Social Science Databases Research Articles

Older people's experiences of everyday travel in the urban environment: a thematic synthesis of qualitative studies in the United Kingdom

AbstractCompared to younger age groups, older people spend more time in their locality and rely more heavily on its pedestrian and public transport infrastructure. Qualitative studies provide unique insight into people's experiences. We conducted a qualitative evidence synthesis of United Kingdom-based studies of older people's experiences of travelling in the urban environment. We searched health, social science, age-related and transport-related databases from 1998 to 2017. Fourteen papers (from 12 studies) were included in a thematic synthesis, a three-staged process that moves iteratively between codes, descriptive themes and cross-cutting analytical themes. Emerging themes were discussed with policy advisers. Four overarching themes were identified. The first and second theme pointed to the importance of ‘getting out’ and of being independent travellers. The third and fourth themes highlighted how local environments and travel systems enabled (or prevented) older people from realising these valued dimensions of travel. The loss of local amenities and micro-environmental features, such as pavement quality, personal safety and aesthetic appearance, were recurrent concerns. Free modes of travel like walking and bus travel were highly valued, including the social engagement they facilitated. Our review suggests that, while its extrinsic value (reaching destinations) matters, the intrinsic value of travel matters too. The process of travel is experienced and enjoyed for its own sake, with older people describing its contribution to their wellbeing.

Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review.

ObjectivesTo review the research literature on cultural safety education within post-secondary health science programs. MethodsWe conducted health and social science database searches from 1996-2016, using combined keywords: cultural competence or safety; teaching or curriculum; universities, polytechnics or professional programs; and Aboriginal or Indigenous. In dyads, authors selected, and reviewed studies independently followed by discussion and consensus to identify thematic linkages of major findings. ResultsA total of 1583 abstracts and 122 full-text articles were reviewed with 40 selected for final inclusion. Publications from Australia, Canada, New Zealand and the United States described curriculum development and delivery. A variety of evaluation approaches were used including anecdotal reports, focus groups, interviews, course evaluations, reflective journals, pre-post surveys, critical reflective papers, and exam questions. Duration and depth of curricular exposure ranged from one day to integration across a six-year program. Changes in student knowledge, attitude, self-confidence, and behaviour when working with Indigenous populations were reported. Cultural safety education and application to practice were shown to be linked to improved relationships, healthier outcomes, and increased number of Indigenous people entering health education programs and graduates interested in working in diverse communities. ConclusionsThis review provides a summary of multidisciplinary didactic and experiential instructional approaches to cultural safety education and the impact on students, educators and Indigenous people. Institutional support, strategic planning and cultural safety curriculum policy within post-secondary settings and community engagement are imperative for positive student experiences, advocacy, and actions toward health equity and improved health for Indigenous people and communities.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient's end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

Bearing Witness: Exploring the End-of-Life Needs of Homeless Persons and Barriers to Appropriate Care.

Traditional models of palliative care are largely inaccessible to homeless persons, and their preferences regarding end-of-life care are poorly understood. The purpose of the present scoping review is to summarize the burgeoning gray and academic literature on end-of-life care for homeless persons. Five medical databases, seven social science databases, and four gray literature databases were searched, resulting in 57 relevant titles. Six themes emerged: (a) Characteristics of homeless persons who require end-of-life care; (b) preferences and concerns of homeless persons approaching the end of life; (c) the role of spirituality for homeless persons at the end of life; (d) barriers to care at the patient, provider, and institutional or structural levels; (e) inclusive models of palliative care; and (f) implications for policy and practice. Practitioners and homeless persons must negotiate many obstacles in the provision and receipt of palliative care. However, there is tremendous potential and opportunity to improve the quality of life at the end of life for this vulnerable population.

Health promotion and prevention among the unemployed: a systematic review.

The interactions between unemployment and health create a need for specific interventions for health promotion and prevention. This overview provides information on how health promotion for the unemployed has been approached with an analysis of controlled intervention studies between 1996 and 2016. The literature search consulted 11 international databases in medicine, social sciences and psychology. A total of 30 health interventions for the unemployed were identified, with 43 articles that included the effects of intervention. A controlled-study design was used in 14 studies. The health promotion measures were generally based on individual counselling, case management, training or group services. The overview demonstrates the breadth of variation in target groups and types of measures. Their result indicators for health and integration into the labor market vary substantially, as do the employment promotion effects. There is evidence of improved health and labor market integration for established approaches like the JOBS Program and JobFit. Effects are rather moderate or low in magnitude and the effect mechanisms often remain unclear. Effects weaken over time. While success is more common in the areas of health, physical activity, nutrition and stress relief, there was no impact on smoking behavior. A significant evolution can be observed in the quality and quantity of health promotion for the unemployed over time. There is a need for further research on the effectiveness and sustainability of interventions. Intervention strategies should be developed that take account of the diversity of the unemployed and their different needs.

