nguyen XTK, Huynh SV, Hua TD, Tran HTT, Tran-Chi VL. The effect of vaccination beliefs regarding vaccination benefits and COVID-19 fear on the number of vaccination injections. Front Psychol 2022; 13:968902. [PMID: 36337543 PMCID: PMC9627305 DOI: 10.3389/fpsyg.2022.968902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
The Coronavirus disease pandemic of 2019 is a vast worldwide public health hazard, impacting people of all ages and socioeconomic statuses. Vaccination is one of the most effective methods of controlling a pandemic like COVID-19. This study aims to investigate the relationship between the number of vaccination injections and fear of COVID-19 and test whether beliefs benefit from vaccination COVID-19 mediate the effect of fear of COVID-19 on the number of vaccination injections. A total of 649 Vietnamese adults were enrolled online to finish answering, including scales The Health Belief Model (HBM) and The Fear of COVID-19 (FCV-19S), consisting of 340 (52.4%) males and 309 (47.6%) females. The data were analyzed using variance, regression, and a simple mediation model. The total score of COVID-19 fear was M = 22.26, SD = 5.49. Vietnamese fear of COVID-19 was at a medium level. Our results suggest that 18- to 20-year-olds are more fearful of COVID-19 than others. People who received the first dosage exhibited a greater fear of COVID-19 than those who received the second dose and were not inoculated. Additionally, the beliefs benefit of vaccination COVID-19 has a role in the relationship between the number of vaccination injections and fear of COVID-19. During the pandemic, adults in Vietnam are more afraid of COVID-19 than during prior outbreaks. Besides, the Vietnamese populace demonstrated a considerable demand for and high acceptability of the COVID-19 vaccine. The current study indicates that psychological counselors and therapists should counsel clients on the value of vaccination and address the fear of COVID-19 as public understanding of the benefits of vaccines increases. To further clarify the effect of this issue on the correlation between fear of COVID-19 and the number of vaccinations, the results of this study indicate that the existing vaccine communication factor for COVID-19 vaccination should be modified to increase confidence in the benefits of immunization.
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Affiliation(s)
- Hai The Hoang
- Faculty of Psychology and Education, The University of Danang, University of Science and Education, Danang, Vietnam
| | - Xuan Thanh Kieu Nguyen
- Faculty of Social Sciences and Public Relations, HUTECH University, Ho Chi Minh City, Vietnam
| | - Son Van Huynh
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Thuy Doan Hua
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Hien Thi Thuy Tran
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
| | - Vinh-Long Tran-Chi
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh City, Vietnam
- *Correspondence: Vinh-Long Tran-Chi
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Rauh LD, Lathan HS, Masiello MM, Ratzan SC, Parker RM. A Select Bibliography of Actions to Promote Vaccine Literacy: A Resource for Health Communication. JOURNAL OF HEALTH COMMUNICATION 2020; 25:843-858. [PMID: 33719890 DOI: 10.1080/10810730.2021.1878312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this bibliography, the researchers provide an introduction to the available evidence base of actions to promote vaccine literacy. The research team organized interventions to create a tool that can inform health communicators and practitioners seeking a resource focused on strategy and implementation design for actions that support vaccine literacy. This scoping bibliography is honed specifically to respond to the urgency of the current pandemic, when supporting and increasing vaccine literacy offers promise for achieving the critically needed high levels of vaccination. Over the course of the coming months and year, this bibliography will be a dynamic and "living" document hosted and maintained on vaccineliteracy.com.
