Background & Objective: This systematic review evaluates the impact of guidelines on healthcare professionals' behavior and explores the resulting outcomes. Methods: Using PRISMA methodology, Scopus and Web of Science databases were searched, yielding 624 results. After applying inclusion criteria, 67 articles were selected for in-depth analysis. Results: The studies focused on key clusters: Target behaviors, Effectiveness, Research designs, Behavioral frameworks, and Publication outlets. Prescription behavior was the most studied (58.2 %), followed by other health-related behaviors (31.3 %) and hygiene practices (10.4 %). Significant behavior changes were reported in 46.3 % of studies, with 17.9 % showing negative effects, and 22.4 % reporting mixed results. Quantitative methods dominated (56.8 %), while qualitative methods (19.4 %) and review designs (13.4 %) were less common. Theoretical Domain Framework (TDF) and Behavior Change Wheel (BCW) were frequently used frameworks, with the UK and the USA contributing most studies. Medical doctors (44.8 %) were the primary participants, followed by general healthcare providers (37.3 %). Conclusions: The study highlights the varied effectiveness of guidelines, with prescription behavior being the most investigated. Guidelines influenced behavior positively in less than half of the cases, and doctors were the primary focus, rather than nurses. The complexity of interventions suggests a need for further research to develop more effective behavioral interventions and to standardize methodological approaches to reduce clinical variation in healthcare.

BackgroundActive workstations have been proposed as a feasible approach for reducing occupational sedentary time. This study used a network meta-analysis (NMA) to assess and compare the overall efficacy of active workstation interventions according to type and concomitant strategy for reducing work-specific sitting time in office workers.MethodsPubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from database inception until May 2022 to obtain randomized controlled trials (RCTs) assessing the efficacy of active workstations with or without concomitant strategies for reducing occupational sedentary time in office workers. The risk of bias of the RCTs included in this study was assessed according to the Cochrane Handbook. An NMA with STATA 15.1 was used to construct a network diagram, league figures, and the final surface under the cumulative ranking curve (SUCRA) values. The certainty of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach.ResultsA total of 23 eligible studies including eight different types of interventions with 1428 office workers were included. NMA results showed that compared to a typical desk, multicomponent intervention (standardized mean difference (SMD) = - 1.50; 95% confidence interval (CI) - 2.17, - 0.82; SUCRA = 72.4%), sit-stand workstation + promotion (Reminders of rest breaks, posture variation, or incidental office activity) (SMD = - 1.49; 95%CI - 2.42, - 0.55; SUCRA = 71.0%), treadmill workstation + promotion (SMD = - 1.29; 95%CI - 2.51, - 0.07; SUCRA = 61.6%), and sit-stand workstation (SMD = - 1.10, 95%CI - 1.64, - 0.56; SUCRA = 50.2%) were effective in reducing occupational sedentary time for office workers.ConclusionsMulticomponent intervention, sit-stand workstation + promotion, treadmill workstation + promotion, and sit-stand workstation appear to be effective in reducing work-specific sedentary time for office workers. Furthermore, multicomponent interventions and active workstations + promotion better reduced work-specific sedentary time than active workstation alone. However, the overall certainty of the evidence was low.

Background: There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards. Methods: Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework. Results: Of the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic. Conclusions: Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.

