搜索结果：Campbell systematic reviews

Many factors such as declining physical function, low socioeconomic status and unemployment play a role in the complex health and social needs of older adults. While healthcare providers can assist in treating health conditions, non-clinical interventions are most likely needed to meet their social needs and improve wellbeing. Social prescribing has been introduced to help primary care providers and other connectors meet patient's social needs that contribute to poor health and inequalities. With the increasing recognition of these complex challenges, decision-makers need to know which social prescribing interventions or social prescriptions are effective for older adults. To map the available evidence on the effectiveness of social prescribing interventions and social prescriptions addressing a non-medical health-related need for older adults in clinical and community settings. We searched the following databases from inception until November 14, 2023, with no language restrictions: Ovid MEDLINE, Embase, EBM Reviews, Elsevier Scopus, Epistemonikos, CABI CAB Direct, NIHR PROSPERO, WHO Global Index Medicus, Clarivate Web of Science Social Sciences Citation Index (SSCI), Conference Proceedings, Clarivate Korean Citation Index (KCI), Clarivate SciELO Citation Index and Google Scholar via Harzing Publish or Perish. Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate for systematic reviews and studies with concurrent control groups assessing the effectiveness of social prescribing and social prescription interventions on the wellbeing of older adults. Conflicts were resolved through consensus. We developed and pilot-tested a data collection form in EPPI-Reviewer. Data was extracted and coded individually by reviewers based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Data extraction was validated by a second reviewer for 20%. We assessed the quality of reviews using the AMSTAR2 tool. The quality of primary studies was not assessed. We included 662 articles (430 primary studies, 232 reviews) that assessed the effectiveness of social prescribing interventions or social prescriptions targeting non-medical health-related social needs of older adults to improve their health and wellbeing. Over 65% of the articles were published in 2019 or later.AMSTAR2 quality was rated as critically low for 55%, low for 31%, moderate for 6% and high for only 4% of systematic reviews. Of the included primary studies, 48% were randomized controlled trials and 52% were non-randomized studies.Most of the evidence was from high-income countries (78% of reviews and 93% of primary studies), few from upper-middle (25% of reviews and 5% of primary studies), and lower-middle (9% of reviews and 3% of primary studies) countries, and none from low-income countries (0%). The most common intervention types identified were psychosocial (e.g. social and emotional support interventions), with 81% of reviews and 63% of primary studies including these interventions, lifestyle (exercise on prescription) with 45% of reviews and 30% of primary studies including these interventions, and arts-based (museums, galleries, arts & crafts), with 29% of reviews and 20% of primary studies including these interventions. These were followed by material support in 13% of reviews and 7% of primary studies, and nature-based interventions in 10% of reviews and 4% of primary studies. Ninety-eight percent of the reviews and 95% of the primary studies focused on assessing the impact on individual outcomes (e.g. participant wellbeing/quality of life), with 41% of reviews and 47% of primary studies assessing process outcomes (e.g. participant satisfaction), and 27% of both reviews and primary studies looking at health system outcomes (e.g. health/social service use). Eleven percent of reviews and primary studies looked at adverse effects, and no studies assessed health equity as a community outcome.Key characteristics of social prescribing interventions or social prescriptions were described in few included articles; codesign of the interventions in 6% of reviews and 15% of primary studies, while participant empowerment was described in 24% of reviews and 19% of primary studies.Most articles focused on a population at risk of or experiencing inequity (91% of reviews and 96% of primary studies). Less than 10% of both reviews and primary studies conducted any equity analysis to assess differential effects for populations experiencing inequities across factors such as age, gender or ethnicity. Most of the available evidence on social prescribing and social prescription was on psychosocial and health system interventions; there is limited research on material support and nature-based interventions. Furthermore, despite the aims of social prescribing or social prescription to empower communities and reduce health inequalities, there are few studies that assess community-level outcomes or adverse effects. There is a need for more research in low-middle-income countries and for high-quality reviews. This map can help identify priorities for further research and promote the use of existing evidence in policy and practice. EGM = evidence and gap map.GP = general practitioner.LGBTQIA2S+: lesbian, gay, bisexual, transgender, queer (or sometimes questioning), intersex, asexual, and two-spirited.PICO: population, intervention, comparison, outcome. PROGRESS-Plus: Place of residence (urban/rural), Race/ethnicity/culture and language, Occupation, Gender or sex, Religion, Occupation, Socioeconomic status, Social capital and Plus factors.WHO = World Health Organization. Declarative title: Evidence and gap map on social prescribing for older adults shows most programs have focused on psychosocial and lifestyle programs with few studies on material support and nature-based programs, little focus on equity issues, and a need for better quality systematic reviews. The EGM in brief: Mapping the evidence on the effectiveness of social prescribing interventions and social prescriptions addressing a non-medical need for older adults shows that many of the systematic reviews are of critically low quality, most articles come from high-income countries, and few articles, if any, look at material-support and nature-based interventions, health equity as a community-level outcome or assess adverse effects. What is this EGM about? Many older adults experience health disparities that are often associated with complex health and social issues. Social needs may not be routinely addressed by healthcare providers but are equally important as health conditions. Social prescribing is an intervention that can help primary care providers and other connectors to meet these social needs by connecting older adults to social supports in the community. Decision-makers need to know which social prescribing interventions and social prescriptions are effective at addressing a non-medical need in this population. What is the aim of this EGM? To show available evidence from systematic reviews and primary studies on the effect of social prescribing or social prescriptions that address a non-medical need for older adults in clinical and community settings. What studies are included? This EGM includes 662 articles (232 systematic reviews and 430 primary studies) that assessed and reported the effect of interventions which connect individuals to non-clinical services and activities to improve their health and wellbeing. Studies could be in any language and come from any region. What are the main findings of this gap map? Most of the evidence is from high-income countries, with very little from upper- and lower-middle-income, and none from low-income countries. The majority of evidence has been published in 2019 or later, and over half of the systematic reviews are of critically low quality. The most reported interventions are psychosocial support interventions (81% of reviews, 63% of primary studies), with social and emotional support interventions being the most common (59% of reviews, 41% of primary studies). Lifestyle interventions, such as exercise (39% of reviews, 25% of primary studies), and arts-based interventions including museums, galleries, arts & crafts (20% of reviews, 11% of primary studies) were also commonly reported. Material support (13% of reviews, 7% of primary studies) and nature interventions (10% of reviews, 4% of primary studies) were among the least common. The focus of most studies was to improve individual outcomes (e.g. participant wellbeing/quality of life), that were assessed in over 90% of both reviews and primary studies. Process outcomes (e.g. participant satisfaction) were assessed in 41% of reviews and 47% of primary studies, and health system outcomes (e.g. health/social service use) in 27% of reviews and 27% of primary studies. Few studies assessed adverse effects (11% of reviews and 11% of primary studies) or community-level outcomes (13% of reviews, 9% of primary studies), and none assessed health equity as a community outcome. Equity assessment showed that over 90% of both reviews and primary studies focused on populations experiencing health inequities across factors such as gender, ethnicity, income, rurality or age-associated frailty. Only 10% conducted analysis to assess whether findings varied across different groups of populations experiencing inequities based on factors such as gender, age, or ethnicity. What do the findings of the map mean? The evidence on social prescribing interventions and social prescriptions is concentrated on psychosocial and health system interventions with less on material support and nature-based interventions. Few studies assessed community-level outcomes and adverse effects. There is a need for more high-quality research as many included systematic reviews are of critically low quality. This map can guide interest holders to identify interventions that connect older adults to non-clinical services and can help researchers and funders consider areas of major gaps as priorities for further research. How up-to-date is this EGM? The authors searched for studies up until November 2023.