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Affiliation(s)
- Lauren D Rauh
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Hannah S Lathan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | | | - Scott C Ratzan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Ruth M Parker
- Division of General Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Kaufman J, Ryan R, Betsch C, Parkhill A, Shapiro G, Leask J, Menning L, Tugwell P, Costa DS, Danchin M, Rada G, Hill S. Instruments that measure psychosocial factors related to vaccination: a scoping review protocol. BMJ Open 2019; 9:e033938. [PMID: 31822547 PMCID: PMC6924734 DOI: 10.1136/bmjopen-2019-033938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/16/2019] [Accepted: 11/18/2019] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION As vaccine-preventable disease outbreaks increase, there is growing international interest in monitoring public attitudes towards vaccination and implementing and evaluating vaccine promotion interventions. Outcome selection and measurement are central to intervention evaluation. Measuring uptake rates alone cannot determine which elements in a multicomponent vaccine-promotion intervention are most effective, why specific populations are undervaccinated or when confidence in vaccines is wavering. To develop targeted and cost-effective interventions and policies, it is necessary to measure vaccination-related psychosocial factors such as knowledge, attitudes and aspects of decision-making. This scoping review aims to identify, compare and summarise the properties and validation of instruments for measuring vaccination-related psychosocial factors and identify gaps where no instruments exist. METHODS AND ANALYSIS We will search Medline OVID, Embase OVID, CINAHL and PsycINFO with no date restriction, using a pilot-tested search strategy of terms related to vaccination: knowledge, attitudes, trust, acceptance and decision-making and measurement, psychometric testing or validation. This search will be supplemented with manual search and expert consultation. We will include studies that describe instrument development, adaptation or testing and include evaluation of at least two measurement properties (eg, content, criterion, or construct validity; test-retest reliability; internal consistency; sensitivity; responsiveness). Instruments measuring a vaccination-related psychosocial factor in any population will be included. All studies will be screened by one reviewer, with a sample double-screened to confirm accuracy. Disagreements will be resolved with a third reviewer. Data will be synthesised narratively and through summary tables to chart and compare instrument characteristics such as factors measured, date and/or location of development or validation, measurement properties evaluated and population. ETHICS AND DISSEMINATION This scoping review aims to provide an overview of existing instruments and ascertain measurement gaps where no measurement instruments currently exist. The identified instruments will form the basis of an open-access online repository of instruments.
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Affiliation(s)
- Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Cornelia Betsch
- Health Communication, Faculty of Philosophy, University of Erfurt, Erfurt, Germany
| | - Anne Parkhill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Gilla Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Julie Leask
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Nursing, University of Sydney, Camperdown, New South Wales, Australia
| | - Lisa Menning
- Immunization, Vaccines and Biologicals, World Health Organization, Geneve, GE, Switzerland
| | - Peter Tugwell
- Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Sj Costa
- Pain Management Research Institute, The University of Sydney, St Leonards, New South Wales, Australia
| | - Margaret Danchin
- Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Gabriel Rada
- Evidence-Based Healthcare Program, Pontificia Universidad Católica de Chile, Santiago, Chile
- Epistemonikos, Santiago, Chile
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
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Dreesens D, Stiggelbout A, Agoritsas T, Elwyn G, Flottorp S, Grimshaw J, Kremer L, Santesso N, Stacey D, Treweek S, Armstrong M, Gagliardi A, Hill S, Légaré F, Ryan R, Vandvik P, van der Weijden T. A conceptual framework for patient-directed knowledge tools to support patient-centred care: Results from an evidence-informed consensus meeting. PATIENT EDUCATION AND COUNSELING 2019; 102:1898-1904. [PMID: 31118137 DOI: 10.1016/j.pec.2019.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/01/2019] [Accepted: 05/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Patient-directed knowledge tools are designed to engage patients in dialogue or deliberation, to support patient decision-making or self-care of chronic conditions. However, an abundance of these exists. The tools themselves and their purposes are not always clearly defined; creating challenges for developers and users (professionals, patients). The study's aim was to develop a conceptual framework of patient-directed knowledge tool types. METHODS A face-to-face evidence-informed consensus meeting with 15 international experts. After the meeting, the framework went through two rounds of feedback before informal consensus was reached. RESULTS A conceptual framework containing five patient-directed knowledge tool types was developed. The first part of the framework describes the tools' purposes and the second focuses on the tools' core elements. CONCLUSION The framework provides clarity on which types of patient-directed tools exist, the purposes they serve, and which core elements they prototypically include. It is a working framework and will require further refinement as the area develops, alongside validation with a broader group of stakeholders. PRACTICE IMPLICATIONS The framework assists developers and users to know which type a tool belongs, its purpose and core elements, helping them to develop and use the right tool for the right job.
