Framework Synthesis Method Research Articles

Barriers and Facilitators for Physical Activity Among Children and Youth With Autism-A Scoping Review.

The purpose of this scoping review was to systematically synthesize barriers and facilitators for physical activity (PA) among children and youth with autism spectrum disorders (ASD) across the socioecological model. Five electronic databases were searched in March 2022 for studies examining barriers and facilitators for PA among children and youth with ASD. An updated search was performed in April 2024. The framework synthesis method was utilized, and the socioecological model was the chosen framework. Fifty-four studies published from 2008 to 2024 were included. Among the included studies, 57% included the perspectives of children and youth with ASD alone or together with proxies (eg,parents, teachers, and coaches), while 43% included only the perspectives of proxies. Barriers and facilitators on the intrapersonal and interpersonal levels were most substantial. The analysis led to 2 main categories of barriers and facilitators, those unique to children and youth with ASD, and those similar to what had been identified through research on children and youth, both typically developing and with other disabilities. This comprehensive scoping review shows the complexity of factors contributing to barriers and facilitators for PA among children and youth with ASD, and highlights both the factors unique to this population and more general factors affecting PA participation. The findings from this synthesis might be used to guide the development of inclusive PA in physical education, organized sports, and other community PA arenas.

Exploring the contribution of cancer palliative care development toward alleviating the human crisis of suffering in low- and middle-income countries: A framework synthesis protocol.

Inadequate access to cancer care, high mortality, and out-of-pocket expenditure contribute to health-related suffering in low- and middle-income countries, making palliative care a relevant option. How palliative care development has alleviated suffering is not systematically studied, necessitating this review's conduct. The objective of this systematic review with a framework synthesis approach is to identify and map the dimensions and indicators of cancer palliative care development and the components of integration between cancer and palliative care in LMICs. Uni- and multi-disciplinary databases like Cochrane, MEDLINE (PubMed), EMBASE, CINAHL Complete, and PsycINFO will be systematically searched for eligible studies exploring cancer palliative care development in LMICs and their contribution to alleviating health-related suffering in the cancer context. Our selection process will encompass countries classified by the World Bank as low-income (26 countries), lower-income (54 countries), and upper-middle-income (54 countries). Review findings will be synthesised and analysed using a best-fit framework synthesis method using 2 frameworks (the WHO model of components and indicators for palliative care development and integration elements between oncology and palliative care), and the findings will be developed as themes and subthemes, and patterns interpreted using these 2 models. This review will analyse the development of cancer palliative care in LMICs. It will identify gaps in provision, solutions derived at the regional level to address them, and best practices and failed models with reasons underpinning them.

Integrating virtual patients into undergraduate health professions curricula: a framework synthesis of stakeholders’ opinions based on a systematic literature review

BackgroundVirtual patients (VPs) are widely used in health professions education. When they are well integrated into curricula, they are considered to be more effective than loosely coupled add-ons. However, it is unclear what constitutes their successful integration. The aim of this study was to identify and synthesise the themes found in the literature that stakeholders perceive as important for successful implementation of VPs in curricula.MethodsWe searched five databases from 2000 to September 25, 2023. We included qualitative, quantitative, mixed-methods and descriptive case studies that defined, identified, explored, or evaluated a set of factors that, in the perception of students, teachers, course directors and researchers, were crucial for VP implementation. We excluded effectiveness studies that did not consider implementation characteristics, and studies that focused on VP design factors. We included English-language full-text reports and excluded conference abstracts, short opinion papers and editorials. Synthesis of results was performed using the framework synthesis method with Kern’s six-step model as the initial framework. We appraised the quality of the studies using the QuADS tool.ResultsOur search yielded a total of 4808 items, from which 21 studies met the inclusion criteria. We identified 14 themes that formed an integration framework. The themes were: goal in the curriculum; phase of the curriculum when to implement VPs; effective use of resources; VP alignment with curricular learning objectives; prioritisation of use; relation to other learning modalities; learning activities around VPs; time allocation; group setting; presence mode; VPs orientation for students and faculty; technical infrastructure; quality assurance, maintenance, and sustainability; assessment of VP learning outcomes and learning analytics. We investigated the occurrence of themes across studies to demonstrate the relevance of the framework. The quality of the studies did not influence the coverage of the themes.ConclusionsThe resulting framework can be used to structure plans and discussions around implementation of VPs in curricula. It has already been used to organise the curriculum implementation guidelines of a European project. We expect it will direct further research to deepen our knowledge on individual integration themes.