Timely and contextually relevant evidence is essential for decision-making in policy domains, especially during crisis or outbreaks like the COVID-19 pandemic. While systematic reviews provide methodological rigor, their cost and duration limit their policy utility. Rapid reviews offer a pragmatic alternative but are typically static and quickly become outdated as new studies, grey literature, and local knowledge emerge, leading to duplication of effort and losing track of policy decisions and use of evidence. This paper presents a pragmatic framework for converting rapid reviews into living evidence synthesis (LES) systems within policy contexts, especially in low- and middle-income countries (LMICs). Drawing on the experience of eBASE Africa, the framework demonstrates how LES functions can be incrementally embedded within conventional rapid-review workflows. It integrates PRISMA-aligned methods with continuous evidence surveillance across academic literature, grey literature, and non-traditional evidence sources such as social media and Indigenous Ways of Knowing, treating these as structured and systematically incorporated evidence streams, supported by responsible use of artificial intelligence and digital tools with human oversight. The framework reconceptualizes rapid reviews as entry points to living evidence systems, offering a scalable pathway to improve efficiency, continuity, and policy relevance, particularly in LMIC settings. Good decisions in health, education, and other policy areas depend on having the right information at the right time. This became especially clear during the COVID-19 pandemic, when policymakers needed quick answers to urgent questions. Researchers often provide this information through systematic reviews, which carefully collect and analyze existing studies. While these reviews are thorough and reliable, they usually take a long time to complete and can be expensive. This makes them less useful when decisions need to be made quickly. To respond to urgent needs, many organizations use rapid reviews. These are faster versions of systematic reviews that provide timely insights for decision-makers. However, rapid reviews have an important limitation: they are usually done once and then left unchanged. As new studies, reports, and local experiences become available, the findings of these reviews can quickly become outdated. This means that policymakers may rely on information that no longer reflects the latest evidence. It can also lead to duplication of effort, as new reviews are started from scratch instead of building on existing work. This paper explores a practical way to solve this problem by transforming rapid reviews into what are called “living evidence synthesis” systems. A living evidence system is one that is continuously updated as new information becomes available. Instead of treating a review as a one-time product, it becomes an ongoing process that evolves over time. Drawing on the experience of eBASE Africa, this study presents a step-by-step framework for making this transition, particularly in low- and middle-income countries. These settings often face resource constraints, making it even more important to use time and funding efficiently. The framework shows how organizations can gradually build living evidence systems into their existing rapid review processes, rather than starting from scratch. One key feature of this approach is the use of continuous evidence monitoring. This means regularly searching for and incorporating new information from a wide range of sources. In addition to academic research, this includes grey literature such as policy reports, as well as non-traditional sources like social media and Indigenous knowledge. These sources are treated as valuable forms of evidence and are systematically included in the review process. The framework also emphasizes the careful use of digital tools and artificial intelligence to support this work. These tools can help identify new studies, organize information, and reduce the workload for researchers. However, human oversight remains essential to ensure that the information is accurate, relevant, and ethically used. Another important aspect is maintaining transparency and methodological rigor. The approach aligns with established standards such as PRISMA, ensuring that the process remains systematic and credible even as it becomes more flexible and continuous. Overall, this paper argues that rapid reviews should not be seen as final products, but as starting points for ongoing learning. By turning them into living systems, it is possible to keep evidence up to date, reduce duplication, and make better use of available resources. This approach can improve the relevance and usefulness of evidence for policymakers, especially in fast-changing situations and resource-limited settings. Thus, the proposed framework offers a practical and scalable way to ensure that evidence remains current, inclusive, and responsive to real-world needs. It highlights how combining traditional research methods with continuous updating and diverse knowledge sources can lead to better-informed decisions and more effective policies.

Experiencing the death of a loved one can be very distressing for children and adolescents. If the bereavement is not managed, it can lead to lifelong consequences such as poor mental health outcomes. Despite this being a universal experience, there is a lack of agreement in the theoretical definitions of fundamental concepts of grief, loss and bereavement. Research has suggested child grief has specific characteristics determined by their age and developmental stage and needs, as well as the circumstances surrounding the death. A significant challenge in the field is identifying age appropriate and validated interventions that are specific for children and adolescents. Evidence and Gap Maps (EGMs) can contribute to addressing this gap by providing a comprehensive and visual synthesis of the existing evidence. This EGM aimed to identify, synthesise and map existing published and unpublished (grey literature) evidence of primary studies and systematic reviews of bereavement interventions for children and adolescents, targeted at improving psychosocial outcomes. The searches for this EGM were carried out using electronic databases (n = 6), web search engines, repositories and grey literature. The search terms were developed based on the participants, bereavement terminology and types of interventions. Searches were conducted over May and June 2024. All primary studies and systematic reviews of bereavement interventions for children and adolescents between 0 and 24 years of age, in English or Spanish were included in this EGM. Search results were imported into EndNote, where results were collated and duplicates deleted. Results were then imported into EPPI-reviewer where additional duplicates were removed. Titles and abstracts were screened in duplicate. Potential studies were then divided and full text was screened in duplicate, a third reviewer resolved any conflicts. Data was extracted from sources that fit the inclusion criteria in duplicate. The information extracted was participant age, country, study design, intervention type, intervention name, duration, form of delivery, provider, target death and type of death, evaluation and outcomes. A total of 99 sources are included in this EGM. Interventions were carried out in different parts of the world but most evidence was identified in the USA, Australia, Canada and The Netherlands. The age that most evidence concentrated on is the age group between 10 to 14 years with underpinning theories, cognitive behavioural therapy and expressive therapies the most reported. The majority of interventions were delivered face to face and included different types (interventions, programmes, support groups and camps). Most reported a duration of 6-10 sessions and targeted parental death. Outcomes reported were various (n = 49), mostly focused on grief, coping, emotional expression, adjustment to death and emotional wellbeing. The majority of systematic reviews were rated as low quality and the majority of domains classified for randomised control trials were unclear. This EGM provides a systematic, searchable and visual tool for policy makers, practitioners, researchers and members of the public to identify the existing evidence on bereavement interventions for children and adolescents. The EGM identified the areas where most evidence is currently concentrated, as well as areas where further research is warranted for specific age groups and types of death experienced. The EGM also identified the need for higher quality evidence as well as longitudinal evaluations. Declarative title: Bereavement interventions are mainly aimed at adolescents, suggesting the need to target younger children and designing more rigorous interventions measuring focused outcomes which can mainstream the impact as well as facilitate the comparison and efficacy of interventions. What is this EGM about? This EGM is mapping the existing evidence on bereavement interventions for children and adolescents. Experiencing a