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Article ; Online: When “Normal” Becomes Normative

Claire Glenton / Benedicte Carlsen

International Journal of Qualitative Methods, Vol

A Case Study of Researchers’ Quotation Errors When Referring to a Focus Group Sample Size Study

2019 Volume 18

Abstract: In 2011, we published a review exploring how researchers report and justify their focus group sample sizes. We concluded that sample sizes vary widely and that most researchers give no explanation for their sample size. The aim of our 2011 study was to ... ...

Abstract	In 2011, we published a review exploring how researchers report and justify their focus group sample sizes. We concluded that sample sizes vary widely and that most researchers give no explanation for their sample size. The aim of our 2011 study was to describe practice rather than develop guidance. However, after our study was published, we noticed that new researchers were using our information about typical sample sizes as justification for their own sample size. In other words, practice that we had presented as typical or “normal” but generally lacking in justification was being used as normative. The current study aims to explore the misrepresentation of descriptive information as normative. Specifically, we map this type of quotation error in references to our 2011 study. Using Google Scholar, we identified all articles referencing our study. We then extracted quotations where the researchers had referred to our study and categorized these as follows: (a) quotations where the researchers had used the descriptive information from our study to justify their sample size and (b) quotations where the researchers had referred to our study for other purposes or where the purpose was unclear. We assessed 205 articles that had referred to our 2011 study. We identified the type of quotation error we were interested in, namely the misrepresentation of descriptive information as normative, in 50.7% of the included articles. Our study shows very high rates of one type of quotation error: the misrepresentation of descriptive information about focus group sample size as normative. Researchers referring to other researchers’ work carry most of the responsibility for ensuring that they do this appropriately. However, the authors of the research being referred to also need to consider how they can make their results clearer. We offer suggestions as to how this might be achieved.
Keywords	Social sciences (General) ; H1-99
Subject code	306
Language	English
Publishing date	2019-04-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Community health workers at the dawn of a new era

Claire Glenton / Dena Javadi / Henry B. Perry

Health Research Policy and Systems, Vol 19, Iss S3, Pp 1-

5. Roles and tasks

2021 Volume 16

Abstract: Abstract Background This is the fifth of our 11-paper supplement on “Community Health Workers at the Dawn of a New Era.” When planning new community health worker (CHW) roles or expanding existing roles, programme planners need to analyse global and ... ...

Abstract	Abstract Background This is the fifth of our 11-paper supplement on “Community Health Workers at the Dawn of a New Era.” When planning new community health worker (CHW) roles or expanding existing roles, programme planners need to analyse global and local research evidence and evidence-based guidance on the effectiveness and safety of relevant tasks performed by CHWs. Methods In this paper, we explore key areas of consideration when selecting roles and tasks; present current knowledge regarding these issues; and suggest how decision-makers could consider these issues when assigning tasks in their setting. This paper draws on the chapter “Community Health Worker Roles and Tasks” in Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers, as well as on a recently published compendium of 29 case studies of national CHW programmes and on recently published literature pertaining to roles and tasks of CHWs. Results This paper provides a list of questions that aim to help programme planners think about important issues when determining CHW roles and tasks in their setting. Planners need to assess whether the recommended roles and tasks are considered acceptable and appropriate by their target population and by the CHWs themselves and those who support them. Planners also need to think about the practical and organizational implications of each task for their particular setting with regard to training requirements, health systems support, work location, workload, and programme costs. Conclusion When planning CHW roles and tasks, planners, programme implementers, and policy-makers should draw from global guidance and research evidence, but they also need to engage with the experiences, needs, and concerns of local communities and health workers. By drawing from both sources of information, they will stand a better chance of developing programmes that are effective in achieving their goals while remaining acceptable to those affected ...
Keywords	Community health worker ; Health worker roles ; Programme planning ; Evidence-based guidance ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Purposive sampling in a qualitative evidence synthesis

Heather Ames / Claire Glenton / Simon Lewin

BMC Medical Research Methodology, Vol 19, Iss 1, Pp 1-

a worked example from a synthesis on parental perceptions of vaccination communication

2019 Volume 9

Abstract: Abstract Background In a qualitative evidence synthesis, too much data due to a large number of studies can undermine our ability to perform a thorough analysis. Purposive sampling of primary studies for inclusion in the synthesis is one way of achieving ...