Healthcare workers' perspectives on barriers and facilitators to referral and recruitment to diabetes prevention programmes: a systematic review protocol.

Diabetes is a growing global health problem. International guidelines recommend identification, screening, and referral to behavioural programmes for those at high risk of developing type 2 diabetes. Diabetes prevention programmes (DPPs) can prevent type 2 diabetes in those at high risk, however many eligible participants are not referred to these programmes. Healthcare workers (HCWs) are pivotal to the referral and recruitment processes. This study aims to identify, appraise and synthesise the evidence on barriers and facilitators to referral and recruitment to DPPs from the perspective of HCWs. A "best fit" framework synthesis method will synthesise qualitative, quantitative, and mixed methods evidence on factors that affect HCWs referral and recruitment to DPPs, with the Theoretical Domains Framework (TDF) as the a priori framework. MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and Scopus will be searched for primary studies published in English. Year of publication will be restricted to the last 26 years (1997-2023). Quality will be assessed using the Mixed Methods Appraisal Tool. A mix of deductive coding using the TDF and inductive coding of data that does not fit the TDF will be synthesised into themes representing the whole dataset. The relationships between the final set of themes will be explored to create a new model to understand HCWs' perspectives on referral and recruitment to DPPs. Sensitivity analysis will be carried out on this conceptual model. Confidence in the synthesised findings will be assessed using the GRADE-CERQual approach. One author will screen, extract, appraise the literature while a second author will independently verify a 20% sample at each stage. Participation in DPPs is key for programme impact. HCWs typically identify those at risk and refer them to DPPs. Understanding HCWs' perspectives on the barriers and facilitators to referral and recruitment will inform future implementation of DPPs.

A VUCA-ready workforce: exploring employee competencies and learning and development implications

PurposeThe author aims to develop an employee competency framework for a volatility, uncertainty, complexity and ambiguity (VUCA) environment and propose learning and development (L&D) interventions for organisations and employees to develop competencies for thriving in a VUCA environment.Design/methodology/approachThe framework synthesis method was used to determine employee competencies that are essential in a VUCA world.FindingsThe author identified 10 competencies that are essential for employee development in a VUCA world. The author categorised these employee competencies as cognitive (cognitive flexibility, agility mindset and personal ambidexterity), cross-cultural (cross-cultural intelligence and cross-cultural collaboration), analytical (creativity and complex problem solving) and personal effectiveness competencies (personal resilience, continuous learning and adaptive mindset).Practical implicationsThe proposed competencies could be used for the personal development of employees and organisations. The VUCA competency framework developed in this study includes behavioural dimensions for each competency, which could be used in self-assessment, recruitment and selection and talent and performance management. Furthermore, the author proposes L&D interventions required for developing these competencies. Overall, this study contributes to human resources (HR) development in the VUCA era by proposing the development of specific individual competencies as necessary conditions for survival and growth.Originality/valueVUCA competencies empower employees to not only survive but also thrive in an unpredictable and rapidly changing world. By incorporating these competencies in L&D interventions, organisations can help employees develop the necessary competencies to thrive in a VUCA environment, thus contributing to their personal and organisational success.

Educator-Perceived Barriers and Facilitators to Structured-Physical Activity in Early Childhood Centres: A Systematic Review

ABSTRACT Purpose: Physical activity (PA) and motor competence development are vital for young children, yet many early childhood education and care (ECEC) centers struggle to successfully implement PA programs, particularly those organized and led by educators. This review aimed to synthesize qualitative literature to (1) identify educator-perceived barriers and facilitators to structured-PA in ECEC centers, and (2) map these to the COM-B model and Theoretical Domains Framework (TDF). Methods: Following PRISMA guidelines, a systematic search of five databases was conducted in April 2021 and updated in August 2022. Records were screened in Covidence software using predefined eligibility criteria. Using the framework synthesis method, data extraction and synthesis were conducted in coding forms in Excel and NVivo. Results: Of 2382 records identified, 35 studies were included, representing 2,365 educators across 268 ECEC centers in 10 countries. Using the COM-B model and TDF, an evidence-informed framework was developed. Findings revealed the greatest barriers concerned educator “opportunity” (e.g. competing time and priorities, policy tensions, indoor/outdoor space constraints) and “capability” (e.g. lack of PA knowledge and practical, hands-on skills) to implement structured-PA. Although fewer studies reported factors that influenced educator “motivation”, several themes intersected across the three COM-B components illustrating the complexity of behavioral determinants in this setting. Conclusions: Interventions grounded in theory that utilize a systems approach to target multiple levels of influence on educator behavior, and are flexible and adaptable locally, are recommended. Future work should seek to address societal barriers, structural challenges in the sector, and the PA educational needs of educators. PROSPERO Registration: CRD42021247977