significant bereavement at a young age can be a challenging experience. The majority of children and adolescents manage to cope but some may need additional supports. Interventions and professional support can prevent children and adolescents from developing poor mental health in the future. Thus, it is important to identify the best interventions that exist and determine why these are successful in supporting young people. What is the aim of this EGM? This evidence and gap map aims to synthesise the existing primary studies and systematic reviews on bereavement interventions for children and adolescents, as well as their characteristics. This EGM will help identify the interventions that are more effective helping children and adolescents (0–24 years of age) and why. The comprehensive search included different databases and platforms: Applied Social Sciences Index and Abstracts (ASSIA), ERIC, Social Services Abstracts, ProQuest Dissertations and Theses Global, APA PsycInfo, Embase, and MEDLINE All. We included grey literature and commercial and non-commercial sources to ensure the review is as comprehensive as possible. Additionally, the EGM included all types of interventions. What studies are included? The EGM includes a total of 99 primary studies and systematic reviews reporting on bereavement interventions for children and adolescents as well as their characteristics. What are the main findings of this gap map? The primary studies included came from different parts of the world but mainly from USA, Australia, Canada and The Netherlands. This means the existing evidence is concentrated in a small number of countries, despite bereavement being a global issue. Most of these interventions were created for children and adolescents between 10 and 14 years of age. This means that some age groups, particularly young children, have no access or less access to bereavement interventions from which they may have benefitted. Most interventions were informed by Cognitive Behavioural Therapy and expressive therapies, it was important to see that these interventions were supported by scientific evidence and theories. Interventions were mostly delivered in person over a duration of between 6 and 10 sessions. The EGM also shows that the majority of existing interventions for children and adolescents aimed to help participants with their grief, coping emotional expression, adjustment to death and emotional wellbeing. Overall, the quality of included reviews was mainly categorised as low or critically low using the AMSTAR-2 Assessment tool. The risk of bias for randomised control trials was also evaluated using the Cochrane Risk of Bias Tool 1. Overall, risk of bias was difficult to assess due to poor reporting. What do the findings of the map mean? Bereavement interventions are very heterogenous in the outcomes reported, comparison is therefore challenging. Most of the evidence is concentrated on adolescents and not in younger children. More rigorous designs and longitudinal evaluations are needed to determine the efficacy of bereavement interventions. How up to date is this EGM? Searches for this EGM were carried out between May and June 2024.

Worldwide, the population is ageing. As the population ages, so does the prevalence of age-related diseases such as arthritis, osteoporosis, diabetes, hypertension, cancer and dementia, increasing the demand on health and social care services. The evidence underpinning treatments and interventions for most health and social care issues is derived from populations younger than 80 years of age because this age group is often excluded from taking part in clinical trials. This raises concerns that many established treatments may not be the most suitable or effective approach for those aged 80 years or more. Our aim was to produce an interactive evidence and gap map to provide an overview of the volume, diversity and nature of the evidence on health and social care interventions that target adults over 80 years of age. We searched 18 databases: Medline, PsycINFO, HMIC, Social Policy and Practice, Ageline, CINAHL Complete, ASSIA, PQDT; Epistemonikos; Cochrane, CENTRAL, Campbell systematic reviews, Web of Science, SCI, SSCI, AHCI, CPCI-S, CPCI-SSH, and ESCI (in October 2022). Searches were updated in July 2024. Forward and backward citation searching was also undertaken in 2024 using CiteSearch, Scopus and Google Scholar. We included systematic reviews, randomised controlled trials (RCTs) and primary qualitative studies in the map that focused on the effectiveness and/or experience of any health or social care interventions for adults aged 80 years or more. All studies were independently screened for eligibility by two people at both title/abstract and full text stages. Interventions were categorised in line with the WHO definition of five domains that facilitate healthy ageing: building and maintaining intrinsic capacity, health services models and approaches, enabling environments and technologies, building and maintaining relationships and learning, growing and making decisions. Interventions could cut across multiple domains. The data extraction tool was developed on EPPI reviewer and was modified and tested through piloting and revising by the core team. The tool was informed by the research question and the structure of the map. As well as extracting data on population characteristics, intervention domain and sub-categories, we extracted additional data to enable filters, such as specific health conditions, and equity characteristics. Standardised tools were used to assess study quality for all studies: AMSTAR-2 for systematic reviews; Cochrane Risk of Bias tool (version 1) for RCTs; and the Wallace criteria for primary qualitative studies. Data extraction and quality appraisal were extracted by one person and checked by a second. We included 172 studies: 36 systematic reviews, 120 RCTs and 16 primary qualitative studies. Most of the systematic reviews were assessed as low or very low quality with only five assessed as moderate to high quality. Similarly, most of the RCTs were assessed to be at medium to high risk of bias, with only 27 RCTs assessed with an overall low risk of bias. Ten of the qualitative studies were assessed as high quality. Over a third of the studies (n = 67) in the map have been published since 2020. The majority of the evidence, over 90% (n = 157/172), was focused within the domain of building and maintaining intrinsic capacity, and within this domain, on either surgical and medical procedures (n = 75) or medicines and medical technologies (n = 54) in predominantly the cardiovascular, neuromuscular and digestive areas. Rehabilitation and behavioral interventions were also represented. Only a small number of studies focused on health conditions linked to ageing: frailty a focus of research in 14 studies, and falls in six studies. Only two studies addressed mental health therapies, and there were no studies focused on skin conditions, genitourinary health and or voice/speech conditions. The second most frequently represented domain was health service models and/or approaches (n = 38), predominantly relating to home visits (n = 15, all RCTs) and comprehensive geriatric assessment and integrated care (n = 5, all RCTs). The three intervention domains of enabling environments and technologies, building and maintaining relationships and learning, growing and making decisions were poorly represented in the evidence. The majority of studies measured physiological outcomes of health, such as measures of functional health, chronic health markers or symptoms, and adverse events; few studies assessed measures of well-being or psychosocial health. Sixteen studies reported on experiences of interventions, mostly from the experience of the older adult (n = 9) and were in relation to heart surgery and procedures, colon surgery, resuscitation, medicines review and preventative screening. Only 7% of outcomes in the map were in the psychological health and wellbeing category. Social health (including connectedness and participation) was not featured as an outcome in any studies. Studies were primarily conducted in Europe and Asia: these two regions representing over 75% of the evidence. There were several gaps evident in the map, including but not limited to, end-of-life care (including advance care planning) and healthcare delivery such as hospital-at-home and telehealth. Several potential research areas where synthesis might be valuable were also identified such as medicines optimisation, home visits, and specific health conditions such as osteoporosis treatments. As the worldwide population continues to age, it is increasingly important that we have evidence of appropriate effective interventions for those who have reached their 80s, 90s and beyond, a group often left out of trials. This evidence and gap map shows that currently there is a clear bias towards interventions orientated around a biomedical view of health focused on intrinsic capacity, and relatively little on the wider functional and psychosocial aspect of health, or on enabling environments, such as adaptations to health and care services, or