Abstract	Abstract Background In a qualitative evidence synthesis, too much data due to a large number of studies can undermine our ability to perform a thorough analysis. Purposive sampling of primary studies for inclusion in the synthesis is one way of achieving a manageable amount of data. The objective of this article is to describe the development and application of a sampling framework for a qualitative evidence synthesis on vaccination communication. Methods We developed and applied a three-step framework to sample studies from among those eligible for inclusion in our synthesis. We aimed to prioritise studies that were from a range of settings, were as relevant as possible to the review, and had rich data. We extracted information from each study about country and study setting, vaccine, data richness, and study objectives and applied the following sampling framework:1.Studies conducted in low and middle income settings2.Studies scoring four or more on a 5-point scale of data richness3.Studies where the study objectives closely matched our synthesis objectives Results We assessed 79 studies as eligible for inclusion in the synthesis and sampled 38 of these. First, we sampled all nine studies that were from low and middle-income countries. These studies contributed to the least number of findings. We then sampled an additional 24 studies that scored high for data richness. These studies contributed to a larger number of findings. Finally, we sampled an additional five studies that most closely matched our synthesis objectives. These contributed to a large number of findings. Conclusions Our approach to purposive sampling helped ensure that we included studies representing a wide geographic spread, rich data and a focus that closely resembled our synthesis objective. It is possible that we may have overlooked primary studies that did not meet our sampling criteria but would have contributed to the synthesis. For example, two studies on migration and access to health services did not meet the sampling criteria but ...
Keywords	Purposive sampling ; Qualitative evidence synthesis ; Systematic review ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The TRANSFER Approach for assessing the transferability of systematic review findings

Heather Munthe-Kaas / Heid Nøkleby / Simon Lewin / Claire Glenton

BMC Medical Research Methodology, Vol 20, Iss 1, Pp 1-

2020 Volume 22

Abstract: Abstract Background Systematic reviews are a key input to health and social welfare decisions. Studies included in systematic reviews often vary with respect to contextual factors that may impact on how transferable review findings are to the review ... ...

Abstract	Abstract Background Systematic reviews are a key input to health and social welfare decisions. Studies included in systematic reviews often vary with respect to contextual factors that may impact on how transferable review findings are to the review context. However, many review authors do not consider the transferability of review findings until the end of the review process, for example when assessing confidence in the evidence using GRADE or GRADE-CERQual. This paper describes the TRANSFER Approach, a novel approach for supporting collaboration between review authors and stakeholders from the beginning of the review process to systematically and transparently consider factors that may influence the transferability of systematic review findings. Methods We developed the TRANSFER Approach in three stages: (1) discussions with stakeholders to identify current practices and needs regarding the use of methods to consider transferability, (2) systematic search for and mapping of 25 existing checklists related to transferability, and (3) using the results of stage two to develop a structured conversation format which was applied in three systematic review processes. Results None of the identified existing checklists related to transferability provided detailed guidance for review authors on how to assess transferability in systematic reviews, in collaboration with decision makers. The content analysis uncovered seven categories of factors to consider when discussing transferability. We used these to develop a structured conversation guide for discussing potential transferability factors with stakeholders at the beginning of the review process. In response to feedback and trial and error, the TRANSFER Approach has developed, expanding beyond the initial conversation guide, and is now made up of seven stages which are described in this article. Conclusions The TRANSFER Approach supports review authors in collaborating with decision makers to ensure an informed consideration, from the beginning of the review process, ...
Keywords	Transferability ; Applicability ; Indirectness ; Relevance ; Evidence ; Systematic review methodology ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ugandan health workers' and mothers' views and experiences of the quality of maternity care and the use of informal solutions

Susan Munabi-Babigumira / Claire Glenton / Merlin Willcox / Harriet Nabudere

PLoS ONE, Vol 14, Iss 3, p e

A qualitative study.

2019 Volume 0213511

Abstract: Introduction Although the coverage of maternity services in some low and middle-income countries (LMIC) has greatly improved, the quality of maternity care remains poor, and maternal mortality rates are high. In this study, we describe the meaning and ... ...

