Why is public health literature so difficult to find?

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1 Why is public health literature so difficult to find? Ruth Turley SURE/DECIPHer, Cardiff University September 2014

2 Content 1. Searching goals and good practice 2. Why is public health more difficult? 3. What does this mean for public health review authors?

3 Searching goal Capture all relevant evidence with the least amount of noise

4 Good practice Build search terms PICO - population, intervention, comparison, outcome use synonyms, spellings Search several databases e.g. Pubmed, Medline, Embase, Psycinfo Search journals by hand Contact experts

5 Esu et al sources searched including grey literature and hand searching 77 records found and screened 18 included. 24% relevance

6 So...what makes public health so tricky?

7 1. Review scope

8 E.g. Improving Fruit & veg consumption

9 2. Terminology Lack of standard terminology Different disciplines, countries etc. can describe the same thing in different ways

10 E.g. Slum settings Slum, shanty, shantyhouse, barrio, favela, kampung, tugurio, ghetto, bidon, bidonville, informal shack, irregular shack, illegal shack, shack dweller, squatter camp, habitat precaire, habitat spontane, quartier irregulier, asentamiento irregular, colonia popular, villa miseria, ciudad perdida, edina achouaia, mudal safi, pelli gewal, lahbach, elendsviertel, brarek, foundouks, tanake, aashwa, truschobi, taudis, morro, loteamento, comunidade, ahata, katra, watta, jhopadpatti, umjondolo, mabanda, kijiji, barraca, conventillos

11 3. Type of evidence Not just RCTs! Thus larger amount of research to sift through and need detailed search strategy for study designs

12 4. Where evidence is stored Widely scattered Discipline-specific databases May be published in a journal that is not indexed in databases May not be published!

13 What does all this mean for a public health review author? Very complex database search strategies to achieve sensitivity and specificity E.g. Baker et al Community wide interventions to promote physical activity

14 1. residence characteristics/ 2.. community health planning/ 3. exp health promotion/ 4. exp community health services/ 5. (national adj (policy or policies or strateg* or program*)).ti,ab. 6. exp mass media/ 7. community networks/ 8. community health centers/ 9. "marketing of health services"/ 10. cities/ 11. rural population/ or rural health/ 12. urban population/ 13. community-institutional relations/ 14. exp environment design/ 15. city planning/ 16. environmental planning.ti,ab. 17. social environment/ 18. urban health/ 19. "health education"/ 20. social marketing/ 21. ((state or county or town or city or village or nation*) adj2 (wide or whole orcommunit*)).ti,ab. 31. (Communit* adj2 base*).ti,ab. 32. ((built environment* or urban environment* or environmental) adj (change* or intervention*)).ti,ab. 33. (environment* adj2 infrastructure).ti,ab. 34. (urban adj2 (regeneration or renewal or plan* or design* or policy or policies or strateg* or program*)).ti,ab. 35. ((media or advertising or radio or television or newspaper* or poster* or flyer* or "information booklet*") adj3 (information or education or campaign or intervention or strateg* or program* or policy or policies)).ti,ab. 36. social marketing.ti,ab. 37. ("point of decision" adj3 (stair* or travel*)).ti,ab. 38. (health counsel* or individual counsel*).ti,ab. 39. (community adj3 (collaborati* or coalition)).ti,ab. 40. ((school* or work?place* or employer* or classroom or college) adj2 (strateg* or program* or policy or policies)).ti,ab. 41. ((public or community) adj2 (information or education or campaign or intervention or strateg* or program* or policy or policies)).ti,ab. 42. (policy change* or fiscal change*).ti,ab. 43. (policy adj3 (interven* or change or introduce* or modif* or alter*)).ti,ab. 44. physical infrastructure.ti,ab. 45. ((road or land) adj us*).ti,ab. 46. (Legislation or legislative).ti,ab. 22. ((combined* or multiple or multi or multifactorial or partner*) adj2 (program* 47. ((Voluntary or volunteer or charities or charity or non-government or or strateg* or intervention* or organi?ation*)).ti,ab. government or "not for profit") adj2 (group*1 or organisation* or 23. (media intervention* or whole community or community intervention* or department*1 or club*1)).ti,ab. community organsai?ation*1).ti,ab. 48. or/ (community adj2 (design or action or program* or partner*)).ti,ab. 25. ((health or community or environment*) adj (policy or policies)).ti,ab. 26. (urban design or "land use policies" or "land use policy").ti,ab. 27. ((transportation or travel) adj (policy or policies)).ti,ab. 28. health planning.ti,ab. 29. ((neighbo?rhood* or city or cities or community) adj2 (development or regeneration or renewal or design* or plan* or polic*)).ti,ab. 30. (community wide or community setting* or community group* or organi?ation* level*1).ti,ab.