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Affiliation(s)
- Dunja Dreesens
- Knowledge Institute of Medical Specialists, Utrecht, the Netherlands; Department of Family Medicine, Maastricht University/School CAPHRI, Maastricht, the Netherlands.
| | - Anne Stiggelbout
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Thomas Agoritsas
- Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, USA.
| | - Signe Flottorp
- Division of health services, Norwegian Institute of Public Health, Oslo, Norway; Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
| | - Jeremy Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
| | - Leontien Kremer
- Department Pediatrics, University of Amsterdam, Amsterdam, the Netherlands; Princess Maxima Centrum for Pediatric Oncology, Utrecht, the Netherlands.
| | - Nancy Santesso
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada.
| | - Dawn Stacey
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Nursing, University of Ottawa, Ottawa, Canada.
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
| | - Melissa Armstrong
- Department of Neurology, College of Medicine / University of Florida, Gainesville, USA.
| | - Anna Gagliardi
- University Health Network/Toronto General Hospital Research Institute, Toronto, Canada.
| | - Sophie Hill
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Australia; Cochrane Consumers and Communication Group, La Trobe University, Melbourne, Australia.
| | | | - Rebecca Ryan
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Australia; Cochrane Consumers and Communication Group, La Trobe University, Melbourne, Australia.
| | - Per Vandvik
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
| | - Trudy van der Weijden
- Department of Family Medicine, Maastricht University/School CAPHRI, Maastricht, the Netherlands.
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Ryan R, Hill S. Supporting implementation of Cochrane methods in complex communication reviews: resources developed and lessons learned for editorial practice and policy. Health Res Policy Syst 2019; 17:32. [PMID: 30922338 PMCID: PMC6437949 DOI: 10.1186/s12961-019-0435-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/10/2019] [Indexed: 12/23/2022] Open
Abstract
Every healthcare encounter involves some form of communication and there is growing recognition that effective health communication is central to the delivery of safe, high-quality healthcare. Conversely, poor communication has a range of adverse consequences for those receiving healthcare and the systems delivering care, including elevated patient safety risks. Increasing understanding and documentation of the key role that good communication plays in healthcare design and delivery has meant there is growing demand from policy-makers and other decision-makers for evidence on the effects of health communication interventions - that is, how best to communicate. While systematic reviews of such interventions are fundamental to building this evidence base, such interventions and reviews are often highly complex and pose considerable challenges for authors and editors. In this paper, we describe our experience as a Cochrane editorial group identifying common issues in reviews of communication interventions and developing resources to support authors to better meet these challenges. Our analysis found that issues typically fell into one or more of the following three stages of the review process: understanding and applying systematic review methods (e.g. selecting outcomes for analysis); reporting the review's methods (e.g. describing key decisions made in conducting the review); and interpreting the findings (e.g. incorporating quality of the evidence into findings of the review). We also found that common issues reflected both practical difficulties (such as the typically large size of reviews and disparate measures for outcomes) and conceptual challenges (for instance, the difficulties of identifying comparisons). While extensive advice for Cochrane systematic reviewers exists, this standardised advice does not cover all of the issues emerging for complex communication reviews. In response, we therefore developed a collection of resources, both general and targeted to specific methodological issues. Here, we describe the types of resources developed and the aims of these, the rationale for why we needed to fill specific gaps in existing advice, and reflect on the lessons for future editorial practice, policies and research in relation to the implementation of Cochrane review methods in the area of health communication.