Abstract	Introduction Although the coverage of maternity services in some low and middle-income countries (LMIC) has greatly improved, the quality of maternity care remains poor, and maternal mortality rates are high. In this study, we describe the meaning and determinants of maternity care quality from the perspective of health workers and mothers in Uganda, the informal solutions used by health workers to manage their daily challenges, and we suggest ways in which maternal care quality can be improved. Methods We conducted a qualitative study in the Mpigi and Rukungiri districts of Uganda. Twenty-eight health workers based at selected health centres participated in structured interviews. Thirty-six mothers, half of whom had delivered at health facilities, participated in focus group discussions. Data were analysed thematically, and informed by the WHO framework on quality of care for maternal and newborn health and by Lipsky's street level bureaucracy concept. Results According to health workers, knowledge of clinical standards and processes, timeliness, and women's choice during labour, as well as resources, physical infrastructure; collaboration with mothers, professionals and community health workers; were important aspects of good quality care. Mothers' perceptions of good quality care were largely similar to health workers' views, though mothers were more concerned about health workers' interaction skills. Structural challenges sometimes led health workers to develop informal solutions such as asking mothers to purchase their own supplies with variable implications on the quality of care. While several of these informal solutions were useful in addressing bottlenecks in the health system, they sometimes placed additional burdens and personal costs on health workers, created mistrust, inequity in care and negative experiences among mothers who could not afford the extra costs. Conclusions Health system structural factors; including technical, interpersonal, resource and infrastructural factors; impede the provision ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Development of a checklist for people communicating evidence-based information about the effects of healthcare interventions

Andrew D Oxman / Simon Lewin / Atle Fretheim / Claire Glenton / Sarah Rosenbaum / Signe Flottorp

BMJ Open, Vol 10, Iss

a mixed methods study

2020 Volume 7

Abstract: Objectives To make informed decisions about healthcare, patients and the public, health professionals and policymakers need information about the effects of interventions. People need information that is based on the best available evidence; that is ... ...

Abstract	Objectives To make informed decisions about healthcare, patients and the public, health professionals and policymakers need information about the effects of interventions. People need information that is based on the best available evidence; that is presented in a complete and unbiased way; and that is relevant, trustworthy and easy to use and to understand. The aim of this paper is to provide guidance and a checklist to those producing and communicating evidence-based information about the effects of interventions intended to inform decisions about healthcare.Design To inform the development of this checklist, we identified research relevant to communicating evidence-based information about the effects of interventions. We used an iterative, informal consensus process to synthesise our recommendations. We began by discussing and agreeing on some initial recommendations, based on our own experience and research over the past 20–30 years. Subsequent revisions were informed by the literature we examined and feedback. We also compared our recommendations to those made by others. We sought structured feedback from people with relevant expertise, including people who prepare and use information about the effects of interventions for the public, health professionals or policymakers.Results We produced a checklist with 10 recommendations. Three recommendations focus on making it easy to quickly determine the relevance of the information and find the key messages. Five recommendations are about helping the reader understand the size of effects and how sure we are about those estimates. Two recommendations are about helping the reader put information about intervention effects in context and understand if and why the information is trustworthy.Conclusions These 10 recommendations summarise lessons we have learnt developing and evaluating ways of helping people to make well-informed decisions by making research evidence more understandable and useful for them. We welcome feedback for how to improve our advice.
Keywords	Medicine ; R
Subject code	306
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cochrane i Norge - Hvordan formidler vi resultatene fra Cochrane-oversikter?

Claire Glenton / Sarah Rosenbaum

Norsk Epidemiologi, Vol 23, Iss

2013 Volume 2

Abstract: Cochrane-systematiske oversikter oppleves ofte som lite tilgjengelige. En av hovedaktivitetene til det norske Cochrane-miljøet er å utvikle måter å presentere resultatene fra Cochrane-oversikter på for at de lettere tas i bruk. Vi beskriver her fire ... ...