Background This systematic map principally sought to understand the different forms of effectiveness that existing studies evaluate in relation to Natural Flood Management (NFM) in the UK with a supplementary question of whether studies engaged with climate change and future flood risk. NFM measures seek to protect, enhance, emulate, or restore the natural function of rivers as part of approaches to flood risk management (FRM). While there is agreement in both academic and practice/policy literature that NFM should be part of a holistic FRM strategy to address current and future flood risk, the specifics of how to expand the application of and consistently implement NFM successfully in practice are less well known. A core focus of this study is on how the effectiveness of NFM measures is evaluated in different studies based on approaches drawn from the Environmental Impact Assessment (EIA) literature: procedural, substantive, transactive and normative. The systematic map also examines how studies account for climate change, which is a crucial issue given the connections between NFM and climate change adaptation and resilience. Methods We searched 13 bibliographic databases, Google scholar as a web-based search engine, and 21 organisational sites. Articles were screened by title, abstract, and full text based on defined eligibility criteria. Checks were performed for consistency amongst reviewers. Forms of effectiveness were coded on the basis of the included studies in the systematic map. The quantity and characteristics of the available evidence are summarised with the frequencies of effectiveness forms for each NFM measure are presented in heat maps. Review findings A total of 216 articles reported eligible studies that were coded as part of the systematic map. Overall, the systematic map shows that the majority of studies considered at least one approach to effectiveness; however, very few studies considered multiple forms of effectiveness. The systematic map also demonstrates that climate change is considered systematically by around one-quarter of studies although many studies make claims about NFM’s effectiveness in the face of future climatic change. Conclusions NFM can be effective in several different ways owing to their multiple benefits; however, there are evidence gaps around understanding these different forms of effectiveness. This is particularly marked for studies considering transactive and normative effectiveness. Interdisciplinary studies are more likely to consider multiple forms of effectiveness. This systematic map also found that whilst 75% of studies mention future climate change in their studies, only 24.1% contain a systematic consideration of the issue through, for example, using climate change projections. NFM is also at risk of climate change (e.g. through drought) and therefore it is imperative that study designs seek to incorporate consideration of effectiveness under future climate change. Policymakers should be made aware of the lack of understanding of how NFM measures perform under future climate change. Keywords Flooding, Flood risk management, Environmental Impact Assessment, Climate change adaptation, River catchments, Nature-based solutions, Natural Flood Management Background Natural flood management (NFM) measures seek to protect, enhance, emulate, or restore the natural function of rivers as part of approaches to flood risk management (FRM). While there is agreement in both academic and practice/policy literature that NFM, in a general sense, should be part of a holistic FRM strategy to address current and future flood risk, the specifics of how to consistently implement NFM successfully in practice are less well known. This is particularly acute for practitioners in the UK given the nature of the UK’s biophysical and socio-political context. There is a recognition that existing reviews of NFM effectiveness in the UK tend to focus on the natural science basis and it is unclear how studies account for climate change. Further, reviews tend to focus only on UK studies. This systematic map aims to highlight the way in which existing NFM studies, from different disciplinary backgrounds and across Europe, evaluate effectiveness, and the extent to which they account for climate change. This knowledge can help to make recommendations for future areas of research where the multiple issues around understanding effectiveness can be synthesised, and where climate change is systematically taken into account. Methods This systematic map protocol addresses the following question: what approaches exist to evaluate the effectiveness of UK-relevant natural flood management measures? The protocol details the methodology that will be used to conduct a systematic map of the range of peer-reviewed journal papers, policy documents, guidance, and other forms of grey literature which currently exist on NFM to give an overview on the way in which the effectiveness of NFM is conceived. The methods detail the search strategy employed for gathering items across the peer-reviewed academic literature and grey literature. Additionally, the methods outline how the reviewers will approach article screening, and the eligibility criteria to include/exclude articles. The methods also details the steps taken to ensure consistency across all reviewers, the data coding strategy, and methods for presenting the final systematic map. Together, the methods employed will help to identify current knowledge gaps, and will enable recommendations to be made for future research.

Background: The interrelationships between research evidence and policy-making are complex. Different theoretical frameworks exist to explain general evidence-policy interactions. One largely unexplored element of these interrelationships is how evidence interrelates with, and influences, policy/political agenda-setting. This review aims to identify the elements and processes of theories, frameworks and models on interrelationships of research evidence and health policy-making, with a focus on actionability and agenda-setting in the context of mental health in low- and middle-income countries (LMICs). Methods: A systematic review of theories was conducted based on the BeHeMOTh search method, using a tested and refined search strategy. Nine electronic databases and other relevant sources were searched for peer-reviewed and grey literature. Two reviewers screened the abstracts, reviewed full-text articles, extracted data and performed quality assessments. Analysis was based on a thematic analysis. The included papers had to present an actionable theoretical framework/model on evidence and policy interrelationships, such as knowledge translation or evidence-based policy, specifically target the agenda-setting process, focus on mental health, be from LMICs and published in English. Results: From 236 publications included in the full text analysis, no studies fully complied with our inclusion criteria. Widening the focus by leaving out 'agenda-setting', we included ten studies, four of which had unique conceptual frameworks focusing on mental health and LMICs but not agenda-setting. The four analysed frameworks confirmed research gaps from LMICs and mental health, and a lack of focus on agenda-setting. Frameworks and models from other health and policy areas provide interesting conceptual approaches and lessons with regards to agenda-setting. Conclusion: Our systematic review identified frameworks on evidence and policy interrelations that differ in their elements and processes. No framework fulfilled all inclusion criteria. Four actionable frameworks are applicable to mental health and LMICs, but none specifically target agenda-setting. We have identified agenda-setting as a research theory gap in the context of mental health knowledge translation in LMICs. Frameworks from other health/policy areas could offer lessons on agenda-setting and new approaches for creating policy impact for mental health and to tackle the translational gap in LMICs.

The purpose of this guidance note is to describe and define impact evaluation for member organizations of UNEG; and to articulate some of the main theoretical and practical considerations when carrying out impact evaluations.