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Affiliation(s)
- Rebecca Ryan
- Cochrane Consumers and Communication Group, Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
| | - Sophie Hill
- Cochrane Consumers and Communication Group, Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
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Gorst SL, Young B, Williamson PR, Wilding JPH, Harman NL. Incorporating patients' perspectives into the initial stages of core outcome set development: a rapid review of qualitative studies of type 2 diabetes. BMJ Open Diabetes Res Care 2019; 7:e000615. [PMID: 30899531 PMCID: PMC6398822 DOI: 10.1136/bmjdrc-2018-000615] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/29/2019] [Indexed: 01/08/2023] Open
Abstract
Conducting systematic reviews of qualitative studies to incorporate patient perspectives within the early stages of core outcome set (COS) development can be resource intensive. We aimed to identify an expedited approach to be used as part of the wider COS development process. Specifically, we undertook a rapid review of qualitative studies of patients' views and experiences of type 2 diabetes. We searched MEDLINE from inception to June 2017 to identify studies reporting qualitative empirical findings of perspectives of people with type 2 diabetes. Qualitative methodological filters were used to minimize irrelevant references. Drawing on content analysis, data synthesis involved identifying text in eligible studies relevant to outcomes of type 2 diabetes and interpreting and categorizing this according to the 38 core domains of the Core Outcome Measures in Effectiveness Trials taxonomy. Of 146 studies screened, 26 were included. Four hundred and fifty-eight outcomes were derived from the included studies. In comparison to the outcomes extracted from clinical trials, more life impact outcomes were derived from the qualitative studies, but fewer physiological/clinical outcomes. Outcomes relating to 'mortality/survival' and 'role functioning' were more prevalent in studies conducted in low/middle-income countries. This rapid review and synthesis of qualitative studies identified outcomes that had not previously been identified by a systematic review of clinical trials. It also identified differences in the types of outcomes given prominence to in the clinical trials and qualitative literatures. Incorporating qualitative evidence on patient perspectives from the outset of the COS development process can help to ensure outcomes that matter to patients are not overlooked. Our method provides a pragmatic and resource-efficient way to do this. For those developing international COS, our method has potential for incorporating the perspectives of patients from diverse countries in the early stages of COS development.
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Affiliation(s)
- Sarah L Gorst
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Bridget Young
- MRC North West Hub for Trials Methodology Research, Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - John P H Wilding
- Obesity and Endocrinology Clinical Research Group, University of Liverpool and Aintree University Hospital, Liverpool, UK
| | - Nicola L Harman
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
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Qualitative focus groups with stakeholders identify new potential outcomes related to vaccination communication. PLoS One 2018; 13:e0201145. [PMID: 30067802 PMCID: PMC6070264 DOI: 10.1371/journal.pone.0201145] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/09/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Communication interventions are widely used to promote childhood vaccination and sustain vaccine acceptance, but communication’s role in changing people’s beliefs and behaviours is not well understood. To determine why these interventions work or where they fail, evaluations must measure a range of outcomes in addition to vaccination uptake. As part of a larger project to develop a preliminary Core Outcome Set for vaccination communication, we conducted a qualitative focus group study exploring how parents and health professionals perceive and experience communication encounters and what outcomes are relevant to them. Methods Focus group participants included parents and health professionals involved in vaccination communication (healthcare providers, researchers and policymakers). Participants discussed their experiences with communication for childhood vaccination, and what made the communication ‘successful’ or 'unsuccessful.' Our analysis involved two stages: first, we thematically analysed the discussions, identifying key parent and professional themes. In stage two, we used an interpretive analysis approach to translate the themes and quotes into measurable outcomes. We compared these outcomes with outcomes measured in vaccination communication trials (previously identified and mapped). Results We held three focus groups with parents (n = 12) and four with professionals (n = 19). In stage one, we identified six parent themes (primarily related to decision-making) and five professional themes (primarily related to intervention planning, delivery and evaluation). In stage two, we translated 47 outcomes from parents and 73 from professionals (91 total, de-duplicated). All stakeholders discussed attitudes or beliefs and decision-making outcomes most frequently. Most (66%) of the focus group-generated outcomes were not measured in vaccination communication trials. Conclusion Consulting with stakeholders through focus groups allowed us to explore how parents and professionals experienced vaccination communication, identify those aspects of the experience that were important to them, and translate these into outcomes that can be prioritised into a Core Outcome Set and measured in intervention evaluations.