Abstract	Cochrane-systematiske oversikter oppleves ofte som lite tilgjengelige. En av hovedaktivitetene til det norske Cochrane-miljøet er å utvikle måter å presentere resultatene fra Cochrane-oversikter på for at de lettere tas i bruk. Vi beskriver her fire hovedprinsipper for dette arbeidet, og gir eksempler på dokumentformater vi har vært med på å utvikle. De overordnete prinsippene er: 1) Informasjonen bør være forståelig for personer uten ekspertkunnskap om forskningsmetodikk. Vi har erfart at når det gjelder forståelsen av resultater fra systematiske oversikter går det største skillet mellom forskere og ikke-forskere og i mindre grad mellom ulike grupper som helsepersonell, pasienter og byråkrater. 2) Informasjonen bør presenteres på en mest mulig nøytral måte. 3) Informasjonen bør være brukertilpasset. Det innebærer at vi innhenter tilbakemeldinger fra sluttbrukere i utviklingsarbeidet og gjør nødvendige tilpasninger i flere omganger. 4) Informasjonsstrukturen bør følge ”1:3:25-prinsippet”. Her presenteres informasjonen både summarisk (1 side), kort oppsummert (3 sider), og mer utdypende (25 sider). I artikkelen beskriver vi flere presentasjonsformater vi har utviklet, blant annet ”Summary of Findings” der resultatene av Cochrane-oversikter presenteres i lettfattelige tabeller; ”plain language summaries”, som er tekstbaserte oppsummeringer rettet mot en bred lesergruppe; ”SUPPORT summaries” rettet mot byråkrater og ”policymakers”; og ”DECIDE Frameworks” der resultatene presenteres sammen med annen informasjon som er relevant i en beslutningsprosess. Glenton C, Rosenbaum S. Cochrane in Norway – How do we disseminate findings from Cochrane reviews? Nor J Epidemiol 2013; 23 (2): 215-219. ENGLISH SUMMARY Cochrane systematic reviews are often perceived as inaccessible. One of the main activities of the Norwegian branch of the Cochrane Collaboration is to develop ways to present the results of Cochrane reviews so that they are easier to use. In this paper we describe four main principles that underlie this work, and several of the document formats we have helped produce. Our overarching principles: 1) Information should be understandable for people who do not have expert knowledge about research methodology. When it comes to understanding the results of systematic reviews, we have experienced that the biggest difference is between researchers and non-researchers and to a lesser extent between health personnel, patients and policy makers. 2) Information should be presented in a neutral form. 3) Information should be developed using a user-oriented approach. This involves us collecting responses from the end users in our developmental work and making the necessary adjustments in several phases. 4) The information structure should follow the “1:3:25 principle” where the information is structured in several layers, with increasing level of detail. In this paper, we describe several of the document formats that we have helped develop, including Summary of Findings tables, where we present the results of Cochrane reviews in tables; a plain language summary format where the results are presented as text-based summaries written for a broad user group; SUPPORT summaries written for policy makers; and DECIDE Frameworks, where the results are presented together with other information that may be relevant in a decision making process.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2013-11-01T00:00:00Z
Publisher	Norsk Forening for Epidemiologi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Systematic mapping of existing tools to appraise methodological strengths and limitations of qualitative research

Heather Menzies Munthe-Kaas / Claire Glenton / Andrew Booth / Jane Noyes / Simon Lewin

BMC Medical Research Methodology, Vol 19, Iss 1, Pp 1-

first stage in the development of the CAMELOT tool

2019 Volume 13

Abstract: Abstract Background Qualitative evidence synthesis is increasingly used alongside reviews of effectiveness to inform guidelines and other decisions. To support this use, the GRADE-CERQual approach was developed to assess and communicate the confidence we ...

Abstract	Abstract Background Qualitative evidence synthesis is increasingly used alongside reviews of effectiveness to inform guidelines and other decisions. To support this use, the GRADE-CERQual approach was developed to assess and communicate the confidence we have in findings from reviews of qualitative research. One component of this approach requires an appraisal of the methodological limitations of studies contributing data to a review finding. Diverse critical appraisal tools for qualitative research are currently being used. However, it is unclear which tool is most appropriate for informing a GRADE-CERQual assessment of confidence. Methodology We searched for tools that were explicitly intended for critically appraising the methodological quality of qualitative research. We searched the reference lists of existing methodological reviews for critical appraisal tools, and also conducted a systematic search in June 2016 for tools published in health science and social science databases. Two reviewers screened identified titles and abstracts, and then screened the full text of potentially relevant articles. One reviewer extracted data from each article and a second reviewer checked the extraction. We used a best-fit framework synthesis approach to code checklist criteria from each identified tool and to organise these into themes. Results We identified 102 critical appraisal tools: 71 tools had previously been included in methodological reviews, and 31 tools were identified from our systematic search. Almost half of the tools were published after 2010. Few authors described how their tool was developed, or why a new tool was needed. After coding all criteria, we developed a framework that included 22 themes. None of the tools included all 22 themes. Some themes were included in up to 95 of the tools. Conclusion It is problematic that researchers continue to develop new tools without adequately examining the many tools that already exist. Furthermore, the plethora of tools, old and new, indicates a lack of consensus ...
Keywords	Methodological limitations ; Qualitative research ; Qualitative evidence synthesis ; Systematic mapping ; Framework synthesis ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Communication around HPV vaccination for adolescents in low- and middle-income countries