models of care. There is also a clear need for more research to understand the experiences and preferences of interventions from adults aged 80 years or more. Research exclusively focussed on people aged over 80 targets medical treatments and surgical procedures, neglecting healthcare services or wellbeing, and much of it is poor quality. The Evidence and Gap Map (EGM) in brief: Most of the studies in people aged over 80 investigate medical procedures and treatments with a focus on basic health needs and the ability to function, with fewer studies about health and care services or wellbeing. What is this EGM about?: Our population is ageing, which means that people are living longer, and age-related illnesses such as arthritis, dementia and cancer are becoming more common. Studies investigating interventions (treatments, procedures, therapies and services) are often focused on people aged under 80, because those who are older are often excluded from taking part in trials. Therefore, the treatments that are considered best practice in a general population might not be the best option for people aged over 80. This EGM displays evidence of interventions from systematic reviews and randomised controlled trials (RCTs) and studies looking at experiences (qualitative studies) where the people being investigated were aged over 80. What is the aim of this EGM?: The aim of this EGM is to provide easy access to studies that investigate interventions for people aged over 80. The studies are grouped by types of interventions and outcomes. Overall, the EGM provides an overview of the volume and nature of evidence on interventions for this age group. What studies are included?: The EGM contains 172 studies investigating interventions for people aged over 80. The interventions are organized into five groups: building and maintaining intrinsic capacity (ability to function both physically and mentally), health services an/or approaches, enabling environments and technologies, building and maintaining relationships and learning, growing and making decisions. The EGM contains 36 systematic reviews, 120 RCTs and 16 qualitative studies. What are the main findings of this gap map?: Research in older people is becoming more common as the population ages. Over a third of studies (n = 67) in the map have been published since 2020. However, most of the research was moderate to poor quality. Most of the systematic reviews (n = 31) and RCTs (n = 93) were rated as low or very low quality. Only a small number of studies focused on health conditions linked to ageing, with frailty covered in 14 studies, and falls in 6 studies. Most of the studies (n = 157) were about building and maintaining intrinsic capacity, focusing on the treatment and/or prevention of diseases and health disorders. The categories with most studies were those that involved surgery (n = 75 studies), and those that involved medicines or medical devices (n = 54). Only two studies addressed mental health therapies, and no studies examined ‘end of life’, skin conditions, genitourinary health and or voice/speech conditions. Several studies (n = 38) examined health services and/or health approaches. Some of these (n = 15) were RCTs assessing the effectiveness of home visits and a smaller number (n = 5) assessed geriatric assessment. Surprisingly, there were no systematic reviews in the map covering those topics. The only systematic review in the health services category investigated admitting older adults with sepsis into intensive care units. Similarly, there were no systematic reviews in the categories of enabling environments and technologies and learning, growing and making decisions. The most common outcomes reported in the studies were physiological measures of health (such as blood cholesterol levels, or blood pressure), measures of physical function (such as strength, balance), chronic health symptoms and side effects and complications. Only 7% of outcomes in the map were in the psychological health and wellbeing category. Social health (including connectedness and participation) was not featured as an outcome in any studies. Sixteen studies reported on experiences of interventions, mostly from the experience of the older adult (n = 9) and were in relation to heart surgery and procedures, colon surgery, resuscitation, medicines review and preventative screening. What do the findings of the map mean?: This EGM provides information on systematic reviews, RCTs and qualitative studies that have examined the effectiveness of interventions for people aged over 80. This is important because people in older age groups are often excluded from research, meaning the interventions that are best for the general population might not be most suitable for them. While studies in people aged over 80 focus on basic health needs, older people are under-represented in studies about psychosocial aspects of health or enabling environments such as adaptations to health and care services. There is also a need for more studies examining how people aged over 80 experience treatments, therapies and services. How up-to-date is this EGM?: The EGM contains studies published up until July 2024.

Natural language processing (NLP) techniques offer promising solutions for semi-automating the time-consuming process of abstract screening in systematic reviews. The exponential growth of published literature has created significant bottlenecks, with review teams manually assessing thousands of abstracts over weeks to months. Single reviewers can miss 5-13% of relevant studies, necessitating dual screening that further increases workload. Advances in artificial intelligence, including deep learning models such as BERT and its successors, show potential for automating this critical step, but comprehensive evidence on optimal approaches, performance, and practical feasibility remains limited. This systematic review aimed to assess techniques, performance, and feasibility of NLP approaches for title and abstract screening by characterizing the range of NLP methods used, summarizing performance on key metrics like workload reduction and recall, evaluating real-world implementation feasibility, and identifying research gaps and future directions. We searched PubMed, Web of Science, Embase, CINAHL, The Cochrane Library, Scopus, and gray literature sources from inception to December 2024. The search strategy, developed with an information specialist and peer-reviewed using PRESS guidelines, targeted keywords related to natural language processing, machine learning, abstract screening, and systematic reviews. Additional sources included conference proceedings, preprint servers, reference lists, forward citation tracking, and expert consultation. We included primary studies of any design describing development or evaluation of NLP techniques for automating title and abstract screening in evidence syntheses. Eligible studies reported on NLP methods, screening performance (workload reduction, recall, precision), or implementation feasibility. Studies using only rule-based approaches without machine learning, systematic reviews of NLP methods, commentaries, and conference abstracts were excluded. No language or date restrictions were applied. Two reviewers independently screened titles, abstracts, and full texts using Covidence software, with disagreements resolved through discussion. Data extraction covered study characteristics, NLP techniques, training approaches, performance metrics, and feasibility considerations. Risk of bias was assessed using a modified ROBIS tool. Given diverse techniques and outcomes, we conducted narrative synthesis following SWiM guidelines, grouping studies by NLP approach. From 4,105 records, 19 studies met inclusion criteria, with 68.4% published since 2023, reflecting rapid field advancement. Studies employed diverse approaches from traditional machine learning (Support Vector Machines, Random Forests) to advanced deep learning models, particularly BERT variants. Most achieved >90% recall with workload reductions of 13-96%, representing substantial time savings. Deep learning models with transfer learning consistently outperformed traditional approaches. However, implementation faced significant barriers including requirements for high-quality training data, specialized computational resources, technical expertise, and user-friendly interfaces. Performance was generally better for targeted reviews with lower inclusion prevalence. NLP techniques, especially deep learning with transfer learning, show substantial promise for semi-automating abstract screening with potential for large workload savings while maintaining high recall. However, challenges remain regarding training data quality, computational requirements, technical expertise needs, and user-centered design. Realizing full potential requires interdisciplinary collaboration to develop reliable, generalizable tools integrating seamlessly with human expertise and existing workflows. Future priorities include creating standardized datasets, conducting prospective evaluations, developing user-friendly interfaces, and establishing implementation best practices to