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Kaufman J, Ryan R, Walsh L, Horey D, Leask J, Robinson P, Hill S. Face-to-face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst Rev 2018; 5:CD010038. [PMID: 29736980 PMCID: PMC6494431 DOI: 10.1002/14651858.cd010038.pub3] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and acceptance of vaccines.Face-to-face information or educational interventions are widely used to help parents understand why vaccines are important; explain where, how and when to access services; and address hesitancy and concerns about vaccine safety or efficacy. Such interventions are interactive, and can be adapted to target particular populations or identified barriers.This is an update of a review originally published in 2013. OBJECTIVES To assess the effects of face-to-face interventions for informing or educating parents about early childhood vaccination on vaccination status and parental knowledge, attitudes and intention to vaccinate. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, five other databases, and two trial registries (July and August 2017). We screened reference lists of relevant articles, and contacted authors of included studies and experts in the field. We had no language or date restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs evaluating the effects of face-to-face interventions delivered to parents or expectant parents to inform or educate them about early childhood vaccination, compared with control or with another face-to-face intervention. The World Health Organization recommends that children receive all early childhood vaccines, with the exception of human papillomavirus vaccine (HPV), which is delivered to adolescents. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two authors independently reviewed all search results, extracted data and assessed the risk of bias of included studies. MAIN RESULTS In this update, we found four new studies, for a total of ten studies. We included seven RCTs and three cluster-RCTs involving a total of 4527 participants, although we were unable to pool the data from one cluster-RCT. Three of the ten studies were conducted in low- or middle- income countries.All included studies compared face-to-face interventions with control. Most studies evaluated the effectiveness of a single intervention session delivered to individual parents. The interventions were an even mix of short (ten minutes or less) and longer sessions (15 minutes to several hours).Overall, elements of the study designs put them at moderate to high risk of bias. All studies but one were at low risk of bias for sequence generation (i.e. used a random number sequence). For allocation concealment (i.e. the person randomising participants was unaware of the study group to which participant would be allocated), three were at high risk and one was judged at unclear risk of bias. Due to the educational nature of the intervention, blinding of participants and personnel was not possible in any studies. The risk of bias due to blinding of outcome assessors was judged as low for four studies. Most studies were at unclear risk of bias for incomplete outcome data and selective reporting. Other potential sources of bias included failure to account for clustering in a cluster-RCT and significant unexplained baseline differences between groups. One cluster-RCT was at high risk for selective recruitment of participants.We judged the certainty of the evidence to be low for the outcomes of children's vaccination status, parents' attitudes or beliefs, intention to vaccinate, adverse effects (e.g. anxiety), and immunisation cost, and moderate for parents' knowledge or understanding. All studies had limitations in design. We downgraded the certainty of the evidence where we judged that studies had problems with randomisation or allocation concealment, or when outcomes were self-reported by participants who knew whether they'd received the intervention or not. We also downgraded the certainty for inconsistency (vaccination status), imprecision (intention to vaccinate and adverse effects), and indirectness (attitudes or beliefs, and cost).Low-certainty evidence from seven studies (3004 participants) suggested that face-to-face interventions to inform or educate parents may improve vaccination status (risk ratio (RR) 1.20, 95% confidence interval (CI) 1.04 to 1.37). Moderate-certainty evidence from four studies (657 participants) found that face-to-face interventions probably slightly improved parent knowledge (standardised mean difference (SMD) 0.19, 95% CI 0.00 to 0.38), and low-certainty evidence from two studies (179 participants) suggested they may slightly improve intention to vaccinate (SMD 