Kelly Dickson

Human well-being impacts of terrestrial protected areas

BackgroundEstablishing Protected Areas (PAs) is among the most common conservation interventions. Protecting areas from the threats posed by human activity will by definition inhibit some human actions. However, adverse impacts could be balanced by maintaining ecosystem services or introducing new livelihood options. Consequently there is an ongoing debate on whether the net impact of PAs on human well-being at local or regional scales is positive or negative. We report here on a systematic review of evidence for impacts on human well-being arising from the establishment and maintenance of terrestrial PAs.MethodsFollowing an a priori protocol, systematic searches were conducted for evidence of impacts of PAs post 1992. After article title screening, the review was divided into two separate processes; a qualitative synthesis of explanations and meaning of impact and a review of quantitative evidence of impact. Abstracts and full texts were assessed using inclusion criteria and conceptual models of potential impacts. Relevant studies were critically appraised and data extracted and sorted according to type of impact reported. No quantitative synthesis was possible with the evidence available. Two narrative syntheses were produced and their outputs compared in a metasynthesis.ResultsThe qualitative evidence review mapped 306 articles and synthesised 34 that were scored as high quality. The quantitative evidence review critically appraised 79 studies and included 14 of low/medium susceptibility to bias. The meta-synthesis reveals that a range of factors can lead to reports of positive and negative impacts of PA establishment, and therefore might enable hypothesis generation regarding cause and effect relationships, but resulting hypotheses cannot be tested with the current available evidence.ConclusionsThe evidence base provides a range of possible pathways of impact, both positive and negative, of PAs on human well-being but provides very little support for decision making on how to maximise positive impacts. The nature of the research reported to date forms a diverse and fragmented body of evidence unsuitable for the purpose of informing policy formation on how to achieve win-win outcomes for biodiversity and human well-being. To better assess the impacts of PAs on human well-being we make recommendations for improving research study design and reporting.

Mediating policy-relevant evidence at speed: are systematic reviews of systematic reviews a useful approach?

When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the reviews of reviews (RoR) method in order to advance understanding of this important tool for policy makers. Drawing on our experiences, we present, where possible, potential solutions to these challenges to demonstrate that RoRs, despite their limitations, can be useful for mediating policy-relevant evidence at speed.

Exploring issues in the conduct of website searching and other online sources for systematic reviews: how can we be systematic?

Websites and online resources outside academic bibliographic databases can be significant sources for identifying literature, though there are challenges in searching and managing the results. These are pertinent to systematic reviews that are underpinned by principles of transparency, accountability and reproducibility. We consider how the conduct of searching these resources can be compatible with the principles of a systematic search. We present an approach to address some of the challenges. This is particularly relevant when websites are relied upon to identify important literature for a review. We recommend considering the process as three stages and having a considered rationale and sufficient recordkeeping at each stage that balances transparency with practicality of purpose. Advances in technology and recommendations for website providers are briefly discussed.

What is positive youth development and how might it reduce substance use and violence? A systematic review and synthesis of theoretical literature

BackgroundPreventing adolescent substance use and youth violence are public health priorities. Positive youth development interventions are widely deployed often with the aim of preventing both. However, the theorised mechanisms by which PYD is intended to reduce substance use and violence are not clear and existing evaluated interventions are under-theorised. Using innovative methods, we systematically searched for and synthesised published theoretical literature describing what is meant by positive youth development and how it might reduce substance use and violence, as part of a broader systematic review examining process and outcomes of PYD interventions.MethodsWe searched 19 electronic databases, review topic websites, and contacted experts between October 2013 and January 2014. We included studies written in English, published since 1985 that reported a theory of change for positive youth development focused on prevention of smoking, alcohol consumption, drug use or violence in out-of-school settings. Studies were independently coded and quality-assessed by two reviewers.ResultsWe identified 16 studies that met our inclusion criteria. Our synthesis suggests that positive youth development aims to provide youth with affective relationships and diverse experiences which enable their development of intentional self-regulation and multiple positive assets. These in turn buffer against or compensate for involvement in substance use and violence. Existing literature is not clear on how intentional self-regulation is developed and which specific positive assets buffer against substance use or violence.ConclusionsOur synthesis provides: an example of a rigorous systematic synthesis of theory literature innovatively applying methods of qualitative synthesis to theoretical literature; a clearer understanding of how PYD might reduce substance use and violence to inform future interventions and empirical evaluations.