revolutionize evidence synthesis efficiency. Declarative title: Natural language processing substantially reduces abstract screening workload but requires significant expertise and specialized computing resources. The review in brief Natural language processing techniques can reduce manual abstract screening workload by 30-90% while maintaining over 90% recall of relevant studies, with deep learning models showing the greatest promise for systematic review automation. What is this review about? Problem statement: Systematic reviews are the highest level of evidence for policy and practice, but exponential literature growth has made abstract screening a major bottleneck, taking weeks to months. Single reviewers miss 5-13% of relevant studies, making dual independent screening the gold standard, at significant cost in time and resources. What is the aim of this review? This systematic review examines the techniques, performance, and feasibility of natural language processing methods for automating title and abstract screening in systematic reviews. What are the main findings of this review? What studies are included? This review includes 19 studies that evaluated NLP techniques for automating abstract screening in systematic reviews, rapid reviews, scoping reviews, and other evidence syntheses. Studies came from diverse global regions, with 68.4% published in 2023 or later. Studies varied in design and corpus size (hundreds to tens of thousands of articles), mostly from medical literature, and demonstrated generally good methodological quality. Do NLP techniques reduce workload while maintaining accuracy? NLP techniques consistently demonstrate substantial workload reductions while maintaining high recall of relevant studies. Workload reductions range from 13-96%, with most studies achieving reductions of 30-60%. Most studies achieve recall rates exceeding 90%, meaning they successfully identify over 90% of relevant articles. Precision varied widely (10-99%), primarily affecting the volume of articles requiring manual review rather than the risk of missing relevant studies. Which NLP approaches perform best? Deep learning models, particularly those leveraging transfer learning with large pretrained language models like BERT and its variants (BioBERT, PubMedBERT), consistently outperform traditional machine learning approaches. Traditional approaches such as Support Vector Machines perform well but are generally outperformed by these modern architectures. What factors affect implementation feasibility? Several key factors influence the practical implementation of NLP systems. High-quality training data and specialist technical expertise are prerequisites. Computational resources vary from standard computing for simpler models to specialized GPU infrastructure for advanced deep learning approaches. User-friendly interfaces and domain generalizability remain key challenges for broader adoption. What do the findings of this review mean? NLP offers substantial promise for reducing the abstract screening burden. Workload reductions of 30-90% could accelerate evidence synthesis and policy translation. However, successful implementation requires careful planning, technical expertise, and adequate computational resources. Standardized datasets, user-friendly tools, and clearer best-practice guidance are needed to realise this potential. How up-to-date is this review? The review authors searched for studies up to December 2024.

High-quality systematic reviews and meta-analyses are essential for translating evidence into practice. We conducted an umbrella review to evaluate the methodological quality of systematic reviews and meta-analyses published in the field of behaviour analysis up to and including 2023. Eligible studies were identified through targeted searches of seven behaviour analysis journals using APA PsycINFO. Quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) and Revised AMSTAR (R-AMSTAR) instruments. Temporal trends were analysed using Bayesian multilevel regression. The protocol was preregistered on the Open Science Framework (doi.org/10.17605/OSF.IO/U38Z4). We identified 64 reviews (16 of which included a meta-analysis), all of which were rated as 'critically low' quality using the AMSTAR 2 criteria. Methodological shortcomings included absent protocol registration, inadequate risk of bias assessment, and failure to assess publication bias. Mean R-AMSTAR adherence was 43.8% (range 11-66%) and increased by 1.08% per year (population-level average marginal effect from the multilevel logistic model (95% CI [0.59, 1.58]), indicating robust methodological improvement over time. Currently, many systematic reviews and meta-analyses in behaviour analysis do not yet meet contemporary standards of methodological rigour. Enhancing the quality, transparency, and consistency of evidence synthesis is vital if systematic reviews are to meaningfully inform practice.

This is the protocol for a Campbell mega-map. This mega-map has two main objectives: 1. Identify, map, and describe existing evidence from systematic reviews and evidence and gap maps on interventions and programs aimed at creating and sustaining age-friendly environments. 2. Identify existing gaps in methods, interventions, outcomes, and geographies to assist researchers and policymakers in making evidence-informed research and funding decisions.

Artificial intelligence (AI) has the potential to improve the efficiency of evidence synthesis and reduce human error. However, robust methods for evaluating rapidly evolving AI tools within the practical workflows of evidence synthesis remain underdeveloped. This protocol describes a study design for assessing the effectiveness, efficiency, and usability of AI tools in comparison to traditional human-only workflows in the context of Cochrane systematic reviews. Members of the Cochrane Evaluation of (Semi-)Automated Review Methods (CESAR) project developed an adaptive platform study-within-a-review design, modeled after clinical platform trials. This design employs a master protocol to concurrently evaluate multiple AI tools (interventions) against a standard human-only process (control) across 3 key review tasks: title and abstract screening, full-text screening, and data extraction. The adaptive framework allows for the addition or removal of AI tools based on interim performance analyses without necessitating a restart of the study. Performance will be assessed using metrics such as accuracy (sensitivity, specificity, precision), efficiency (time on task), response stability, impact of errors, and usability, in alignment with Responsible use of AI in evidence SynthEsis principles. The study will generate comparative data about the performance and usability of specific AI tools used in a semiautomated or fully automated manner relative to standard human effort. The protocol provides a flexible framework for the assessment of AI tools in evidence synthesis, addressing the limitations of static, one-time evaluations. This study protocol presents a novel methodological approach to addressing the challenges of evaluating AI tools for evidence syntheses. By validating entire workflows rather than individual technologies, the findings will establish an evidence base for determining the viability of integrating AI into evidence synthesis workflows. The adaptive design of this study is flexible and can be adopted by other investigators, ensuring that the evaluation framework remains relevant as new tools emerge. Doctors and researchers rely on systematic reviews, which are thorough summaries of all available research on a health topic, to guide decisions about patient care. However, creating these reviews is a slow and demanding process, often taking more than a year to finish. AI tools could help speed up this work and reduce human errors, but there are currently no reliable ways to test how well these tools perform in real-world settings. This article describes the design of a study that will rigorously test how well AI tools perform when used in actual systematic review workflows, specifically within Cochrane Reviews. The study will compare AI-assisted methods with the traditional approach, where 2 trained researchers independently complete each step. It will look at 3 main tasks: choosing which studies might be relevant based on their titles and abstracts, reading the full-text publication to confirm which studies should be included, and extracting important information from those studies. A key strength of this study is its flexible design. Instead of testing just 1 AI tool at a single point in time, the study allows researchers to add or remove AI tools as new ones become available, similar to how some modern drug trials are run. This approach helps the study keep up with the fast pace of AI development. Researchers will assess the AI tools based on their accuracy, the time they save, how consistent their results are, and how easy they are to use. The ultimate goal of this study is to give the research community strong evidence about when and how AI can be safely and effectively used in systematic reviews to help summarize medical research.