0.55, 95% CI 0.24 to 0.85). Low-certainty evidence found the interventions may lead to little or no change in parent attitudes or beliefs about vaccination (SMD 0.03, 95% CI -0.20 to 0.27; three studies, 292 participants), or in parents' anxiety (mean difference (MD) -1.93, 95% CI -7.27 to 3.41; one study, 90 participants). Only one study (365 participants) measured the intervention cost of a case management strategy, reporting that the estimated additional cost per fully immunised child for the intervention was approximately eight times higher than usual care (low-certainty evidence). No included studies reported outcomes associated with parents' experience of the intervention (e.g. satisfaction). AUTHORS' CONCLUSIONS There is low- to moderate-certainty evidence suggesting that face-to-face information or education may improve or slightly improve children's vaccination status, parents' knowledge, and parents' intention to vaccinate.Face-to-face interventions may be more effective in populations where lack of awareness or understanding of vaccination is identified as a barrier (e.g. where people are unaware of new or optional vaccines). The effect of the intervention in a population where concerns about vaccines or vaccine hesitancy is the primary barrier is less clear. Reliable and validated scales for measuring more complex outcomes, such as attitudes or beliefs, are necessary in order to improve comparisons of the effects across studies.
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Affiliation(s)
- Jessica Kaufman
- La Trobe UniversityCentre for Health Communication and Participation, School of Psychology and Public HealthBundooraVICAustralia3086
| | - Rebecca Ryan
- La Trobe UniversityCentre for Health Communication and Participation, School of Psychology and Public HealthBundooraVICAustralia3086
| | - Louisa Walsh
- La Trobe UniversityCentre for Health Communication and Participation, School of Psychology and Public HealthBundooraVICAustralia3086
| | - Dell Horey
- La Trobe UniversityCollege of Science, Health and EngineeringBundooraVICAustralia3086
| | - Julie Leask
- The University of SydneySydney Nursing SchoolSydneyNSWAustralia2050
| | - Priscilla Robinson
- La Trobe UniversityDepartment of Public Health, School of Psychology and Public HealthBundooraVICAustralia3086
| | - Sophie Hill
- La Trobe UniversityCentre for Health Communication and Participation, School of Psychology and Public HealthBundooraVICAustralia3086
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Dodd S, Clarke M, Becker L, Mavergames C, Fish R, Williamson PR. A taxonomy has been developed for outcomes in medical research to help improve knowledge discovery. J Clin Epidemiol 2017; 96:84-92. [PMID: 29288712 PMCID: PMC5854263 DOI: 10.1016/j.jclinepi.2017.12.020] [Citation(s) in RCA: 305] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 11/30/2022]
Abstract
Objectives There is increasing recognition that insufficient attention has been paid to the choice of outcomes measured in clinical trials. The lack of a standardized outcome classification system results in inconsistencies due to ambiguity and variation in how outcomes are described across different studies. Being able to classify by outcome would increase efficiency in searching sources such as clinical trial registries, patient registries, the Cochrane Database of Systematic Reviews, and the Core Outcome Measures in Effectiveness Trials (COMET) database of core outcome sets (COS), thus aiding knowledge discovery. Study Design and Setting A literature review was carried out to determine existing outcome classification systems, none of which were sufficiently comprehensive or granular for classification of all potential outcomes from clinical trials. A new taxonomy for outcome classification was developed, and as proof of principle, outcomes extracted from all published COS in the COMET database, selected Cochrane reviews, and clinical trial registry entries were classified using this new system. Results Application of this new taxonomy to COS in the COMET database revealed that 274/299 (92%) COS include at least one physiological outcome, whereas only 177 (59%) include at least one measure of impact (global quality of life or some measure of functioning) and only 105 (35%) made reference to adverse events. Conclusions This outcome taxonomy will be used to annotate outcomes included in COS within the COMET database and is currently being piloted for use in Cochrane Reviews within the Cochrane Linked Data Project. Wider implementation of this standard taxonomy in trial and systematic review databases and registries will further promote efficient searching, reporting, and classification of trial outcomes.