15 49. exp exercise/ aerobic*)).ti,ab. 50. running/ 77. ((decreas* or reduc* or discourag*) adj5 (sedentary or deskbound or "physical* 51. walking/ inactiv*")).ti,ab. 52. physical fitness/ 78. sport*3.ti,ab. 53. swimming/ 79. walk*3.ti,ab. 54. (fitness adj class*).ti,ab. 80. running.ti,ab. 55. gardening/ 81. jogging.ti,ab. 56. exp "physical education and training"/ 82. pilates.ti,ab. 57. exp dancing/ 83. yoga.ti,ab. 58. exp sports/ 84. ((cycle or cycling) adj5 (school* or work or workplace or commut* or travel* or 59. exp sport/ equipment or facilit* or rack*1 or store*1 or storing or park* or friendly or infrastructure)).ti,ab. 60. exp yoga/ 85. bicycl*.ti,ab. 61. exp fitness centers/ 86. (bike*1 or biking).ti,ab. 62. recreation/ 87. (swim*1 or swimming).ti,ab. 63. "play and playthings"/ 88. (exercis*3 adj5 aerobic*).ti,ab. 64. exp motor activity/ 89. rollerblading.ti,ab. 65. (fitness adj (regime* or program*)).ti,ab. 90. rollerskating.ti,ab. 66. cardiorespiratory fitness.ti,ab. 91. skating.ti,ab. 67. aerobic capacity.ti,ab. 92. exertion*1.ti,ab. 68. ((moderate or vigorous*) adj activ*).ti,ab. 93. strength training.ti,ab. 69. (led walk* or health walk*).ti,ab. 94. resilience training.ti,ab. 70. (physical adj5 (fit* or train* or activ* or endur*)).ti,ab. 95. weight lifting.tw. 71. (exercis* adj5 (fit* or train* or activ* or endur*)).ti,ab. 96. travel mode*1.tw. 72. ((leisure or fitness) adj5 (centre* or center* or facilit*)).ti,ab. 97. (active adj (travel*4 or transport* or commut*)).tw. 73. ((promot* or uptak* or encourag* or increas* or start* or adher* or sustain* or maintain*) adj5 gym*).ti,ab. 98. (multimodal transportation or alternative transport* or alternative travel*).ti,ab. 74. ((promot* or uptak* or encourag* or increas* or start* or adher* or sustain* or maintain*) adj5 physical activ*).ti,ab. 99. recreation*1.ti,ab. 75. ((promot* or uptak* or encourag* or increas* or start* or adher* or sustain* or 100. ("use" adj3 stair*).ti,ab. maintain*) adj5 (circuit* or aqua*)).ti,ab (pedestrianis* or pedestrianiz*).ti,ab. 76. ((promot* or uptak* or encourag* or increas* or start* or adher* or sustain* or 102. or/ maintain*) adj5 (exercis* or exertion or keep fit or fitness class or yoga or

16 103. randomized controlled trial.pt controlled clinical trial.pt (randomized or randomised or placebo or randomly or trial).ab Random allocation/ or clinical trial/ or single-blind method/ or double-blind method/ or control groups/ 107. Intervention studies/ 108. evaluation studies/ 109. program evaluation/ 110. Comparative study.pt quasi-experiment*.ti,ab (pre test or pretest or (posttest or post test)).ti,ab trial.ti (time adj series).ti,ab (pre test or pretest or (posttest or post test)).ti,ab ((evaluat* or intervention or interventional) adj8 (control or controlled or study or program* or comparison or "before and after" or comparative)).ti,ab ((intervention or interventional) adj8 (effect* or evaluat* or outcome*)).ti,ab ((process or program*) adj3 (effect* or evaluat*)).ti,ab (controlled before or "before and after stud*" or follow up assessment).ti,ab or/ animals/ not (humans/ and animals/) not and 102 and limit 123 to yr=" "

17 What does all this mean for a public health review author? Very complex database search strategies to achieve sensitivity and specificity Need to adapt search in many databases (well maybe) Expect thousands of search results to screen!

18 E.g. Thomson et al Housing improvements for health and socioeconomic outcomes 27 bibliographic databases, 12 grey literature databases, 23 websites plus handsearching, experts etc. 59,248 references screened. 336 potentially relevant looked at in full-text 39 studies included. 0.5% relevant!!

19 Conclusions Systematic searching for upstream public health evidence can be tricky! Teams need time and skills to manage it Are there smarter ways to identify relevant research?

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