Hakan Safaralilo Foss / Ann Oldervoll / Atle Fretheim / Claire Glenton / Simon Lewin

Systematic Reviews, Vol 8, Iss 1, Pp 1-

a systematic scoping overview of systematic reviews

2019 Volume 15

Abstract: Abstract Background Human papillomavirus (HPV) infection causes cervical cancer. More than 80% of those diagnosed with cervical cancer live in low- and middle-income countries (LMICs). The World Health Organization recommends vaccination as a public ... ...

Abstract	Abstract Background Human papillomavirus (HPV) infection causes cervical cancer. More than 80% of those diagnosed with cervical cancer live in low- and middle-income countries (LMICs). The World Health Organization recommends vaccination as a public health measure against cervical cancer. Communication interventions are able to change how people think about vaccination and are thus instrumental in addressing vaccine hesitancy. Our aim was to provide a broad scoping overview of the available evidence on communication with adolescents, parents, and other stakeholders around HPV vaccination for adolescents, with a specific focus on LMICs. Methods We conducted a systematic scoping overview of systematic reviews addressing a range of questions regarding communication around HPV vaccination. We considered reviews published between 2007 and 2018 focusing on communication around HPV vaccination and that searched for qualitative or quantitative studies for inclusion. We searched the Epistemonikos database which includes reviews from multiple electronic databases. Two overview authors screened titles and abstracts and examined potentially eligible reviews in full text. Data extraction was performed by one overview author and verified by a second. We assessed the reliability of the included reviews using an adapted version of AMSTAR 2. Results We included twelve reviews in our overview. Four reviews assessed the effectiveness of communication interventions. These interventions intended to inform or educate about HPV and HPV vaccination, such as videos and fact sheets, or to remind or recall, such as text message reminders. Eight reviews assessed factors associated with HPV vaccination uptake, including communication-related factors such as whether the vaccine was recommended by a physician and people’s knowledge regarding the vaccine. Nine reviews searched for studies from LMICs, but most found only a small number of studies from these countries. Conclusions The small number of studies identified from LMICs is of concern ...
Keywords	HPV ; Human papillomavirus ; Vaccine ; Communication ; Intervention ; Adolescents ; Medicine ; R
Subject code	410
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementation considerations when expanding health worker roles to include safe abortion care

Claire Glenton / Annik M. Sorhaindo / Bela Ganatra / Simon Lewin

BMC Public Health, Vol 17, Iss 1, Pp 1-

a five-country case study synthesis

2017 Volume 13

Abstract: Abstract Background Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed ... ...

Abstract	Abstract Background Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician providers to include the delivery of abortion care. Methods We conducted a multi-country case study synthesis in Bangladesh, Ethiopia, Nepal, South Africa and Uruguay, where the roles of non-physician providers have been formally expanded to include the provision of abortion care. We searched for documentation from each country related to non-physician providers, abortion care services and role expansion through general internet searches, Google Scholar and PubMed, and gathered feedback from 12 key informants. We carried out a thematic analysis of the data, drawing on categories from the SURE Framework of factors affecting the implementation of policy options. Results Several factors appeared to affect the successful implementation of including non-physician providers to provide abortion care services. These included health workers’ knowledge about abortion legislation and services; and health workers’ willingness to provide abortion care. Health workers’ willingness appeared to be influenced by their personal views about abortion, the method of abortion and stage of pregnancy and their perceptions of their professional roles. While managers’ and co-workers’ attitudes towards the use of non-physician providers varied, the synthesis suggests that female clients focused less on the type of health worker and more on factors such as trust, privacy, cost, and closeness to home. Health systems factors also played a role, including workloads and incentives, training, supervision and support, supplies, referral systems, and monitoring and evaluation. Strategies used, with varying success, to address some of these issues in the study countries included values clarification ...
Keywords	Reproductive health ; Abortion ; Health systems ; Human resources for health ; Task shifting ; Role expansion ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2017-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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