These reviews are currently being conducted by the Evidence Reviews Facility:
Many reviews of the use of research evidence in public health decision-making have been suggestive of an underutilisation of research evidence in decision-making in local public health decision-making. Several potential barriers and facilitators to the utilisation of research evidence in decision-making have been identified. However, understanding how these can be addressed is challenging as we often lack detailed understandings of current practice and process models which identify evidence needs at different stages of decision-making for different types of decisions being made. Many of the issues surrounding the perceived underutilisation of research evidence may be as much a reflection of the ‘supply’ side and ensuring that research is produced in a way that can be used either instrumentally or for enlightenment, as much as a reflection of the ‘demand’ side and the need to stimulate engagement with research evidence among policy-makers. This work focusses on one type of ‘intervention’ – embedded researchers – and explores their potential in helping organisations to become more research active. We view organisations that are research active as those that are engaging with research evidence (i.e. using research evidence to inform their practice or decision-making) or generating research (i.e. producing research internally or commissioning research) or who are influencing research (i.e. influencing the conduct of research or contributing to influence research priorities).
See the report here (PDF).
Older people are more likely to be characterised by risk factors for loneliness including having poorer health, having a long-term illness or disability, living alone, and being widowed. During the current coronavirus crisis, millions of older people (70+) across the UK and elsewhere are advised to be particularly stringent about social distancing, and to avoid contact with those outside their household. This places older people at even higher risk of social isolation and loneliness. Social isolation and loneliness adversely affect quality of life, wellbeing and mental health, and are associated with physical ill health and mortality. However, what works to prevent or mitigate loneliness is less clear. The requirement for older people to restrict their activities during the COVID-19 pandemic has identified a need to understand how to minimise the impact of loneliness and isolation, at a distance.
A number of evidence reviews have highlighted the diverse range of interventions aimed to address and alleviate loneliness (and the consequences of loneliness) amongst older people in a variety of settings. In the main, these have been face-to-face interventions, either in groups or between individuals. Given the current ‘stay at home’ instructions from Government, these face-to-face interventions are not possible. Much of our social contact now has to be conducted over the telephone, or through use of videoconferencing tools. We are conducting a rapid review exploring what are effective befriending, social support, and low intensity psychosocial interventions delivered remotely to reduce social isolation and loneliness among older people, and are attempting to understand how they ‘work. This work is being led jointly by the EPPI-Centre and the Older People and Frailty PRU, with colleagues from the University of York/Hull York Medical School and National University of Ireland (Galway). We are conducting a review of reviews and are undertaking novel syntheses of the results including Narrative Synthesis, Intervention Component Analysis and Qualitative Comparative Analysis.
See the rapid review of systematic reviews report here.
Adult Specialist Services for Victim-Survivors of Sexual Violence and Abuse
Prevalence of sexual violence and abuse remains largely unknown and underreported, but it is estimated that around 25% of women and 5% of men in England and Wales have experienced some type of sexual assault since the age of 16. In recent years there has been an unprecedented surge in demand for specialist support for victim-survivors of sexual violence and abuse, which may be attributable in part to the #metoo and #timesup movements which have encouraged people to speak out about their experiences of assault or abuse, sometimes dating back years or even decades. This increase in demand has come at a time when resources are severely under-resourced and when commissioning has been devolved to a local level.
The first stage of this review will comprise a systematic map to describe the nature and extent of evidence on the effectiveness and appropriateness of specialist adult services for people who have experienced sexual violence and abuse. Once we have mapped the available evidence we will consult with stakeholders and DHSC later this summer. The consultations will help us to determine the most useful way to approach an in-depth review and synthesis with the aim of helping local and national commissioners to make informed decisions about services for victim-survivors.
[protocol not registered yet – waiting until the second stage to put this up on PROPERO]
Precision Public Health: A Rapid Critical Review
The potential for ‘artificial intelligence’ and ‘big’ / ‘real world’ data to enable interventions to be precisely tailored to the needs of specific individuals has been gaining increasing interest. Accompanying the rise of ‘precision medicine’ there has been an active debate as to whether the same approaches can be applied in public health, and where the possible limitations may lie. This EPPI-Centre study, currently underway, is critically assessing the claims and counter-claims made about ‘precision public health’. Precision Public Health describes both the use of genomic data in public health decision-making, as well as the use of other new sources of big data, which often necessitate using analytics supported by Artificial Intelligence and Machine Learning to generate evidence. In this study, we aim to assess the challenges expressed in the literature around increasing precision in public health decision-making, and some of the underlying assumptions in this endeavour. We aim to critically evaluate the key arguments and debates published in recent literature and to situate these within long-standing debates and theories in public health. It is intended that this work will help to illuminate the feasibility and challenges of adopting this approach, as well as a critical assessment of some of the opportunities that increasing precision could bring to public health decision-making.
Inappropriate treatment at the end of life: a systematic review of qualitative evidence
Inappropriate treatment can occur when people are nearing the end of life. Pain and other symptoms at the end of life can be undertreated, leading to avoidable suffering for patients. Conversely, overtreatment has been found to be widespread and some evidence suggests that more aggressive treatments are associated with poorer quality of life for both patients and carers. Clinicians, patients and their family members face challenges in determining the point at which treatments focused on sustaining life should give way to treatments focused on relieving pain and other symptoms.
There is a substantial body of evidence on interventions to improve end-of-life care, particularly those focused on clarifying and communicating patient preferences. This systematic review will add to this evidence base by exploring the ways in which inappropriate treatment is understood and experienced, and illuminating the processes by which it might arise. It will search for qualitative studies focusing on under- or overtreatment, inappropriate or futile treatment for patients at or near the end of life and use thematic synthesis to identify key themes.
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The Evidence Reviews Facility is a collaboration between: EPPI-Centre (Evidence for Policy and Practice Information and Co-ordinating Centre), UCL Institute of Education, University College London; CRD (Centre for Reviews and Dissemination), University of York; and PHES (Public Health, Environments and Society), London School of Hygiene and Tropical Medicine.