Healthcare workers’ perspectives on barriers and facilitators to referral and recruitment to diabetes prevention programmes: a systematic review protocol

Background: Diabetes is a growing global health problem. International guidelines recommend identification, screening, and referral to behavioural programmes for those at high risk of developing type 2 diabetes. Diabetes prevention programmes (DPPs) can prevent type 2 diabetes in those at high risk, however many eligible participants are not referred to these programmes. Healthcare workers (HCWs) are pivotal to the referral and recruitment processes. This study aims to identify, appraise and synthesise the evidence on barriers and facilitators to referral and recruitment to DPPs from the perspective of HCWs. Methods: A “best fit” framework synthesis method will synthesise qualitative, quantitative, and mixed methods evidence on factors that affect HCWs referral and recruitment to DPPs, with the Theoretical Domains Framework (TDF) as the a priori framework. MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and Scopus will be searched for primary studies published in English. Year of publication will be restricted to the last 25 years (1997–2022). Quality will be assessed using the Mixed Methods Appraisal Tool. A mix of deductive coding using the TDF and inductive coding of data that does not fit the TDF will be synthesised into themes representing the whole dataset. The relationships between the final set of themes will be explored to create a new model to understand HCWs’ perspectives on referral and recruitment to DPPs. Sensitivity analysis will be carried out this conceptual model. Confidence in the synthesised findings will be assessed using the GRADE-CERQual approach. One author will screen, extract, appraise the literature while a second author will independently verify a 20% sample at each stage. Discussion: Participation in DPPs is key for programme impact. HCWs typically identify those at risk and refer them to DPPs. Understanding HCWs’ perspectives of the barriers and facilitators to referral and recruitment will inform future implementation of DPPs.

Identifying barriers and facilitators of translating research evidence into clinical practice: A systematic review of reviews.

Translating research into clinical practice is a global priority because of its potential impact on health services delivery and outcomes. Despite the ever-increasing depth and breadth of health research, most areas across the globe seem to be slow to translate relevant research evidence into clinical practice. Thus, this review sought to synthesise existing literature to elucidate the barriers and facilitators to the translation of health research into clinical practice. A systematic review of reviews approach was utilised. Review studies were identified across PubMed, Scopus, Embase, CINAHL and Web of Science databases, from their inception to 15 March 2021. Searching was updated on 30 March 2022. All retrieved articles were screened by two authors; reviews meeting the inclusion criteria were retained. Based on the review type, two validated tools were employed to ascertain their quality: A Measurement Tool to Assess Systematic Reviews-2 and International Narrative Systematic assessment. The framework synthesis method was adopted to guide the analysis and narrative synthesis of data from selected articles. Ten reviews met the inclusion criteria. The study revealed that the translation of new evidence was limited predominantly by individual-level issues and less frequently by organisational factors. Inadequate knowledge and skills of individuals to conduct, organise, utilise and appraise research literature were the primary individual-level barriers. Limited access to research evidence and lack of equipment were the key organisational challenges. To circumvent these barriers, it is critical to establish collaborations and partnerships between policy makers and health professionals at all levels and stages of the research process. The study concluded that recognising barriers and facilitators could help set key priorities that aid in translating and integrating research evidence into practice. Effective stakeholder collaboration and co-operation should improve the translation of research findings into clinical practice.

Barriers and enablers to sustaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following attendance at a self-management support intervention for type 2 diabetes. Methods: The review will use the “best fit” framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample. Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.

Barriers and enablers to sustaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following attendance at a self-management support intervention for type 2 diabetes. Methods: The review will use the "best fit" framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample. Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.

