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Tian C, Xu M, Lai H, Sun M, Lu Y, Wang Y, Tong B, Wang Y, Na F, Wang J, Li Q, Ge L. Management for children and adolescents with overweight and obesity: a recommendations mapping. Pediatr Res 2024:10.1038/s41390-024-03357-3. [PMID: 38914759 DOI: 10.1038/s41390-024-03357-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Childhood obesity is a global public health issue, and the status of clinical practice guidelines (CPGs) as instruction manuals for the management of childhood obesity remains unclear. This study aims to identify and apprise the methodological and reporting quality of CPGs focused on childhood obesity and provide an overview of key recommendations. METHODS Databases and websites reporting guidelines were searched from January, 2018 to September, 2023. The methodological quality was graded using the AGREE II, and RIGHT was used to assess the reporting completeness. RESULTS Among the six included CPGs, two were rated as high quality and considered "Recommended" and three were reported no less than 80%. CPGs included 184 recommendations cover diagnosis, assessment and management of complications, interventions and prevention. The diagnostic criteria for children with obesity over 2 years of age are based on normative BMI percentiles, depending on sex and age. CPGs recommended the delivery of multi-component behavior-changed interventions included controlling diet and increasing physical activity. Pharmacological interventions and bariatric surgery are considered as complementary therapies. CONCLUSION CPGs for childhood obesity should emphasize the impact of psychological factors and consider the provision of interventions from multiple settings, and could consider the role of complementary alternative therapies. IMPACT Six guidelines have been published in the past 5 years focusing children obesity. Recommendations covered diagnosis, multiple intervention and prevention. Guidelines should focus on the role of complementary alternative therapies. Guidelines should emphasize the impact of psychological factors. Guidelines should consider the provision of interventions from multiple settings.
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Affiliation(s)
- Chen Tian
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| | - Meng Xu
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| | - Honghao Lai
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Mingyao Sun
- Evidence-Based Nursing Research Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yao Lu
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yong Wang
- First Clinical School of Medicine, Lanzhou University, Lanzhou, China
| | - Bo Tong
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yiyun Wang
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Feiyang Na
- Department of Pediatric, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Jing Wang
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Qiong Li
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China.
| | - Long Ge
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China.
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China.
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China.
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Cyrkot S, Hartling L, Scott SD, Elliott SA. Parents' User Experience Accessing and Using a Web-Based Map of COVID-19 Recommendations for Health Decision-Making: Qualitative Descriptive Study. JMIR Form Res 2024; 8:e53593. [PMID: 38506915 PMCID: PMC10956570 DOI: 10.2196/53593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The eCOVID19 Recommendations Map & Gateway to Contextualization (RecMap) website was developed to identify all COVID-19 guidelines, assess the credibility and trustworthiness of the guidelines, and make recommendations understandable to various stakeholder groups. To date, little has been done to understand and explore parents' experiences when accessing and using the RecMap website for COVID-19 health decision-making. OBJECTIVE To explore (1) where parents look for COVID-19 health information and why, (2) parents' user experience when accessing and using the RecMap website to make health decisions, and (3) what knowledge mobilization activities are needed to increase parents' awareness, use, and engagement with the RecMap website. METHODS We conducted a qualitative descriptive study using semistructured interviews and a think-aloud activity with parents of children aged 18 years or younger living in Canada. Participants were asked to provide feedback on the RecMap website and to "think aloud" as they navigated the website to find relevant COVID-19 health recommendations. Demographic information was collected using a web-based questionnaire. A hybrid deductive and inductive thematic approach guided analysis and data synthesis. RESULTS A total of 21 participants (13/21, 62% mothers) were interviewed and participated in a think-aloud activity. The data were categorized into four sections, representative of key elements that deductively and inductively emerged from the data: (1) parent information seeking behaviors and preferences for COVID-19, (2) RecMap website usability, (3) perceived usefulness of the RecMap website, and (4) knowledge mobilization strategies to increase awareness, use, and engagement of the RecMap website. Parents primarily used the internet to find COVID-19 information and focused on sources that they determined to be credible, trustworthy, simple, and engaging. As the pandemic evolved, participants' information-seeking behaviors changed, specifically their topics of interest and search frequency. Most parents were not aware of the RecMap website before this study but found satisfaction with its concept and layout and expressed intentions to use and share it with others. Parents experienced some barriers to using the RecMap website and suggested key areas for improvement to facilitate its usability and perceived usefulness. Recommendations included a more user-friendly home page for lay audiences (separate public-facing user interface), improving the search and filter options, quicker navigation, clearer titles, more family-friendly graphics, and improving mobile-friendly access. Several strategies to disseminate the RecMap website were also expressed, including a mix of traditional and nontraditional methods (handouts and social media) in credible and high-traffic locations that parents frequent often. CONCLUSIONS Overall, parents liked the concept of the RecMap website but had some suggestions to improve its usability (language, navigation, and website interface). These findings can be used to improve the RecMap website for parents and offer insight for the development and dissemination of effective web-based health information tools and resources for the general public.
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Affiliation(s)
- Samantha Cyrkot
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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3
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Sayfi S, Charide R, Elliott SA, Hartling L, Munan M, Stallwood L, Butcher NJ, Richards DP, Mathew JL, Suvada J, Akl EA, Kredo T, Mbuagbaw L, Motilall A, Baba A, Scott SD, Falavigna M, Klugar M, Friessová T, Lotfi T, Stevens A, Offringa M, Schünemann HJ, Pottie K. A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations. J Clin Epidemiol 2024; 165:111219. [PMID: 38008266 DOI: 10.1016/j.jclinepi.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/17/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES To make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital "Plain Language Recommendation" (PLR) format vs. the original "Standard Language Version" (SLV). STUDY DESIGN AND SETTING An allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. RESULTS Participants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7-24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI -0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9-1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9-1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7-1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5-1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of -0.3, 95% CI -0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. CONCLUSION Health information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.
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Affiliation(s)
- Shahab Sayfi
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Sarah A Elliott
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | | | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jozef Suvada
- National Evidence and Quality Platform, St. Elizabeth University of Public Health and Social Science, Research Dept., Nam. 1. Maja 1, 81000 Bratislava, Slovak Republic; Experts Consortium for COVID-19, Advisor to Government of Slovak Republic, Bratislava, Slovak Republic; WHO Executive Board, Geneva, Switzerland
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Capetown, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada; Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ashley Motilall
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maicon Falavigna
- National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tereza Friessová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Adrienne Stevens
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Family Medicine, Western University, London, Ontario, Canada.
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Conway A, Ryan A, Harkin D, Mc Cauley C. "It's Another Feather in My Hat"-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia. DEMENTIA 2023; 22:1487-1513. [PMID: 37365816 PMCID: PMC10521156 DOI: 10.1177/14713012231185283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
INTRODUCTION With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia. METHODS The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis. FINDINGS The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-"That's the difficulty there even with apps or anything else." (Theme 2: Motivation)- "It makes me feel good. I feel a little with it [laughs], that its not all gone in there" (Theme 3: Fears and Concerns)- "Can somebody else get into your personal memories?" (Theme 4- Support)- "So it's important that we have that support". Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps. CONCLUSION This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of "feel good moments" and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user's information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
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5
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Elliott SA, Scott SD, Charide R, Patterson-Stallwood L, Sayfi S, Motilall A, Baba A, Lotfi T, Suvada J, Klugar M, Kredo T, Mathew JL, Richards DP, Butcher NJ, Offringa M, Pottie K, Schünemann HJ, Hartling L. A multimethods randomized trial found that plain language versions improved parents' understanding of health recommendations. J Clin Epidemiol 2023; 161:8-19. [PMID: 37421995 DOI: 10.1016/j.jclinepi.2023.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/02/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES To assess the effectiveness of plain language compared with standard language versions of COVID-19 recommendations specific to child health. STUDY DESIGN AND SETTING Pragmatic, allocation-concealed, blinded, superiority randomized controlled trial with nested qualitative component. Trial was conducted online, internationally. Parents or legal guardians (≥18 years) of a child (<18 years) were eligible. Participants were randomized to receive a plain language recommendation (PLR) or standard (SLV) verison of a COVID-19 recommendation specific to child health. Primary outcome was understanding. Secondary outcomes included: preference, accessibility, usability, satisfaction, and intended behavior. Interviews explored perceptions and preferences for each format. RESULTS Between July and August 2022, 295 parents were randomized; 241 (81.7%) completed the study (intervention n = 121, control n = 120). Mean understanding scores were significantly different between groups (PLR 3.96 [standard deviation (SD) 2.02], SLV 3.33 [SD 1.88], P = 0.014). Overall participants preferred the PLR version: mean rating 5.05/7.00 (95% CI 4.81, 5.29). Interviews (n = 12 parents) highlighted their preference for the PLR and provided insight on elements to enhance future knowledge mobilization of health recommendations. CONCLUSION Compared to SLVs, parents preferred PLRs and better understood the recommendation. Guideline developers should strive to use plain language to increase understanding, uptake, and implementation of evidence by the public.