Evidence synthesis is crucial for informing evidence-based practice across various fields. However, the traditional methodology is resource-intensive, and its findings can be outdated before publication. There is a growing trend toward integrating automation and artificial intelligence (AI) approaches into evidence synthesis to enhance efficiency, but standardized adoption is still pending. The goal of this study is to identify peer-reviewed evidence documenting AI readiness for evidence synthesis. We searched MEDLINE, Embase, and Global Index Medicus in May 2025 to identify review articles that evaluated evidence synthesis tools. Relevant study reviews and tool reviews published in English between January 2020 and May 2025 were included in our review of reviews. Tool features and performance metrics were extracted according to stages of the evidence synthesis workflow, including search, screening, appraisal, extraction, and synthesis. We included 21 studies in our review of reviews and identified 46 evidence synthesis tools. Nine tools supported all five stages of the evidence synthesis workflow, among which DistillerSR covered the most workflow-supporting features (19 out of 21). Ten of the identified tools reported sensitivity rates for AI-powered title/abstract screening, all of which achieved ≥ 95 % sensitivity in at least one configuration. Reported sensitivity rates of EPPI-Reviewer, Research Screener and SWIFT-Active Screener consistently reached the 95% threshold with varying degrees of automation. This review found peer-reviewed evidence supporting AI readiness for human-supervised automation of title/abstract screening. However, evidence documenting AI readiness for other evidence synthesis tasks remains limited. DistillerSR and EPPI-Reviewer demonstrated the broadest feature support and strong evidence for AI-powered title/abstract screening. Our study highlights the potential of AI to improve efficiency while maintaining high sensitivity in the screening stage. AI-powered screening may serve as a critical first step toward scaling rapid reviews into living evidence syntheses. Why was the study done: Reviewing large numbers of studies is essential for making informed decisions in healthcare and other fields. This process called evidence synthesis brings together findings from many studies to answer important questions. However, it can take a long time and requires a lot of effort from researchers. By the time a review is completed, new studies may already have been published, making the results less up to date. Artificial intelligence (AI) has been suggested as a way to speed up this process. AI tools can help with tasks such as searching for studies, screening which studies are relevant, extracting data from studies, and combining results. Despite growing interest, it is not yet clear how peer-reviewed literature documents the readiness of these tools. What did the researchers do: In this study, we looked at existing research to understand how well AI is currently supporting evidence synthesis. We searched major health databases for published review articles from 2020 to 2025 that evaluated tools used in evidence synthesis. We then collected evidence on what these tools can do and how well they perform at different stages of the review process. These stages include searching for studies, screening them for relevance, assessing their quality, extracting key information, and combining findings. What did the researchers find: We included 21 review articles and identified 46 different tools designed to support evidence synthesis. A few of these tools could support all stages of the review process. Among them, some tools, such as DistillerSR and EPPI-Reviewer, offered the widest range of features. We found the strongest evidence for the use of AI in screening studies by title and abstract. In this task, AI systems help researchers quickly decide which studies are likely to be relevant. Several tools reported high sensitivity, meaning they were able to correctly identify at least 95% of relevant studies in some settings. However, for other stages of evidence synthesis, such as assessing study quality or combining results, there is still limited evidence on how well AI performs. While AI shows promise, its use beyond screening is not yet fully supported by strong research. What do the findings mean: Overall, the evidence we found suggests that AI is ready to assist with some parts of evidence synthesis, especially the early screening stage. Using AI in this way could make reviews faster while still maintaining quality. This may also help support “living” reviews, which are updated regularly as new evidence becomes available. More research is needed to understand how AI can reliably support the full evidence synthesis process.

Musculoskeletal and back health of school aged children is a global health problem, with evidence that the prevalence of these problems is increasing. Many modern school systems require children to assume sedentary positions for extended periods of time, and the increasing use of classroom-based technology adds to the number of hours seated. With the incidence of musculoskeletal pain reported not only in adult populations but increasingly in young people, an understanding of spinal health and posture may be essential for students. The main objective for conducting this review was to conduct a best evidence systematic review. This means we only included the highest quality papers on the effectiveness of school-based education programs on back health for improving knowledge of back health, ergonomics and postural behaviour in school children aged 4-18 years. We searched the following 21 electronic databases from inception till the 20th January 2023: AMED (EBSCOhost), APA PsycINFO (EBSCOhost), Best Evidence Medical Education (BEME) (EBSCOhost), British Education Index (EBSCOhost), CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials (Wiley), EMBASE (Ovid), ERIC (EBSCOhost), EThOS (British Library), Europe PMC (Europepmc.org), GoogleScholar. Health Technology Assessment (HTA) (INAHTA), Health Management Information Consortium (HMIC) (Ovid), MEDLINE (EBSCOhost), PEDro (pedro.org.au), ProQuest Dissertations & Theses (Proquest), ProQuest Nursing and Allied Health Database (ProQuest), SCOPUS (Elsevier), SportDISCUS (EBSCOhost), Web of Science (Arts and Humanities Citation Index, Science Citation Index Expanded, Social Sciences Citation Index, Emerging Sources Citation Index, Conference Proceedings Citation Index - Science, Conference Proceedings Citation Index - Social Sciences and Humanities; Clarivate), ZEToC (British Library). Selection Criteria. The population eligible for the review included all children and young people between 4 and 18 years of age, attending school. Exclusion criteria: Children under 4 years of age and adults over 18 years of age; chronic disease or conditions or co-morbidities. Studies needed to meet the following criteria to be included: any formal educational school-based programme that included back health, ergonomics and postural behaviour that was designed to support the educational performance of students' knowledge of posture and ergonomics within an educational establishment. We excluded physical activity or exercise only interventions. Included studies were required to have a control group that represented either business-as-usual (no intervention), or a wait-list design. We included studies that examined back care knowledge, knowledge of back care ergonomics, back care behaviours and knowledge of back posture. This was a Best Evidence Systematic Review and only research papers scoring a "good" or "excellent "on the Downs and Black (1998) risk-of-bias form were included. The following research designs were included: randomised controlled trials (RCTs), cluster randomised controlled trials (CRCT) and quasi-randomised controlled trials (QRCTs). We included prospective non-randomised studies (NRSs) with a control group because it was anticipated that very few RCTs would be found. Controlled before-after studies (CBAs), interrupted time series (ITS) studies as well as controlled studies that were non-randomised and included a pre- and post-test were also eligible for inclusion. Titles and abstracts were screened in duplicate. Full texts of studies with seemingly relevant abstracts were retrieved and assessed for eligibility using the pre-specified inclusion criteria. Full texts were also screened in duplicate. Studies were classified as either included or excluded. Two authors independently extracted data from relevant studies. 1,327 potentially relevant papers were found through the searches of the academic databases, while no studies were identified through searches of grey literature and reference lists. After removing 1,256 articles which did not meet the inclusion criteria, 71 studies remained for screening. 