Room temperature detection of low-concentration H2S based on CuO functionalized ZnFe2O4 porous spheres

Room temperature H2S gas sensor with low detection limit is necessary for practical application. In this work, ZnFe2O4 was synthesized through a simple solvothermal method, and then CuO was decorated onto the surface of ZnFe2O4 via a modified metal organic framework synthesis method. After a series of characterization methods, it was found that CuO/ZnFe2O4 had porous nanosphere morphology. Gas sensing measurements indicating that the synthesized CuO/ZnFe2O4 porous spheres exhibited excellent H2S sensing performance under room temperature, including high sensitivity under low concentration (less than 10 ppm), excellent selectivity, low limit of detection (0.1 ppm), good repeatability, and fast response/recovery time. The sensing mechanism was discussed in detail, which is mainly contributed to the sensitization effect of CuO. This work provides a new strategy for constructing room temperature H2S gas sensor based on ZnFe2O4.

Barriers and enablers to sustaining self-management behaviours after completing a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis.

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following completion of a self-management support intervention for type 2 diabetes. Methods: The review will use the "best fit" framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample. Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.

A Best-Fit Framework and Systematic Review of Asymmetric Gameplay in Multiplayer Virtual Reality Games

Increasingly, virtual reality (VR) design and research leverages gameplay asymmetries, flattening discrepancies of interface, abilities, information or other aspects between players. A common goal is to induce social interactions that draw players without head-mounted displays into a shared game world. Exploring these asymmetries resulted in many artifacts, creating an innovative yet disparate research landscape that showcases points for improvement in coverage of the field and theoretical underpinnings. In this article, we present a literature review of asymmetry in multiplayer VR games, using a framework synthesis method to assess the field through a lens of existing literature on asymmetries in gameplay. We provide an overview of this emerging subfield and identify gaps and opportunities for future research. Moreover, we discuss how research artifacts address prior theoretical work and present a “best fit” framework of asymmetric multiplayer VR games for the community to build upon.

The interpretive model of manufacturing: a theoretical framework and research agenda for machine learning in manufacturing

Manufacturing is undergoing a paradigmatic shift as it assimilates and is transformed by machine learning and other cognitive technologies. A new paradigm usually necessitates a new framework to comprehend it fully, organise extant knowledge, identify gaps in knowledge, guide future research and practice, and synthesise new knowledge. Paradoxically, such a framework to guide the research and practice of ML in manufacturing remains absent. This paper attempts to fill this gap by presenting the interpretive model of manufacturing as an integrative framework for ML in manufacturing. A systematic hybrid literature review approach has been adopted to conduct both thematic and conceptual synthesis of the literature. The descriptive literature review method has been used to conduct a thematic synthesis of the literature. The framework synthesis method has been used to complete a conceptual synthesis of the literature. The resultant framework, the interpretive model of manufacturing, is articulated as consisting of scan, store, interpret, execute, and learn as its purposive components. Research questions have been identified for each of these components, as well as at their interfaces, to develop a comprehensive and systematic research agenda. Additional areas for extending research have also been identified. Implications for manufacturing operations, manufacturing strategy, and manufacturing policy have been drawn out for practitioners and policy makers.

Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review

BackgroundCountries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services?MethodsThis systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations.ResultsSeventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed.ConclusionThe CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.

Structural regulation of electroplating sludge by a metal–organic framework synthesis method for an enhanced denitrification activity

Electroplating sludge contained multi-metals and organics. In previous reports, electroplating sludges were usually recycled by direct calcination and pyrolysis for structural regulations. For the first time, a metal–organic framework synthesis method was utilized to regulate the structure of an electroplating sludge. In brief, the sludge was hydrothermally treated in solution of 1,3,5-trimesic acid, ethanol, and N,N-dimethylformamide. After this strategy, the sludge particle size was decreased; metals and organics formed coordination bond, and transformed oxygen-centered radicals to carbon-centered radicals; amorphous phases were re-crystalized to form well-dispersed crystals. As a result, the regulated sludge showed an enhanced denitrification activity. It removed 61.6% of nitric oxide (990 ppm) at a temperature as low as 150 °C. The activity was even close to 99.9% at 350 °C. What is more, the regulated sludge was characterized by plenty of free carboxylic groups and multi-metal catalytic centers, which make it a better catalyst than the pure-reagent-synthesized catalyst. Therefore, this paper put forward a novel strategy for the high value-added utilization of electroplating sludge.

Operationalization of the concepts of interdisciplinarity: An implication elicitation exercises based on the framework synthesis methodology.

