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Cover of Challenges in Conducting EPC Reviews of Behavior Change Interventions

Challenges in Conducting EPC Reviews of Behavior Change Interventions

Methods Research Reports

Investigators: , PhD, MPH, , PhD, , MPP, , PhD, , PhD, , PhD, MPH, , MPH, , MD, MPH, , MD, MPH, , PhD, MA, and , MD, MPH.

Author Information and Affiliations
Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 15-EHC029-EF

Structured Abstract

Objective:

This report describes the challenges faced by systematic reviewers in the Evidence-based Practice Center (EPC) program when reviewing behavior change interventions, and considers whether current guidance is specific enough to address these challenges.

Methods:

A workgroup of members from EPCs, the Scientific Resource Center (SRC), and AHRQ was convened to describe systematic review methods for behavior change interventions in the EPC program and similar programs, and identify gaps in guidance. Complementary methods including a literature scan and key informant interviews were undertaken to reach the objectives. A literature scan was conducted to identify current guidance and methods literature on the inclusion of behavior change literature in systematic reviews. Interviews were held with thought leaders in the field to identify current practices and opinions on using behavior change literature. Workgroup members summarized information from the literature and interviews.

Results:

We identified specific challenges related to study selection (particularly in using single subject experimental designs), data extraction, risk of bias, strength of evidence, presentation and quantitative analysis. Challenges are particularly acute when fields are focused on identifying and describing heterogeneity in populations and treatment effects rather than identifying generalizable effects. Guidance is available, but the sources of guidance most used by the EPC program (EPC, Cochrane, and the National Institute for Health and Care Excellence) lack specificity in addressing these challenges.

Conclusions:

Challenge of reviewing behavior change literature exists at each step of EPC systematic reviews. A larger discussion is needed about how EPC program methods can meet the evidentiary needs and questions of decisionmakers, consistent with the program's aim to provide accurate, independent, and scientifically rigorous information. Any methods approaches moving forward should address the specific needs of decision makers for using reviews of behavior change literature.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2012-00004-C. Prepared by: Scientific Resource Center, Portland, OR

This research was funded through contracts from the Agency for Healthcare Research and Quality to the following Evidence-based Practice Centers: Vanderbilt University (290-2012-00009-I), University of Minnesota (290-2012-00016-I), RAND Corporation (290-2012-00006-I), RTI International and the University of North Carolina (290-201200008-I), and the Scientific Resource Center for the EPC Program (290-2012-00004-C).

Suggested citation:

McPheeters M, Butler M, Maglione M, Viswanathan M, O'Neil M, Epstein R, Anderson A, Guise J-M, Gozu A, Kondo K, Chang C. Challenges in Conducting EPC Reviews of Behavior Change Interventions. Methods Research Report. (Prepared by the Scientific Resource Center under Contract No. 290-2012-00004-C). AHRQ Publication No. 15-EHC029-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2015. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers' 2014 Methods Workgroup 1. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients).

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

1

540 Gaither Road, Rockville, MD 20850; www​.ahrq.gov

Bookshelf ID: NBK311017PMID: 26290922

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