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Table 3 Facilitators to use of systematic reviews by policy makers and health care managers

From: Barriers and facilitators to uptake of systematic reviews by policy makers and health care managers: a scoping review

Attitudes Knowledge Skills Behaviour
Agreement/usefulness Motivation Awareness/familiarity Expertise/experience/training SRs/intrinsic factors Extrinsic factors
Stakeholders described potential uses of the review as being more indirect (creating a culture); for example, for advocacy purposes internally, to promote a particular intervention approach and to identify gaps of where further evaluation was needed [39, 41, 42] Expecting to use the systematic reviews in the future [23] Recognition of relative importance of SR compared to other sources of information such as single studies (culture of evidence-based decision-making) [31] One’s age [23]—younger, more likely to use Delineating the effects for a particular group with more focused subgroup analyses in SRs [44] enhanced their usefulness Making decisions in collaboration with other community organisations increased likelihood of using reviews [23]
SRs to provide guidance and suggestions for implementation of findings, not just reporting facts [43] Willingness of health care providers to use systematic reviews [51]   Number of years since graduation [23]—more recent graduates more likely to use Providing information about the benefits, harms (or risks), and costs [45] Increasing the opportunities for interaction and exchange between policy makers and researchers is key to promoting the use of research evidence in policy [42]
Most policy makers reported having needed the data and reviews in the past 12 months, having commissioned research or reviews during this period, and having used evidence to contribute to the content of policy [42] Perception that reviews facilitate critical appraisal of evidence and are easy to use, information about what works and clearly articulated implications for policy (costs, applicability, impacts on equity) [47]   Providing training in basic search skills may increase use [52] Concise statements about lives or money can infuse the political discussion with a tone of rationality, framing the trade-offs as technical and straightforward [44]. Providing information about the benefits, harms (or risks), and costs [45] One-to-one interaction with the researcher to discuss research findings [43]
Respondents who expected to use the reviews in the future were more likely to have used a review than those who did not expect to use the reviews [22] Presenting selected important systematic reviews to policy makers may change their attitudes towards evidence-based decision-making, presenting successful/unsuccessful policies [51]   Perception that systematic reviews could overcome the barrier of limited critical appraisal skills [22] Identify attributes of the context in which the research included in a systematicreview was conducted to inform assessments of the applicability of the review in other contexts [45]. Concise statements about lives or money can infuse the political discussion with a tone of rationality, framing the trade-offs as technical and straightforward [44]. Providing information about the benefits, harms (or risks), and costs [45] Organisational research culture [23, 24] favouring use of research to inform decision-making
Coming from credible sources [47]    Ongoing training in critical appraisal of research literature [23] Add additional local value toany type of systematic review by using language that is locally applicable and by engaging in discussions about the implications of reviews with the health care managers and policy makers who could potentially act on the reviews’ take-home messages [45]. Identify attributes of thecontext in which the research included in a systematic review was conducted to inform assessments of the applicability of the review in other contexts [45]. Concise statements about lives or money can infuse the political discussion with a tone of rationality, framing the trade-offs as technical and straightforward [44] Fund production and updating of SRs with additional resources for health care managers and policy makers to interact and fund local adaptation process for SR [45]
Relevance to policy decisions [31] Most policy makers reported having needed data and reviews in the past 12 months, having commissioned research or reviews during this period, and having used evidence to contribute to the content of policy [42]    Opportunities for training and education on systematic reviews (definition, significance, appraisal) [30] Ongoing training in critical appraisal of research literature [23] Ensure SRs are included in a one-stop-shop that provides quality-appraised reviews [45]. Add additional local value to any type of systematic review by using language that is locally applicable and by engaging in discussions about the implications of reviews with the health care managers and policy makers who could potentially act on the reviews’ take-home messages [45]. Identify attributes of the context in which the research included in a systematic review was conducted to inform assessments of the applicability of the review in other contexts [45] Collaborative creation of knowledge in a format that is easy to view and comprehensible and allows fast and easy referencing [49]
Reassurance that no reviews have been missed [52]. Respondents who expected to use the reviews in the future were more likely to have used a review than those who did not expect to use the reviews [22]    Opportunities for training and education on systematic reviews (definition, significance, appraisal) [30] Replacing unfamiliar terms or adding definitions to the re view [47]. Ensure SRs are included in a one-stop-shop that provides quality-appraised reviews [45]. Add additional local value to any type of systematic review by using language that is locally applicable and by engaging in discussions about the implications of reviews with the health care managers and policy-makers who could potentially act on the reviews’ take-home messages [45] Involvement of librarians and health information specialists as a solution to lack of database access, establishment of a national portal for expanding access [51]
Coming from credible sources [47]    Teaching about systematic reviews, integration of this course into postgraduate educational curricula, mandatory education of research methods to researchers, consultation support in methodology and scientific writing, professional methodologists on research teams [51] Provide section on the relevance of the evidence and the intervention for low and middle income countries (LMICs) [47]. Ensure SRs are included in a one-stop-shop that provides quality-appraised reviews [45] Involvement in an advisory role by policy makers on research teams (i.e. involved with the development of research questions, assisted with dissemination) [42]
Relevance to policy decisions [31]    Perception that systematic reviews would overcome the barrier of not having enough time to use research evidence [23] Make the user-friendly “front end” of systematic reviews available through an online database that could be searched using keywords that make sense to health care managers and policy-makers and that is linked to the full reviews when they are available through other sources, such as The Cochrane Library [45]. Replacing unfamiliar terms or adding definitions to the review [47] Position of end user within organisation/system: programme manager vs. director vs. medical officer differed in uptake of SRs [22]
Reassurance that no reviews have been missed [52]     Use of stories to help integration come alive for participants so they could see how it lives operationally [49]. Provide section on the relevance of the evidence and the intervention for low and middle income countries (LMICs) [47]. Replacing unfamiliar terms or adding definitions to the re view [47] Value the organisation placed on using research evidence for decision-making [23]
     Make the user-friendly “front end” of systematic reviews available through an online database that could be searched using keywords that make sense to health care managers and policy makers and that is linked to the full reviews when they are available through other sources, such as The Cochrane Library [45]. Provide section on the relevance of the evidence and the intervention for low and middle income countries (LMICs) [47] Having direct access to online database searching [23]
     Use of stories to help integration come alive for participants so they could see how it lives operationally [49]. Make the user-friendly “front end” of systematic reviews available through an online database that could be searched using keywords that make sense to health care managers and policy makers and that is linked to the full reviews when they are available through other sources, such as The Cochrane Library [45] Existence of mechanisms to facilitate transfer of new information in health unit [23]
     Use of less dense and more accessible articles [49]. Use of stories to help integration come alive for participants so they could see how it lives operationally [49] Reallocate funding away from single study knowledge transfer strategies, fund rapid reviews, more proactive knowledge transfer, health care manager [45]
     Removing jargon and using language that is locally applicable, engage in discussion about the potential implications of the review [45]. It must be packaged to incite and persuade, “to translate the evidence into something that is understandable by the average legislator, average citizen” [44]. Concrete recommendations for practice [31] Priority of and support for systematic reviews [51]
     It must be packaged to incite and persuade, “to translate the evidence into something that is understandable by the average legislator, average citizen” [44] Announce priorities to be addressed using SR [51]
     Use of familiar, non-jargon language recommended [47]. Removing jargon and using language that is locally applicable, engage in discussion about the potential implications of the review [45] Meeting requestors time constraints [52]
     Reassurance that no reviews have been missed [52]. Use of familiar, non-jargon language recommended [47]. Removing jargon and using language that is locally applicable, engage in discussion about the potential implications of the review [45] Consistency in follow-up of individuals using on-demand service to appraise and interpret reviews of research [52]
     Easy to use [31]. Framing the evidence in terms of how they can implement it (specifically as a list of questions to be considered when developing and implementing an integrated health system, information about how to engage stakeholders, build relationships and communicate appropriately across target audiences) [49]. Reassurance that no reviews have been missed [52] Researchers and policy makers generally found reviews commissioned through evidence check to accurately reflect the state of the evidence, implying that the requirement for rigour and comprehensiveness was not unnecessarily compromised by the rapid timeframe in which the reviews were conducted. It is likely that this is due to both knowledge brokers’ attempts to assist in precisely defining the focus and scope of reviews early in the commissioning process, and researchers’ depth of content knowledge and methodological expertise [41]
     Easy to use [31]. Framing the evidence in terms of how they can implement it (specifically as a list of questions to be considered when developing and implementing an integrated health system, information about how to engage stakeholders, build relationships and communicate appropriately across target audiences) [49]  
     Using consistent language and standard phrases to describe effect sizes and the quality of the evidence [47]. Easy to use [31]  
     Using consistent language and standard phrases to describe effect sizes and the quality of the evidence [47]