37 articles were excluded based on screening the titles and abstracts. This left 34 articles for further examination of full texts. After the full texts had been read, these 34 studies continued to the quality assessment/risk of bias stage using the Downs and Black ROB form. Only two papers scored 20 or over (i.e. good or excellent) and were included in this systematic review. As the outcomes of the two studies differed, it was not possible to conduct a meta-analysis. Therefore, a narrative synthesis was conducted. Each of these studies showed statistically significant improvements on knowledge and behaviour, in the short term (3-8 months) though these need to be interpreted in light of concerns regarding risk of bias. Despite the comprehensive search of electronic databases, grey literature, hand searching, journals and reference lists of included studies, we only found two 'good' quality studies (scoring 20-25). No studies achieved an "excellent" score, that provided "excellent" evidence, on the effectiveness of school-based education programs on back health for improving knowledge of back health, ergonomics and postural behaviour in school children aged 4-18 years. This highlights the urgent need for high-quality studies to be conducted to assess the effects of these programmes due to the importance of ergonomics and posture in the activities of daily living of school children. Declarative title Educating School children on their Back Health can improve their Knowledge of Back Health, Posture and Ergonomics (functional design) The review in brief: A review of 1,327 studies identified only two robust enough for analysis. While these studies reported improvements in students’ knowledge and behaviour, potential selection and confounding biases limit the findings. Consequently, there is insufficient high-quality evidence to confirm the efficacy of school-based back health programs for children aged 4–18. Further rigorous research is essential to determine if these interventions effectively improve long-term ergonomics and postural habits. What is this review about? Proper posture training helps the body move efficiently, reducing strain on bones, joints, and soft tissues. Poor posture can cause muscle soreness, headaches, poor circulation, stress, and sleep disturbances. To avoid these issues, the work or school environment should be adapted to the user’s needs, a principle known as ergonomics. Ergonomics boosts productivity and comfort by reducing discomfort. Understanding ergonomics helps students prevent injuries in schools by adjusting tools like desks, chairs, and computer screens, emphasising correct posture to reduce repetitive strain and musculoskeletal issues. Poor ergonomic practices and resulting postures are recognised causes of musculoskeletal aches and pains (Sellschop et al., 2018). Ergonomic assessment in schoolchildren is important, as their activities and postures may contribute to the high prevalence of pain among young people, potentially leading to chronic issues later in life (Pavithra & Anand, 2013; Weiguang et al., 2011). The high rates of back pain in children and adolescents, as well as its predictive value for adult spinal pain, have prompted calls for spinal health interventions in schools . Habits formed during school years can influence the likelihood of developing back problems in adulthood. Back pain in adolescence is a risk factor for pain in later years (Harreby et al., 1996), with risk increasing alongside the frequency of adolescent pain (Lise, Charlotte, & Kyvik Kirsten, 2006; Lise, Charlotte, Ohm, et al., 2006). A systematic review and meta-analysis by Salsali et al. (2023) found a weak correlation between physical activity and posture, suggesting multiple factors influence posture. The study emphasises the need for caution when interpreting meta-analyses due to heterogeneity and publication bias. This Campbell best evidence systematic review assesses the effectiveness of school-based education programmes on back health for improving knowledge, ergonomics, and postural behaviour in school children aged 4–18 years. Despite extensive searching, only two methodologically robust studies met the criteria for inclusion. What are the main findings of this review? Out of 34 studies reviewed (1961–2013), only two were robust enough for inclusion. Due to outcome variations, a narrative synthesis replaced a meta-analysis. Although both studies reported significant gains in knowledge and behaviour, a high risk of bias requires cautious interpretation. Ultimately, the scarcity of high-quality research means there is no strong evidence that school-based programs effectively improve ergonomics or postural behaviour in children aged 4–18. The current evidence base remains insufficient to support broad implementation. What do the findings of this review mean? Despite extensive searches across academic databases, grey literature, and reference lists, only two studies scored ‘good’ (20+ on the Downs and Black scale), and none reached ‘excellent’ (25-28). This highlights the urgent need for high-quality research on school-based back health programmes, as ergonomics and posture are crucial for school children’s well-being and preventing back pain in adulthood. How up to date is this review? The review authors searched for studies published up to 20th January 2023.

Background: Widespread land degradation is driven by unsustainable land use and human pressures, and is accelerating climate change and biodiversity loss. Access to land is also essential for livelihoods and well-being, particularly in low- and middle-income countries (L&MICs). Urgent and inclusive land management interventions are needed to mitigate climate impacts, preserve biodiversity, and support vulnerable communities. Governments and international organisations are increasingly promoting land management interventions, such as establishing protected areas, granting land rights and decentralising land management and monitoring. These efforts aim to enable the realisation of several of the Sustainable Development Goals (SDGs) and the Kunming-Montreal Global Biodiversity Framework (KMGBF). The environmental and human development impacts of these interventions, and especially their potential interactions, remain under-researched. This synthesis of the literature can help to inform policy and research decisions in these contexts. Objectives: The purpose of this systematic review was to appraise and synthesise evidence of the effects of three types of land management interventions (community-based or decentralised land management and monitoring, land rights, and protected areas) on environmental and human well-being outcomes in L&MICs. We examined how these effects vary across geographical and social contexts. We also discussed the barriers, enablers, and trade-offs between environmental and human well-being outcomes that impact the effectiveness of the specified interventions. Lastly, we aimed to synthesise cost evidence of included projects. Search methods: The search of included studies was based on the evidence gathered in the Climate Change and Biodiversity Evidence Gap Map (CCB EGM, Marion et al., 2024). The CCB EGM displayed the available rigorous evidence on the effects of climate change and biodiversity interventions on environmental and human well-being outcomes in L&MICs. The systematic search of studies was conducted in March 2024. Selection criteria: From the CCB EGM, we focused on impact evaluations of projects which covered three types of land management interventions in L&MICs: (1) community-based or decentralised land management and monitoring; (2) land rights; and (3) protected areas. In this review, we considered studies published after 2000 that reported intervention effects on both environmental and human well-being outcome groups, aiming to identify possible trade-offs, synergies, and unintended consequences of these land management interventions. Data collection, and analysis: We identified 64 papers representing 58 unique studies. These impact evaluations assessed 60 projects across 26 L&MICs, reporting effects on both environmental and human well-being outcomes. Two independent reviewers conducted the data extraction and risk of bias assessments of projects' effects. With the available evidence, we conducted meta-analyses to synthesise effectiveness findings for comparable outcomes. For the set of included projects, we searched for additional qualitative information to identify barriers, enablers, unintended consequences and trade-offs that can affect project effectiveness, and for cost-related evidence that can inform the cost-effectiveness of these projects. Limitations of this review include: 1) the CCB EGM's search only covered studies published up to March 2024; (2) the CCB EGM's search only used terms in English; (3) the meta-analyses conducted in this review were most often based on a small number of estimates; and 4) half of the included quantitative evidence was judged to have a high risk of bias. Main results: The available evidence looking at the environmental and human well-being effects of these three land management interventions is sparse. Quantitative and qualitative evidence suggests that these interventions represent potentially effective strategies to promote shifts towards sustainable use of land resources and improvements in human livelihoods. These interventions can, however, result in significant trade-offs between environmental health and human welfare. The three interventions reviewed present dissimilar levels of evidence, mostly focused on community-based or decentralised land management and monitoring. Nearly all these projects took place in Africa, Latin America and the Caribbean, and East