How explicable are differences between reviews that appear to address a similar research question? A review of reviews of physical activity interventions

BackgroundSystematic reviews are promoted as being important to inform decision-making. However, when presented with a set of reviews in a complex area, how easy is it to understand how and why they may differ from one another?MethodsAn analysis of eight reviews reporting evidence on effectiveness of community interventions to promote physical activity. We assessed review quality and investigated overlap of included studies, citation of relevant reviews, consistency in reporting, and reasons why specific studies may be excluded.ResultsThere were 28 included studies. The majority (n = 22; 79%) were included only in one review. There was little cross-citation between reviews (n = 4/28 possible citations; 14%). Where studies appeared in multiple reviews, results were consistently reported except for complex studies with multiple publications. Review conclusions were similar. For most reviews (n = 6/8; 75%), we could explain why primary data were not included; this was usually due to the scope of the reviews. Most reviews tended to be narrow in focus, making it difficult to gain an understanding of the field as a whole.ConclusionsIn areas where evaluating impact is known to be difficult, review findings often relate to uncertainty of data and methodologies, rather than providing substantive findings for policy and practice. Systematic ‘maps’ of research can help identify where existing research is robust enough for multiple in-depth syntheses and also show where new reviews are needed. To ensure quality and fidelity, review authors should systematically search for all publications from complex studies. Other relevant reviews should be searched for and cited to facilitate knowledge-building.

Non-drug treatments for symptoms in dementia : an overview of systematic reviews of non-pharmacological interventions in the management of neuropsychiatric symptoms and challenging behaviours in patients with dementia

In order to fill this gap in evidence, PIRU was commissioned by the Department of Health to carry out a systematic review of the effectiveness of non-pharmacological treatments or therapies for managing neuropsychiatric and challenging behaviours in patients with dementia. Given the vast literature on this topic, PIRU carried out an ‘overview’ of reviews which involved examining thirty recent systematic reviews in order to summarise their results on the effectiveness of alternative treatments.

Systematic review and meta-analysis of effects of community-delivered positive youth development interventions on violence outcomes.

Background We systematically reviewed and meta-analysed evaluations testing the effectiveness of positive youth development (PYD) interventions for reducing violence in young people. Methods Two reviewers working independently screened records, assessed full-text studies for inclusion and extracted data. Outcomes were transformed to Cohens d. Quality assessment of included evaluations was undertaken using the Cochrane risk of bias tool. Effect sizes were combined using multilevel meta-analysis. We searched 21 databases, including MEDLINE, PsycINFO, CINAHL and CENTRAL, and hand-searched key journals and websites. We included studies where the majority of participants were aged 11–18 years and where interventions were delivered in community (not clinical or judicial) settings outside of normal school hours. We excluded studies targeting predefined physical and mental health conditions or parents/carers alongside young people. We defined violence as perpetration or victimisation of physical violence including violent crime. Results Three randomised trials were included in this systematic review. Included evaluations each had design flaws. Meta-analyses suggested that PYD interventions did not have a statistically significant effect on violence outcomes across all time points (d=0.021, 95% CI −0.050 to 0.093), though interventions did have a statistically significant short-term effect (d=0.076, 95% CI 0.013 to 0.140). Conclusions Our meta-analyses do not offer evidence of PYD interventions in general having effects of public health significance in reducing violence among young people. Evaluations did not consistently report theories of change or implementation fidelity, so it is unclear if our meta-analyses provide evidence that the PYD theory of change is ineffective in reducing violence among young people.