Parents' use of mobile computing devices, caregiving and the social and emotional development of children: a systematic review of the evidence.

Mobile device use is a rapidly growing, socially acceptable interactional habit. The impact of mobile device use on social interactions, including between parents and young children, is uncertain. The aim was to describe, synthesise and evaluate the evidence about parents' mobile device use, caregiving and children's social and emotional development. Seven medical and social sciences databases were searched using keywords and subject headings. Screening for eligibility used PRISMA guidelines and scientific and reporting quality were assessed with standardised checklists. Eight studies met the inclusion criteria (four surveys, three qualitative and one mixed-method investigation). This small group of studies is of diverse quality, but there is evidence of associations between parents' mobile device use, attention to caregiving and changes in child behaviour. Use of mobile devices during parenting activities may be infrequent and brief, but it can be a potent distraction that reduces caregiver responsiveness to children. An emerging body of research suggests mobile devices are associated with altered attention and responsivity to children by their caregivers and may change caregiver/child interactions. The evidence precludes questions about causality or discussion of impacts on child development. Knowledge gaps have been identified and they require future targeted research.

Patients' Perspectives of Oral and Injectable Type 2 Diabetes Medicines, Their Body Weight and Medicine-Taking Behavior in the UK: A Systematic Review and Meta-Ethnography.

The aim of this review is to identify peoples’ perspectives of their glucose-lowering and anti-obesity drugs in relation to diabetes and weight control and to explore how these views affect medication adherence. Theoretical perspectives associated with medicine-taking behavior are also explored. The systematic review was based on a meta-ethnography of qualitative studies identified through a search of 12 medical and social science databases and subsequent citation searches. The quality of all studies was assessed. Sixteen studies were included with data from 360 UK individuals. No relevant studies were identified which focused on anti-obesity and non-insulin injectable drugs. The review revealed that the patients’ perspectives and emotional state were influenced by starting and/or changing to a new glucose-lowering medicine. These were also influenced by prior medication experience, disease perceptions and interactions with clinicians. Despite reports of positive experiences with and positive perceptions of medicines, and of participation in strategies to regain life control, medication non-adherence was common. Accepting glucose-lowering medicines impacted on the individual’s perception of lifestyle changes, and it was notable that weight loss was not perceived as a strategy to support diabetes management. Synthesis revealed that more than one theory is required to explain medicine-taking behavior. New insights into the underlying factors of poor adherence and the specific practical issues identified in this review can help in the development of patient-centered interventions.Funding: Diabetes UK.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0490-5) contains supplementary material, which is available to authorized users.

A systematic review of mental health care workers' constructions about culturally and linguistically diverse people.

A systematic review of research published in English was conducted across seven electronic databases in psychology, health and social sciences. The aim was to ascertain the nature of mental health care workers’ constructions about culturally and linguistically diverse individuals in order to facilitate provision of culturally appropriate service delivery and multicultural training. The constructs and perspectives of 5,870 mental health workers with regards to minority populations are represented across the 38 studies included. Key themes comprised: Aetiology of Constructions; Content of Constructions, Factors that Influence Constructions; Implications for Cultural Competence, Implications for the Therapeutic Alliance, Recommendations for Training, Recommendations for Practice and Recommendations for Research. The therapeutic alliance was most at risk when practitioners displayed low levels of cultural competency and high levels of racial and ethnic blindness. The changing and increasingly multicultural context within most countries means that mental health systems and workers need to prepare for an increasing range of culturally and linguistically diverse clients in need of support. Recommendations are explored for training, practice and research.