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rana Charide
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Patterson-Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Shahab Sayfi
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ashley Motilall
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Tamara Lotfi
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Jozef Suvada
- Departments of Science and International Studies, St. Elizabeth University of Public Health and Social Science, Bratislava, Slovak Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno-Bohunice, Czech Republic
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dawn P Richards
- Five02 Labs Inc, Toronto, Ontario, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Holger J Schünemann
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
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6
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Stallwood L, Sammy A, Prebeg M, Relihan J, Baba A, Charide R, Sayfi S, Elliott SA, Hartling L, Munan M, Richards DP, Mathew JL, Kredo T, Mbuagbaw L, Motilall A, Scott SD, Klugar M, Lotfi T, Stevens AL, Pottie K, Schünemann HJ, Butcher NJ, Offringa M. Plain Language vs Standard Format for Youth Understanding of COVID-19 Recommendations: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:956-965. [PMID: 37548983 PMCID: PMC10407760 DOI: 10.1001/jamapediatrics.2023.2686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 08/08/2023]
Abstract
Importance To ensure that youths can make informed decisions about their health, it is important that health recommendations be presented for understanding by youths. Objective To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of youths provided with a digital plain language recommendation (PLR) format vs the original standard language version (SLV) of a health recommendation. Design, Setting, and Participants This pragmatic, allocation-concealed, blinded, superiority randomized clinical trial included individuals from any country who were 15 to 24 years of age, had internet access, and could read and understand English. The trial was conducted from May 27 to July 6, 2022, and included a qualitative component. Interventions An online platform was used to randomize youths in a 1:1 ratio to an optimized digital PLR or SLV format of 1 of 2 health recommendations related to the COVID-19 vaccine; youth-friendly PLRs were developed in collaboration with youth partners and advisors. Main Outcomes and Measures The primary outcome was understanding, measured as the proportion of correct responses to 7 comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior. After completion of the survey, participants indicated their interest in completing a 1-on-1 semistructured interview to reflect on their preferred digital format (PLR or SLV) and their outcome assessment survey response. Results Of the 268 participants included in the final analysis, 137 were in the PLR group (48.4% female) and 131 were in the SLV group (53.4% female). Most participants (233 [86.9%]) were from North and South America. No significant difference was found in understanding scores between the PLR and SLV groups (mean difference, 5.2%; 95% CI, -1.2% to 11.6%; P = .11). Participants found the PLR to be more accessible and usable (mean difference, 0.34; 95% CI, 0.05-0.63) and satisfying (mean difference, 0.39; 95% CI, 0.06-0.73) and had a stronger preference toward the PLR (mean difference, 4.8; 95% CI, 4.5-5.1 [4.0 indicated a neutral response]) compared with the SLV. No significant difference was found in intended behavior (mean difference, 0.22 (95% CI, -0.20 to 0.74). Interviewees (n = 14) agreed that the PLR was easier to understand and generated constructive feedback to further improve the digital PLR. Conclusions and Relevance In this randomized clinical trial, compared with the SLV, the PLR did not produce statistically significant findings in terms of understanding scores. Youths ranked it higher in terms of accessibility, usability, and satisfaction, suggesting that the PLR may be preferred for communicating health recommendations to youths. The interviews provided suggestions for further improving PLR formats. Trial Registration ClinicalTrials.gov Identifier: NCT05358990.
