Abstract
BackgroundDecision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones.MethodsWe systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a ‘compass’ question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps.ResultsWe identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems – political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use.ConclusionsThis study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
Highlights
Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one
Four-part structure of the framework Our analysis of the findings from the literature resulted in a conceptual framework (Fig. 2) that focuses on evidence use in crisis zones examined through the lens of four distinct systems that crisis zones operate within
Our theoretical framework can be thought of as a heuristic that can be used to identify (1) the strategies that can be employed to integrate the use of evidence more systematically into decision-making as well as (2) the facilitators and barriers that influence evidence use in decisionmaking in crisis zones, both individually and in relation to each other (Fig. 2)
Summary
Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. Part of the challenge may be a lack of understanding of the benefits of using evidence to inform decision-making. Research evidence can help decision-makers understand a problem, frame options to respond appropriately, and address implementation considerations for interventions in specific contexts. There is a need for a theoretically informed framework outlining the strategies that would leverage facilitators and address the barriers to evidenceinformed decision-making in crisis zones in LMICs. This study aims to fill this gap by developing a conceptual framework
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