BACKGROUND:Over the last few centuries, the overspecialization of various sciences under the pretext of benefiting from pure disciplinary knowledge led to alienation among and competition between different fields of science. Such competition has deviated knowledge from its main objective which is to understand and explain the phenomena. The remedy to this dilemma is to address a new approach, introduced to higher education in the late 1950s as “interdisciplinarity.” Accordingly, the main purpose of this article is to propose the strategic instances of operationalizing interdisciplinarity as the key requirements to provide a guideline for designing interdisciplinarity activities.MATERIALS AND METHODS:The present survey was carried out through the framework synthesis method. To codify the instances of operationalizing interdisciplinarity, the main elements and structures of the model were set as the basis of the query for each element and structure; an independent query was carried out in the literature of the study. The correspondence of the discovered instances was once more compared with the conceptual boxes of the primary theoretical model. Ultimately, the taxonomy was concluded through the operational instances based on the primary framework.RESULTS:A total of 152 strategies were identified as implications of operationalization of 13 layers and 38 sublayers of the multilayer interdisciplinary model.CONCLUSION:The development of interdisciplinarity in the national higher education system requires several measures to be taken at different levels of a discipline or scientific field of study. Relying on this, which is the main basis of entering into interdisciplinarity activities, the present study suggests and presents strategic instances of interdisciplinarity operationalization.

Leadership and Management Competencies for Hospital Managers: A Systematic Review and Best-Fit Framework Synthesis.

ObjectiveCompetent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method.MethodsA systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework.ResultsTwelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism.ConclusionThis review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.

Understanding how local authorities in England address obesity: A wider determinants of health perspective

Local government organisations (LAs) have a major role in the prevention and treatment of obesity in England. This study aims to 1) understand what actions are being taken by LAs to address obesity, and 2) determine how actions counter the perceived causes of obesity when mapped against the Wider Determinants of Health (WDoH) model.Thirty-two LAs were invited to complete an Action Mapping Tool, 10 participated. The tool requires LAs to document actions being implemented locally to address obesity. This then enables LAs to map their actions against the perceived causes of obesity, using the WDoH model as an analytical lens. We collated data from the 10 LAs and used an adapted framework synthesis method for analysis.280 actions were documented across the 10 LAs; almost 60% (n = 166) targeted Individual Lifestyle Factors (ILF), with 7.1% (n = 20), 16.8% (n = 47) and 16.4% (n = 46) targeting Social and Community Factors (SCF), Living and Working Conditions (LWC) and Wider Conditions (WC) respectively. Conversely, 60% of causes were spread across the LWC and WC, with 16.4% regarded as ILF. Physical activity-, weight management-, and health improvement- programmes were most frequently implemented by LAs.There is a stark mismatch between LA actions on obesity and its perceived causes. Given that LAs acknowledge the complex aetiology of obesity, an equally comprehensive approach should be implemented in the future.

A comprehensive map of the evidence on the performance evaluation indicators of public hospitals: a scoping study and best fit framework synthesis

IntroductionKey performance indicators are essential navigation tools for hospitals. They provide managers with valid information enabling them to identify institutional strengths and weaknesses and improve managerial performance. In this study, the synthesis of evidence relating to hospital performance indicators was carried out by means of a field review and the indicators were analyzed through the Best Fit Method.MethodsThe five-step approach of Arksey and O’Malley was used as follows: selection of the research question; search for related studies; selection and refinement of the studies; synthesis and tabulation of key information; derivation of the related summary and report. Applying the Best Fit Framework Synthesis Method, the initial themes and subthemes were created and a model of public hospitals performance evaluation finally generated.ResultsForty-nine studies were considered eligible to form part of the synthesis. The final model included the efficiency/productivity, effectiveness and financial themes. The efficiency/productivity sub-themes incorporated human resources indicators, hospital beds, costs, operating room productivity, emergency rooms, ICU, radiology, labs, technology and equipment productivity. Other sub-themes relate to general indicators such as BOR, ALS, number of outpatients and hospitalized patients. Financial themes included profit, revenue, cash flow, cost, investment, assets, debt and liquidity. Concerning effectiveness, the indicators were categorized in terms of access (equity), safety, quality and responsiveness. The accountability indicators were classified into patient-centeredness, staff orientation, and social responsibility.ConclusionHospital performance management is a multi-dimensional issue, each dimension having its own significance. Based on the evidence, indicators are dependent on the evaluation model employed, the evaluation objective, and the views of executive managers and participants in the study. Selection of the most appropriate indicators is therefore key to a comprehensive performance evaluation system.