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Affiliation(s)
- Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Adrian Sammy
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shahab Sayfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sarah A. Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dawn P. Richards
- Five02 Labs Inc, Toronto, Ontario, Canada
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Joseph L. Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Ashley Motilall
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Adrienne L. Stevens
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nancy J. Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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7
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Meyer N, Hellbrecht I, Breuing J, Hauprich J, Wahlen S, Könsgen N, Bühn S, Becker M, Blödt S, Carl G, Follmann M, Frenz S, Langer T, Nothacker M, Santesso N, Schaefer C, Pieper D. Heterogeneous methodology in the development of patient versions of clinical practice guidelines: a scoping review. J Clin Epidemiol 2023; 161:53-64. [PMID: 37482111 DOI: 10.1016/j.jclinepi.2023.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/17/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES We aimed to gain an overview of the methods and approaches used to develop, disseminate, and implement patient versions of clinical practice guidelines (PVGs). METHODS We searched PubMed and MEDLINE through Ovid for articles reporting on the development, dissemination, or implementation of PVGs until March 2022. We searched the homepages of guideline organizations, screened the reference lists of the included documents, and asked experts to complement the publications. We narratively synthesized the findings. RESULTS Of 3,941 publications screened, 27 were included in the study. The identified method reports focused on patient involvement and peer-review processes. The other included publications highlighted the relevance of broad dissemination strategies and emphasized the importance of patient involvement and improving the readability of PVGs by using lay terms and shorter sentences. CONCLUSION The terminology used for PVGs varies widely. The extent to which the methods were described was heterogeneous. Organizations developing PVGs should make their methods publicly available and use uniform labeling for PVGs in English to improve their use and recognition, not only for other PVG producers but also for patients and the public. A consensus regarding a minimum reporting standard for developing PVGs internationally and developing guiding principles is desirable.
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Affiliation(s)
- Nora Meyer
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
| | - Irma Hellbrecht
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Jessica Breuing
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Julia Hauprich
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Sarah Wahlen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Nadja Könsgen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Stefanie Bühn
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Monika Becker
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Susanne Blödt
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg, Berlin, Germany
| | - Günther Carl
- German Prostate Cancer Support Group, Bonn, Germany
| | - Markus Follmann
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | | | - Thomas Langer
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | - Monika Nothacker
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg, Berlin, Germany
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Dawid Pieper
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany; Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany; Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
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8
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Pottie K, Smith M, Matthews M, Santesso N, Magwood O, Kredo T, Scott S, Bayliss K, Saad A, Haridas R, Detambel N, Motilall A, Tan Y, Steinberg S, Litynska J, Dietl B, Ioiri A, Reveiz L, Welch V, Klugar M, Mbuagbaw L, Rojas MX, Florez ID, Lotfi T, Qaseem A, Mathew JL, Akl EA, Tugwell P, Schünemann HJ. A multistakeholder development process to prioritize and translate COVID-19 health recommendations for patients, caregivers and the public. A case study of the COVID-19 Recommendation Map. J Clin Epidemiol 2022; 148:104-114. [PMID: 35500815 PMCID: PMC9055415 DOI: 10.1016/j.jclinepi.2022.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Kevin Pottie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada; Department of Family Medicine, Western University, London, Ontario, Canada.
| | - Maureen Smith
- Citizen, Chair, Cochrane Consumer Network Executive, Ottawa, Ontario, Canada
| | - Micayla Matthews
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada
| | - Olivia Magwood
- CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Tamara Kredo
- Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa
| | - Sarah Scott
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kerin Bayliss
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; National Institute for Health and Care Excellence, Manchester, UK
| | - Ammar Saad
- CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Rinila Haridas
- CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nicole Detambel
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ashley Motilall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yvonne Tan
- CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | | | - Bart Dietl
- Evidence Prime, Inc., Hamilton, Ontario, Canada
| | - Alfonso Ioiri
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ludovic Reveiz
- Incident Management Systems for COVID-19 and Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Vivian Welch
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation Brno, Czech Republic
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Maria Ximena Rojas
- Instit d'Recerca-Servei D'Epidemiologia Clinica, Hospital de la Santa Creu i Sant Pau, Colombia
| | - Ivan D Florez
