Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis

Ahmad Firas Khalid^{1

2

3}, John N Lavis^{4

5

6

7

8}, Fadi El-Jardali^{5

9

10

11}, Meredith Vanstone^{6

12}

Affiliations

¹ Health Policy PhD Program, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
² Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
³ Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
⁴ Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
⁵ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
⁶ Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
⁷ McMaster Health Forum, McMaster University, Hamilton, ON, Canada.
⁸ Department of Political Science, McMaster University, Hamilton, ON, Canada.
⁹ Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon.
¹⁰ enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.
¹¹ Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon.
¹² Department of Family Medicine, McMaster University, Hamilton, ON, Canada.

PMID: 32070370
PMCID: PMC7027202
DOI: 10.1186/s12961-020-0530-2

Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis

Ahmad Firas Khalid et al. Health Res Policy Syst. 2020.

. 2020 Feb 18;18(1):21.

doi: 10.1186/s12961-020-0530-2.

Authors

Ahmad Firas Khalid^{1

2

3}, John N Lavis^{4

5

6

7

8}, Fadi El-Jardali^{5

9

10

11}, Meredith Vanstone^{6

12}

Affiliations

¹ Health Policy PhD Program, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
² Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
³ Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada. kkhalida@mcmaster.ca.
⁴ Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
⁵ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
⁶ Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
⁷ McMaster Health Forum, McMaster University, Hamilton, ON, Canada.
⁸ Department of Political Science, McMaster University, Hamilton, ON, Canada.
⁹ Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon.
¹⁰ enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.
¹¹ Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon.
¹² Department of Family Medicine, McMaster University, Hamilton, ON, Canada.

PMID: 32070370
PMCID: PMC7027202
DOI: 10.1186/s12961-020-0530-2

Abstract

Background: 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.

Methods: We 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.

Results: We 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.

Conclusions: This 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.

Keywords: Barriers; Crisis zones; Critical interpretive synthesis; Decision-making; Evidence; Facilitators; Health systems research; Knowledge translation; LMICs.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
QUORUM flow chart of the inclusion/exclusion process

**Fig. 2**
Strategies and the facilitators (+) and barriers (−) to support evidence use in crisis zones

See this image and copyright information in PMC

References

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Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis

Affiliations

Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous