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The Effective Public Health Practice Project and the McMaster Evidence-Based Practice Centre are combining their vast expertise in the conducting of systematic reviews to the establishment of the McMaster Evidence Review and Synthesis Centre (MERSC). The primary thrust of the MERSC will be knowledge synthesis, specifically to conduct between 8 and 10 ‘knowledge syntheses’ annually over the five year funding period. This work will be done to support the Canadian Task Force on Preventive Health Care (CTFPHC). Our teams are the successful co-applicants for a CIHR grant of 3.5 million over 5 years. Funding timelines are 2010-2015.
Citations for 2009 and 2010 Projects
Fitzpatrick-Lewis D, Ganann R, Krishnaratne S, Ciliska D, Kouyoumdjian F, Hwang SW. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review. BMC Public Health 2011;11:638.
Fitzpatrick-Lewis D, Yost J, Ciliska D, Krishnaratne S. Communication about environmental health risks: a systematic review. Environ Health 2010;9:67.
Homeless Review for Peel Public Health
Recent projects have included an expedited systematic review for the Region of Peel entitled “Interventions to improve the health and increase access to health care for people who are homeless or at risk of homelessness:
BACKGROUND: Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. METHODS: A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. RESULTS: Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. CONCLUSIONS: These studies provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV
Risk Communication Review
EPHPP is conducting a systematic review to attempt to answer the following questions:
BACKGROUND: Using the most effective methods and techniques for communicating risk to the public is critical. Understanding the impact that different types of risk communication have played in real and perceived public health risks can provide information about how messages, policies and programs can and should be communicated in order to be most effective. The purpose of this systematic review is to identify the effectiveness of communication strategies and factors that impact communication uptake related to environmental health risks. METHODS: A systematic review of English articles using multiple databases with appropriate search terms. Data sources also included grey literature. Key organization websites and key journals were hand searched for relevant articles. Consultation with experts took place to locate any additional references.Articles had to meet relevance criteria for study design [randomized controlled trials, clinical controlled trials, cohort analytic, cohort, any pre-post, interrupted time series, mixed methods or any qualitative studies), participants (those in community-living, non-clinical populations), interventions (including, but not limited to, any community-based methods or tools such as Internet, telephone, media-based interventions or any combination thereof), and outcomes (reported measurable outcomes such as awareness, knowledge or attitudinal or behavioural change). Articles were assessed for quality and data was extracted using standardized tools by two independent reviewers. Articles were given an overall assessment of strong, moderate or weak quality. RESULTS: There were no strong or moderate studies. Meta-analysis was not appropriate to the data. Data for 24 articles were analyzed and reported in a narrative format. The findings suggest that a multi-media approach is more effective than any single media approach. Similarly, printed material that offers a combination of information types (i.e., text and diagrams) is a more effective than just a single type, such as all text. Findings also suggest that factors influencing response to risk communications are impacted by personal risk perception, previous personal experience with risk, sources of information and trust in those sources. CONCLUSIONS: No single method of message delivery is best. Risk communication strategies that incorporate the needs of the target audience(s) with a multi-faceted delivery method are most effective at reaching the audience.
ADHD Review for National Collaborating Centre for Aboriginal Health
Systematic Review of Community-Based Interventions for Children and Adolescents with ADHD and Their Families
ADHD is a condition that is often co-morbid in Aboriginal children diagnosed with FASD. There is currently little information concerning effective FASD-specific interventions. This NCCAH-supported report, released in 2010, reviews literature related to interventions for children and youth living with ADHD. The report's findings may be adapted to support Aboriginal children and adolescents diagnosed with FASD.