The development, implementation and evaluation of interventions to reduce workplace sitting: a qualitative systematic review and evidence-based operational framework

BackgroundProlonged sitting is associated with increased risks of cardiovascular disease, Type 2 diabetes, some cancers, musculoskeletal disorders and premature mortality. Workplaces contribute to a large proportion of daily sitting time, particularly among office-based workers. Interventions to reduce workplace sitting therefore represent important public health initiatives. Previous systematic reviews suggest such interventions can be effective but have reported wide variations. Further, there is uncertainty as to whether effectiveness in controlled trials can be replicated when implemented outside the research setting. The aims of this review are to identify factors important for the implementation of workplace sitting interventions and to translate these findings into a useful operational framework to support the future implementation of such interventions.MethodsA qualitative systematic review was conducted. Four health and social science databases were searched for studies set in the workplace, with office-based employees and with the primary aim of reducing workplace sitting. Extracted data were primarily from author descriptions of interventions and their implementation. Inductive thematic analysis and synthesis was undertaken.ResultsForty studies met the inclusion criteria. Nine descriptive themes were identified from which emerged three higher-order analytical themes, which related to the development, implementation and evaluation of workplace sitting interventions. Key findings included: the importance of grounding interventions in theory; utilising participative approaches during intervention development and implementation; and conducting comprehensive process and outcome evaluations. There was a general under-reporting of information relating to the context within which workplace sitting interventions were implemented, such as details of local organisation processes and structures, as well as the wider political and economic landscape, which if present would aid the translation of knowledge into “real-world” settings.ConclusionsThese findings provided the basis for an operational framework, which is a representation of all nine descriptive themes and three higher-order analytical themes, to support workplace sitting intervention development, implementation and evaluation. Once tested and refined, this framework has the potential to be incorporated into a practical toolkit, which could be used by a range of organisations to develop, implement and evaluate their own interventions to reduce workplace sitting time amongst staff.

A systematic review of the association between rape myth acceptance and male-on-female sexual violence

Rape myth acceptance is considered an established risk factor for male-on-female sexual violence, and is therefore the target of a number of primary prevention programmes. However, there is not a clear evidence base substantiating the role of rape myth acceptance in sexual violence, nor any reviews of recent literature. This review systematically searched relevant Psychology and Social Science databases in Autumn 2016, in order to collate cross-sectional and longitudinal research on the association between rape myth acceptance and self-reported sexual violence. The analysis established associations between these variables in all but one study (Warren, Swan, & Allen, 2015), and two longitudinal studies demonstrated that rape myth acceptance differentiates non-perpetrators from those who go on to exhibit sexual violence behaviours. These findings provide support for the targeting of rape myth acceptance in primary prevention strategies. However, a number of failings within this literature were also identified: instruments used to analyse rape myth acceptance were widely varied; the comprehensiveness of study reporting was universally flawed; measures were rarely taken to ensure participants were heterosexual men; and there remains a dearth of longitudinal evidence, as well as a lack of research outside of the United States. Future directions and other limitations are discussed.

Children and young people\u2019s participation in developing interventions in health and well-being: a scoping review

BackgroundGreater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people’s health and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being.MethodsAn interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier’s Pathways to Participation Model.ResultsThe review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and young people becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level.ConclusionsThis scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted.

Systematic Review of Factors Influencing Smoking Following Release From Smoke-Free Prisons.

Given the current proliferation of prison smoke-free policies internationally, and the multiple benefits of continued smoking abstinence for correctional populations, improved understanding of factors influencing postrelease smoking abstinence is required to inform support strategies aimed at individuals exiting smoke-free prisons. We systematically searched health, social science, and criminal justice databases for studies relating to smoking behaviors among people released from smoke-free prisons. Studies were included if: they were published between January 1, 2000 and July 26, 2017; they were published in English; the population was people who were incarcerated or formerly incarcerated in prisons with total smoke-free policies; and the reported outcomes included measures of: (1) prerelease intention to smoke or remain abstinent from smoking following release, (2) smoking relapse or abstinence following release, or (3) quit attempts following postrelease smoking relapse. Both authors independently screened returned citations to assess eligibility and reviewed studies for methodological quality using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. Fifteen of 121 publications were included. The evidence base in this area is small, almost exclusively US-based, and is mostly methodologically weak. Interventions delivered both pre and postrelease, that strengthen intention to quit, integrate with other substance-use treatment, and facilitate social support for quitting may help maintain postrelease smoking abstinence. There is an urgent need for high-quality research to inform interventions to reduce high smoking relapse rates upon release from smoke-free prisons, to extend the multiple benefits of continued smoking abstinence into the community. Interventions designed to help people remain abstinent from tobacco following release from smoke-free prisons are an important opportunity to improve the health, finances, and well-being of this vulnerable population.

