Criteria for evaluating transferability of health interventions: a systematic review and thematic synthesis

BACKGROUND

Improving the public's health in different countries requires the consideration of diverse health care systems and settings. For evidence-based public health, decision-makers need to consider the transferability of effective health interventions from a primary context to their specific target context. The aim of this systematic review was to develop a model for the assessment of transferability of health interventions through identification and systematization of influencing criteria, including facilitators and barriers.

METHODS

A systematic literature search was performed in the databases PubMed, Embase, CINAHL, and PsycINFO. Articles were eligible if they were published in English or German and provided a description of transferability criteria. Included articles were ranked based on their thematic relevance and methodological support of transferability criteria. Using a qualitative approach, a thematic synthesis was conducted.

RESULTS

Thirty-seven articles were included in the review. The thematic synthesis revealed 44 criteria, covered by 4 overarching themes, which influence transferability of health interventions: The population (P), the intervention (I), and the environment (E) represent 30 conditional transferability criteria, and the transfer of the intervention (T) represents 14 process criteria for transferring the intervention to the target context. Transferability (-T) depends on the dynamic interaction of conditional criteria in the primary and target context as well as on the process of transfer. The description of facilitators and barriers deepens the understanding of the criteria. The synthesis resulted in two related models: the conceptual PIET-T model explains the underlying mechanism of transferability of health interventions and the PIET-T process model provides practical guidance for a transferability assessment.

CONCLUSIONS

Transferability of health interventions is a complex concept, which needs systematic consideration of the primary and target context. It should be anticipated before and evaluated after an intervention is implemented in the target context. Therefore, decision-makers need systematic and practically relevant knowledge on transferability. The synthesized PIET-T conceptual and process models with systematized criteria, facilitators, and barriers are intended as a theoretical basis to determine transferability of health interventions. Further research is needed to develop a practical tool for the PIET-T models and to evaluate the tool's usefulness for decision-making processes and intervention transfer.

Criteria for evaluating transferability of health interventions: a systematic review and thematic synthesis

BACKGROUND

Improving the public's health in different countries requires the consideration of diverse health care systems and settings. For evidence-based public health, decision-makers need to consider the transferability of effective health interventions from a primary context to their specific target context. The aim of this systematic review was to develop a model for the assessment of transferability of health interventions through identification and systematization of influencing criteria, including facilitators and barriers.

METHODS

A systematic literature search was performed in the databases PubMed, Embase, CINAHL, and PsycINFO. Articles were eligible if they were published in English or German and provided a description of transferability criteria. Included articles were ranked based on their thematic relevance and methodological support of transferability criteria. Using a qualitative approach, a thematic synthesis was conducted.

RESULTS

Thirty-seven articles were included in the review. The thematic synthesis revealed 44 criteria, covered by 4 overarching themes, which influence transferability of health interventions: The population (P), the intervention (I), and the environment (E) represent 30 conditional transferability criteria, and the transfer of the intervention (T) represents 14 process criteria for transferring the intervention to the target context. Transferability (-T) depends on the dynamic interaction of conditional criteria in the primary and target context as well as on the process of transfer. The description of facilitators and barriers deepens the understanding of the criteria. The synthesis resulted in two related models: the conceptual PIET-T model explains the underlying mechanism of transferability of health interventions and the PIET-T process model provides practical guidance for a transferability assessment.

CONCLUSIONS

Transferability of health interventions is a complex concept, which needs systematic consideration of the primary and target context. It should be anticipated before and evaluated after an intervention is implemented in the target context. Therefore, decision-makers need systematic and practically relevant knowledge on transferability. The synthesized PIET-T conceptual and process models with systematized criteria, facilitators, and barriers are intended as a theoretical basis to determine transferability of health interventions. Further research is needed to develop a practical tool for the PIET-T models and to evaluate the tool's usefulness for decision-making processes and intervention transfer.