- Department of Pediatrics, Universidad de Antioquia, Calle 67 No. 53-108; Medellin, Antioquia, Colombia; School of Rehabilitation Science, McMaster University, 1280 Main Street West, L8S 3L8, Hamilton, Ontario, Canada; Clinica Las Americas-AUNA, Dg.75B ##2A-80/140, Medellin, Colombia
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada
| | - Amir Qaseem
- American College of Physicians, Philadelphia, PA, USA
| | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; CT Lamont Centre for Primary Care, Bruyere Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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9
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Fearns N, Walker L, Graham K, Gibb N, Service D. User testing of a Scottish Intercollegiate Guideline Network public guideline for the parents of children with autism. BMC Health Serv Res 2022; 22:77. [PMID: 35033068 PMCID: PMC8761326 DOI: 10.1186/s12913-021-07384-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background The Scottish Intercollegiate Guidelines Network (SIGN) is the leading national clinical guideline producer in Scotland. Improved design and dissemination of guidelines produced for the public can empower people to take an active role in self-management and shared decision-making. The public version of the guideline examined covered getting assessed and diagnosed with autism, and approaches that can help. The aim of this study was to test a public version of a guideline for the parents of children and young people with autism, implement improvements, and identify what works in making it usable and accessible. Methods We recruited mothers from across Scotland. User testing involved formal ‘think aloud’ semi-structured interviews that guided users through the booklet. Interviews took place individually and were recorded and transcribed. Key findings were identified and themed using the honeycomb user experience model. Results Fourteen user-testing interviews were conducted. Facilitators for usability and desirability of the guideline included the chunking of text, consistent use of colour and boxes to highlight important information. Simple language, written in a tone of partnership, helped to engage mothers. Value arose from the guidelines ability to explain the process of diagnosis and make mothers feel empowered in their relationships with healthcare professionals. There was a lack of consensus on the usefulness of rating the strength of evidence and recommendations. Conclusion There was a marked similarity between what was important to the mothers and what has been found to be important to other groups. The involvement of service users and carers in the guidelines development was key to its credibility. One size does not fit all in presenting evidence-based recommendations to the public and it is a challenge to provide sufficient information while avoiding information overload. Recommendations and evidence levels are suitable for use in public versions, but these should be kept as simple as possible.
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Affiliation(s)
- Naomi Fearns
- Healthcare Improvement Scotland, Gyle Square 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Laura Walker
- Healthcare Improvement Scotland, Gyle Square 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK
| | - Karen Graham
- Healthcare Improvement Scotland, Gyle Square 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK
| | - Norman Gibb
- Healthcare Improvement Scotland, Gyle Square 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK
| | - Duncan Service
- Healthcare Improvement Scotland, Gyle Square 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK
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10
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Piggott T, Baldeh T, Dietl B, Wiercoch W, Nieuwlaat R, Santesso N, Coello PA, Schünemann HJ. Standardized wording to improve efficiency and clarity of GRADE EtD frameworks in health guidelines. J Clin Epidemiol 2022; 146:106-122. [PMID: 35041970 DOI: 10.1016/j.jclinepi.2022.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Grading of Recommendations Assessment, Development and Evaluation (GRADE)Evidence-to-Decision (EtDs) frameworks are increasingly applied by health guideline developers to improve the use of evidence and transparency of health recommendations. Typically, EtDs include 12 criteria but these are flexible and EtDs have been adapted to different types of health decisions. However, developers of health recommendations struggle with the content that they should include in the EtD. The goal of this work was to provide a standardized template that facilitate the development of GRADE EtDs in health guidelines and examples for practical training. METHODS We began by establishing the need for standardized wording templates in 10 American Society of Hematology guidelines with over 250 recommendations. We drafted template wording, and examples, and sought iterative feedback from methodologists and guideline panels in this guideline and two additional guidelines. RESULTS We generated templates for all EtD criteria describing the type of research evidence considered, ideally based on systematic reviews, using standardized reporting of effect size, integrating the certainty of evidence and addition additional considerations. We also produced templates to inform the completion of the EtD conclusions section that includes recommendations, justification, implementation considerations, monitoring and evaluation and research priorities. CONCLUSION We have taken an applied approach to develop a pragmatic and useful tool to support clarity, transparency, and efficiency of the guideline GRADE EtD process.
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Affiliation(s)
- Thomas Piggott
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Tejan Baldeh
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | | | - Wojtek Wiercoch
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Pablo Alonso Coello
- Iberoamerican Cochrane Center-Servicio de Epidemiología Clínica y Salud Pública, Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; CIBER of Epidemiology and Public Health, Barcelona, Spain
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
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