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Affiliation(s)
- Susanna Dodd
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3GS, UK
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health Institute for Health Sciences, Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, UK
| | - Lorne Becker
- Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Chris Mavergames
- Department of Informatics and Knowledge Management, Cochrane Central Executive, Freiburg, Germany
| | - Rebecca Fish
- Division of Molecular and Clinical Cancer Sciences, University of Manchester, Manchester, UK
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3GS, UK.
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Kaufman J, Ryan R, Lewin S, Bosch-Capblanch X, Glenton C, Cliff J, Oyo-Ita A, Muloliwa AM, Oku A, Ames H, Rada G, Cartier Y, Hill S. Identification of preliminary core outcome domains for communication about childhood vaccination: An online Delphi survey. Vaccine 2017; 36:6520-6528. [PMID: 28835344 DOI: 10.1016/j.vaccine.2017.08.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 08/04/2017] [Accepted: 08/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Communication interventions for childhood vaccination are promising strategies to address vaccine hesitancy, but current research is limited by the outcomes measured. Most studies measure only vaccination-related outcomes, with minimal consideration of vaccine hesitancy-relevant intermediate outcomes. This impedes understanding of which interventions or elements are effective. It is also unknown which outcomes are important to the range of stakeholders affected by vaccine hesitancy. Outcome selection shapes the evidence base, informing future interventions and trials, and should reflect stakeholder priorities. Therefore, our aim was to identify which outcome domains (i.e. broad outcome categories) are most important to different stakeholders, identifying preliminary core outcome domains to inform evaluation of three common vaccination communication types: (i) communication to inform or educate, (ii) remind or recall, and (iii) enhance community ownership. METHODS We conducted a two-stage online Delphi survey, involving four stakeholder groups: parents or community members, healthcare providers, researchers, and government or non-governmental organisation representatives. Participants rated the importance of eight outcome domains for each of the three communication types. They also rated specific outcomes within one domain ("attitudes or beliefs") and provided feedback about the survey. RESULTS Collectively, stakeholder groups prioritised outcome domains differently when considering the effects of different communication types. For communication that aims to (i) inform or educate, the most important outcome domain is "knowledge or understanding"; for (ii) reminder communication, "vaccination status and behaviours"; and for (iii) community engagement communication, "community participation". All stakeholder groups rated most outcome domains as very important or critical. The highest rated specific outcome within the "attitudes or beliefs" domain was "trust". CONCLUSION This Delphi survey expands the field of core outcomes research and identifies preliminary core outcome domains for measuring the effects of communication about childhood vaccination. The findings support the argument that vaccination communication is not a single homogenous intervention - it has a range of purposes, and vaccination communication evaluators should select outcomes accordingly.
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Affiliation(s)
- Jessica Kaufman
- Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia.
| | - Rebecca Ryan
- Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia.
| | - Simon Lewin
- Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway; Health Systems Research Unit, South African Medical Research Council, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa.
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box CH-4002, Basel, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Claire Glenton
- Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway.
| | - Julie Cliff
- Faculdade de Medicina, Eduardo Mondlane University, CP 257 Maputo, Mozambique.
| | - Angela Oyo-Ita
- University of Calabar, PMB 1115 Calabar, Cross River State, Nigeria.
| | - Artur Manuel Muloliwa
- Provincial Directorate of Health, Av. Samora Machel n° 1016 R/C, C.P. N° 14, Nampula, Mozambique.
| | - Afiong Oku
- University of Calabar, PMB 1115 Calabar, Cross River State, Nigeria.
| | - Heather Ames
- Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway.
| | - Gabriel Rada
- Pontifical Catholic University of Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile.
| | - Yuri Cartier
- International Union for Health Promotion and Education, 42 Boulevard de la Libération, 93203 Saint-Denis, France.
| | - Sophie Hill
- Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia.
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