Similarity of the dog and human gut microbiomes in gene content and response to diet

BACKGROUND

Gut microbes influence their hosts in many ways, in particular by modulating the impact of diet. These effects have been studied most extensively in humans and mice. In this work, we used whole genome metagenomics to investigate the relationship between the gut metagenomes of dogs, humans, mice, and pigs.

RESULTS

We present a dog gut microbiome gene catalog containing 1,247,405 genes (based on 129 metagenomes and a total of 1.9 terabasepairs of sequencing data). Based on this catalog and taxonomic abundance profiling, we show that the dog microbiome is closer to the human microbiome than the microbiome of either pigs or mice. To investigate this similarity in terms of response to dietary changes, we report on a randomized intervention with two diets (high-protein/low-carbohydrate vs. lower protein/higher carbohydrate). We show that diet has a large and reproducible effect on the dog microbiome, independent of breed or sex. Moreover, the responses were in agreement with those observed in previous human studies.

CONCLUSIONS

We conclude that findings in dogs may be predictive of human microbiome results. In particular, a novel finding is that overweight or obese dogs experience larger compositional shifts than lean dogs in response to a high-protein diet.

A rule-based named-entity recognition method for knowledge extraction of evidence-based dietary recommendations

Evidence-based dietary information represented as unstructured text is a crucial information that needs to be accessed in order to help dietitians follow the new knowledge arrives daily with newly published scientific reports. Different named-entity recognition (NER) methods have been introduced previously to extract useful information from the biomedical literature. They are focused on, for example extracting gene mentions, proteins mentions, relationships between genes and proteins, chemical concepts and relationships between drugs and diseases. In this paper, we present a novel NER method, called drNER, for knowledge extraction of evidence-based dietary information. To the best of our knowledge this is the first attempt at extracting dietary concepts. DrNER is a rule-based NER that consists of two phases. The first one involves the detection and determination of the entities mention, and the second one involves the selection and extraction of the entities. We evaluate the method by using text corpora from heterogeneous sources, including text from several scientifically validated web sites and text from scientific publications. Evaluation of the method showed that drNER gives good results and can be used for knowledge extraction of evidence-based dietary recommendations.

In situ measurement of Scots pine needle PRI

BACKGROUND

The Photochemical Reflectance Index (PRI) calculated from narrow-band spectral reflectance data is a vegetation index which is increasingly used as an indicator of photosynthetic activity. The leaf-level link between the status of photosynthetic apparatus and PRI has been robustly established under controlled light conditions. However, when a whole canopy is measured instantaneously, the PRI signal is heavily modified by vegetation structure and local variations in incident light conditions. To apply PRI for monitoring the photosynthesis of whole canopies under natural conditions, these large-scale measurements need to be validated against simultaneous leaf PRI. Unfortunately, PRI changes dynamically with incident light and has a large natural variation. No generally accepted procedure exists today for determining the PRI of canopy elements in situ.

RESULTS

We present a successful procedure for in situ measurements of needle PRI. We describe, characterize and test an optical measurement protocol and demonstrate its applicability in field conditions. The measurement apparatus consisted of a light source, needle clip, spectroradiometer and a controlling computer. The light level inside the clip was approximately two-thirds of that on sunlit needle surfaces at midday. During each measurement the needle was inserted into the clip for approximately 5 s. We found no near-instantaneous changes (sub-second scale jumps) in PRI during the measurements. The time constants for PRI variation in light to full shade acclimations were approximately 10 s. The procedure was successfully applied to monitor the greening-up of Scots pine trees. We detected both facultative (diurnal) PRI changes of 0.02 (unitless) and constitutive (seasonal) variations of 0.1. In order to reliably detect the facultative PRI change of 0.02, 20 needles need to be sampled from both sunlit and shaded locations.

CONCLUSIONS

We established a robust procedure for irradiance-dependent leaf (needle) PRI measurements, facilitating empirical scaling of PRI from leaf (needle) to full canopy level and the application of PRI to monitoring the changes in highly structured vegetation. The measured time constants, and facultative and constitutive PRI variations support the use of an artificial light for in situ PRI measurements at leaf (needle) level.