Transdisciplinary working to shape systematic reviews and interpret the findings: commentary

Important policy questions tend to span a range of academic disciplines, and the relevant research is often carried out in a variety of social, economic and geographic contexts. In efforts to synthesise research to help inform decisions arising from the policy questions, systematic reviews need conceptual frameworks and ways of thinking that combine knowledge drawn from different academic traditions and contexts; in other words, transdisciplinary research. This paper considers how transdisciplinary working can be achieved with: conceptual frameworks that span traditional academic boundaries; methods for shaping review questions and conceptual frameworks; and methods for interpreting the relevance of findings to different contexts. It also discusses the practical challenges and ultimate benefits of transdisciplinary working for systematic reviews.

Positive youth development programmes to reduce substance use in young people : systematic review

BACKGROUND Substance use has detrimental short-term and long-term consequences for young people. Positive youth development (PYD) interventions, which favour promotion of positive assets over traditional risk reduction, have received attention recently as a possible intervention to prevent adolescent substance use. We aimed to synthesise the evidence on PYD interventions for reduction in substance use in young people. METHODS We searched 21 databases, including MEDLINE, PsycINFO, CINAHL and CENTRAL, and hand-searched key journals and websites. We included studies with more than half of participants aged 11-18 years where interventions meeting a pre-specified definition of PYD were delivered in community settings outside of normal school hours and did not target parents or young people with pre-defined conditions. Two reviewers screened records, assessed full-text studies for inclusion, and extracted data. A modified Cochrane risk of bias tool was used for quality assessment. RESULTS Ten studies reported in 13 reports were included in our synthesis. PYD interventions did not have an effect of statistical or public health significance on any substance use, illicit drug use or alcohol outcomes in young people. CONCLUSIONS Interventions were diverse in content and delivery. Our review suggests that existing PYD interventions subject to evaluation do not appear to have produced reductions in substance use of public health significance. However, these interventions may not be the best exemplars of a PYD approach. Therefore, our findings should not be taken as evidence for the ineffectiveness of PYD as a theory of change for reducing substance use among young people. Additional rigorous evaluation of PYD interventions is key before further investment. Evaluations were of highly variable quality. Though searches were extensive, we were unable to test for publication bias.

Positive youth development interventions to reduce substance use in young people: systematic review

BACKGROUND Substance use has detrimental short-term and long-term consequences for young people. Positive youth development (PYD) interventions, which favour promotion of positive assets over traditional risk reduction, have received attention recently as a possible intervention to prevent adolescent substance use. We aimed to synthesise the evidence on PYD interventions for reduction in substance use in young people. METHODS We searched 21 databases, including MEDLINE, PsycINFO, CINAHL and CENTRAL, and hand-searched key journals and websites. We included studies with more than half of participants aged 11-18 years where interventions meeting a pre-specified definition of PYD were delivered in community settings outside of normal school hours and did not target parents or young people with pre-defined conditions. Two reviewers screened records, assessed full-text studies for inclusion, and extracted data. A modified Cochrane risk of bias tool was used for quality assessment. RESULTS Ten studies reported in 13 reports were included in our synthesis. PYD interventions did not have an effect of statistical or public health significance on any substance use, illicit drug use or alcohol outcomes in young people. CONCLUSIONS Interventions were diverse in content and delivery. Our review suggests that existing PYD interventions subject to evaluation do not appear to have produced reductions in substance use of public health significance. However, these interventions may not be the best exemplars of a PYD approach. Therefore, our findings should not be taken as evidence for the ineffectiveness of PYD as a theory of change for reducing substance use among young people. Additional rigorous evaluation of PYD interventions is key before further investment. Evaluations were of highly variable quality. Though searches were extensive, we were unable to test for publication bias.