Understanding complex care for older adults within Canadian home care: a systematic literature review

ABSTRACTIn the context of an aging population, both the need for home care services and its complexity of care have increased in many high-income countries. Yet, the definition of what constitutes complex care is largely elusive. This systematic review examined the conceptual definition of complex care within the home care environment using several social and health science databases for research published from 2000 to 2017. Of the 25 articles and reports identified, only 16 addressed complex care specifically and included older adults, aging, and/or home care. The results showed that complex care for older adults is primarily defined from a biomedical approach focusing on chronic disease and management and less commonly from the perspective of the social determinants of health. Future studies should consider the importance of the continuum of care needs from both the biomedical and the social determinants to adequately plan and provide care for older adults.

Action research in the healthcare field: a scoping review

This scoping review aimed to explore international literature related to the application of action research in studies in the healthcare context. Action research is an approach that involves collaboration to develop a process through knowledge building and social change. Several viewpoints of action research have been introduced as the different traditions of developed action research. To develop a coherent process, researchers have to posit their worldviews and theoretical framework and align these with the research aims and procedures, and local transformation needs. This diversity leads to a variety of action research practices in healthcare. Particularly, in this review, we raised the need for examining participants' experiences and changes related to the action research process. This scoping review considered studies that included any professional healthcare provider, patient or recipient of healthcare products or services involved in action research. Studies that used the action research methodology in the healthcare context were included. All quantitative and qualitative studies were considered. The quantitative component considered experimental and epidemiological studies, whereas the qualitative component considered studies that focused on qualitative data. A three-step search strategy was used in this review. MEDLINE, CINAHL, Web of Science, Social Sciences, ERIC, PsycINFO, Health Source, ScienceDirect, Wiley and SciELO databases were searched with no publication date limitation. Studies published in English, Portuguese and Spanish were included. The data were extracted using a charting table, which was developed to record key information from sources relevant to the review question. The findings were descriptively presented, with tables and figures to support the data when appropriate. We included 124 studies with different aims and procedures. The levels of participation ranged from no real input into or influence on the research process to democratic knowledge sharing and collective understanding. The action research processes occurred in diverse settings in the healthcare context, and participants with different objectives and demands took part in the research.From study objectives, knowledge building, and social change data, we developed three domains and categorized the studies. In general, Europe and Australia published more studies in the organizational domain and mainly had healthcare stakeholders as participants. North America published more studies in the individual domain, and Latin America, the continent with a higher percentage of publications, published studies that were more frequently related to the collective domain. Asia and Africa did not have a consistent number of publications. There was a major repercussion on the health promotion perspective in North America and Latin America. There are several ways of conducting action research in healthcare that consider the researcher's aims and theoretical assumptions. Further qualitative systematic review questions may arise from the results and conclusions of this scoping review.

Systematic review of qualitative evaluations of reentry programs addressing problematic drug use and mental health disorders amongst people transitioning from prison to communities

BackgroundThe paper presents a systematic review and metasynthesis of findings from qualitative evaluations of community reentry programs. The programs sought to engage recently released adult prison inmates with either problematic drug use or a mental health disorder.MethodsSeven biomedical and social science databases, Cinahl, Pubmed, Scopus, Proquest, Medline, Sociological abstracts and Web of Science and publisher database Taylor and Francis were searched in 2016 resulting in 2373 potential papers. reviews left 140 papers of which 8 were included after detailed review. Major themes and subthemes were identified through grounded theory inductive analysis of results from the eight papers. Of the final eight papers the majority (6) were from the United States. In total, the papers covered 405 interviews and included 121 (30%) females and 284 (70%) males.ResultsFindings suggest that the interpersonal skills of case workers; access to social support and housing; and continuity of case worker relationships throughout the pre-release and post-release period are key social and structural factors in program success.ConclusionEvaluation of community reentry programs requires qualitative data to contextualize statistical findings and identify social and structural factors that impact on reducing incarceration and improving participant health. These aspects of program efficacy have implications for reentry program development and staff training and broader social and health policy and services.

Indigenous Youth Peer-Led Health Promotion in Canada, New Zealand, Australia, and the United States: A Systematic Review of the Approaches, Study Designs, and Effectiveness.

Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness. A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers. Twenty-four studies were identified for inclusion, based on 20 interventions (9 Australian, 4 Canadian, and 7 from the United States of America). Only one intervention was evaluated using a randomized controlled study design. The majority of evaluations took the form of pre-post studies. Methodological limitations were identified in a majority of studies. Study outcomes included improved knowledge, attitude, and behaviors. Currently, there is limited high quality evidence for the effectiveness of peer-led health interventions with Indigenous young people, and the literature is dominated by Australian-based sexual health interventions. More systematic research investigating the effectiveness of peer-led inventions is required, specifically with Indigenous populations. To improve health outcomes for Indigenous youth, greater knowledge of the mechanisms and context under which peer-delivered health promotion is effective in comparison to other methods of health promotion is needed.

Health Risk Behaviour among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

The burden of health risk behaviour (HRB) among adolescents living with HIV (ALWHIV) in sub-Saharan Africa (SSA) is currently unknown. A systematic search for publications on HRB among ALWHIV in SSA was conducted in PubMed, Embase, PsycINFO, and Applied Social Sciences Index and s databases. Results were summarized following PRISMA guidelines for systematic reviews and meta-analyses. Heterogeneity was assessed by the DerSimonian and Laird method and the pooled estimates were computed. Prevalence of current condom nonuse behaviour was at 59.8% (95% CI: 47.9–71.3%), risky sexual partnerships at 32.9% (95% CI: 15.4–53.2%), transactional sex at 20.1% (95% CI: 9.2–33.8%), and the experience of sexual violence at 21.4% (95% CI: 16.3–27.0%) among ALWHIV. From this meta-analysis, we did not find statistically significant differences in pooled estimates of HRB prevalence between ALWHIV and HIV uninfected adolescents. However, there was mixed evidence on the occurrence of alcohol and drug use behaviour. Overall, we found that research on HRB among ALWHIV tends to focus on behaviour specific to sexual risk. With such a high burden of HRB for the individuals as well as society, these findings highlight an unmet need for age-appropriate interventions to address the behavioural needs of these adolescents.

Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

BackgroundHealthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and “burnout” at work than staff in other sectors. There is a growing call for the ‘triple aim’ of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom’s (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff.ObjectivesThis systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing.MethodsA comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours.ResultsEleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours.ConclusionsThis systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.

Use of synthetic control methodology for evaluating public health interventions: a literature review

BackgroundThe synthetic control method (SCM) improves causal inference in non-randomised studies by building a counterfactual using a weighted combination of potential control units. Widely used in other disciplines, it is not widely used in public health research. Our objectives were to identify the use of SCM studies in health and to summarise strengths and limitations identified in the literature. MethodsWe included studies that used a SCM design to investigate a public health outcome of any intervention in any population. We searched for the term “synthetic control method” in 26 health, social science, and grey literature databases, and looked for additional studies by key authors. No restrictions were placed on language or date. Searches were completed by Feb 16, 2016. We summarised key information about the studies including setting, number of treated and control units, intervention and outcome, number of pre-intervention and post-intervention data points available, and other methods used in the same study. FindingsSearches identified 35 health-related studies of which 23 were from US settings and investigated one treated unit. Most studies had at least ten control units. Interventions that were investigated included health finance and health systems reform, industry regulation, and taxation policies. Common outcomes were mortality rates, and insurance rates and health-care access. Most studies had more than four pre-implementation and post-implementation data points. SCM was most commonly used alongside difference-in-difference methods. Advantages were that it does not rely on parallel pre-implementation trends and that it allows for time-varying unmeasured confounders. Limitations included the need for suitable data on both the treated unit and a pool of potential controls, difficulties if the treated unit is an outlier, and the inapplicability of traditional statistical tests because of the small number of treated and control units and because they have not been randomly allocated. Falsification tests were generally used as an alternative. InterpretationThis comprehensive literature review suggests that SCM has been little used in public health despite some advantages over existing methods. Future research incorporating the method, ideally in combination with other methods, would be of value. FundingFP and PC are funded by the UK Medical Research Council (MC_UU_12017/13, MC_UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 and SPHSU15)

Physical, psychological, sexual, and systemic abuse of children with disabilities in East Africa: Mapping the evidence.

Children with disabilities (CWDs) are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don’t know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE) were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of children with disabilities in East Africa extremely difficult. This needs to be addressed urgently if the abuse of children with disabilities is to be prioritised by the global health community.