Asia and the Pacific. Available evidence on final environmental outcomes, such as biodiversity, climate adaptation and mitigation measures, is limited. Decentralised land management and monitoring increased income, possibly driven by improvements in the governance of natural resources and greater adoption of improved practices and technology. There is evidence that these interventions initiated a shift away from agricultural and forestry harvesting, as they promote forest preservation and development. Land rights led to a small increase in agricultural and livestock productivity, greater diversification of income sources and investments in natural resources or conservation. In turn, protected areas slightly reduced deforestation and improved agricultural and livestock productivity, as well as income and assets. Aligning interventions with existing communities' economic activities and values can create virtuous cycles for the sustainability of land and people's livelihoods. Knowledge-sharing and collaboration opportunities often enabled intervention success, whereas a lack of clarity, governance and funding structures were identified as barriers to intervention success. Conservation interventions can potentially and inadvertently lead to deforestation, land degradation, and biodiversity loss if the local population lacks the incentive to adopt these new practices. Increased wildlife from conservation efforts can also come at the cost of decreased food security and damaged properties, potentially affecting people's livelihoods. The extent and quality of cost evidence were generally insufficient to enable a comprehensive analysis of cost-effectiveness across included land management interventions. The review, however, identified useful insights from four well-documented cases. Authors' conclusions: Environmental and human well-being outcomes are closely linked, and evaluating them in isolation risks overlooking their interacting mechanisms. Interventions should be grounded in local socio-economic and ecological contexts, allow for continuous learning and adjustment, and prioritise inclusive, fair and equitable approaches. More rigorous, theory-informed evaluations that report on both environmental and human well-being are needed. Future research should also better integrate cost-effectiveness analyses from the outset and track long-term and equity-related outcomes. Using agile evaluation methods and remote-sensing data can help close evidence gaps and improve decision-making in complex and dynamic environments. Navigating trade-offs while creating opportunities for virtuous cycles between environmental protection and human well-being through land management interventions in low- and middle-income countries. The review in brief The evidence reporting on both the environmental and human well-being effects of land management interventions is limited. The findings suggest that these interventions result in small positive effects on improved natural resource use and management, productivity and income. Effects on biodiversity, climate mitigation and other longer-term human well-being outcomes remain inconclusive. What is this review about? The accelerating rise in global temperature and depletion of land ecosystems and fauna are highly interconnected, increasingly threatening livelihoods and human well-being in L&MICs. Land management policies aim to conserve, preserve and restore natural resources and ecosystems, while also offering long-term and sustainable economic opportunities for local communities. This review synthesised the available evidence reporting on both the environmental and human well-being effects of three land management policies: community-based or decentralised land management and monitoring, land rights, and protected areas. What is the aim of this review? This Campbell Systematic Review examined the effects of three land management interventions, appraising and synthesising the available evidence. We also explored the barriers, enablers, and trade-offs that can affect these projects, and aimed to synthesise cost evidence of included projects. What are the main findings of this review? What studies are included? We included impact evaluations of land management interventions which reported on both environmental and human well-being effects in L&MICs. We relied on evidence gathered in the Climate Change and Biodiversity Evidence Gap Map (CCB EGM, Marion et al., 2024), identifying 60 land management interventions in 26 L&MICs. Across the three intervention types, the evidence base is limited, especially on the effects of protected areas. Almost half of the evidence was assessed as having a high risk of bias. We also identified 112 documents providing qualitative information, mostly of high or moderate quality, on factors affecting the successful implementation of these projects. Additionally, we found reliable cost evidence for four of the included projects. How has this intervention worked? The effects varied across the three land management interventions. The evidence shows that decentralised land management and monitoring increased income, likely due to better natural resource governance and adoption of improved practices. This intervention type also led to a modest decline in land area used for agriculture and forestry, indicating a shift toward forest preservation. We also observed some improvements in intermediate environmental and human well-being outcomes from land rights interventions. We found that aligning with existing community livelihoods and providing knowledge-sharing and collaboration opportunities contributed to project success in some cases. Lack of clarity and governance, as well as inadequate funding structures, were identified as barriers to project success. We also found that project efforts to conserve the environment can inadvertently result in environmental degradation if local communities lack the incentive to adopt new practices. What do the findings of this review mean? The extent of the current evidence base remains small. Further rigorous quantitative and qualitative analyses are essential to understand the effects of these interventions and to design effective land management policies. While there can be important trade-offs to consider when implementing land management interventions in L&MICs, they can also support virtuous cycles of environmental protection and human well-being. Reporting projects’ cost data can also provide crucial insight into the variability of expenditure needed across different contexts and enhance our understanding of their value for money. How up-to-date is this review? The search for studies was completed in March 2024. This Campbell Systematic Review was published in 2026.

Cognitive impairment, including conditions like dementia, is a growing public health concern as the global population ages. Early detection and diagnosis are critical for optimal management and support. Speech-based cognitive screening tools have emerged as a promising alternative to traditional methods, leveraging advances in natural language processing and machine learning to analyze speech samples for signs of cognitive decline. Despite their potential, the adoption of speech-based screening tools in clinical practice has been slow. This systematic review protocol outlines a plan to synthesize qualitative evidence on the barriers and facilitators to the adoption of speech-based cognitive screening tools. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Eleven electronic databases will be searched: PubMed, Web of Science, Embase, CINAHL, MEDLINE (via Ovid), The Cochrane Library, Campbell Collaboration Library, PsycINFO, Scopus, IEEE Xplore, and ACM Digital Library. Two reviewers will independently screen studies using Covidence software, extract data, assess methodological quality using the Critical Appraisal Skills Programme (CASP) qualitative checklist, and evaluate confidence in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. Thematic synthesis will be used to analyze the evidence. The results will provide insights to inform the development, evaluation, and implementation of speech-based cognitive screening tools, ultimately improving early detection and care for individuals with cognitive impairment.

Despite their central role, Primary Care Practitioners (PCPs) encounter numerous challenges in providing primary care for children. Complex factors spanning all levels of the health system contribute to variability in the quality of paediatric primary care. Contextually informed strategies addressing these factors can deliver positive change. These strategies recognise healthcare as a complex adaptive system and leverage the interconnectedness of the health system and communication networks of healthcare providers. Evidence describing advice-seeking practices of PCPs related to paediatric care is limited. This protocol outlines a mixed methods systematic review that aims to examine how primary care practitioners seek advice regarding paediatric care. The resulting review will synthesise the structures and characteristics of the social networks through which PCPs seek advice regarding paediatric care, how networks are measured, the benefits of these networks, and factors PCPs encounter when seeking advice. The review will be guided by the Joanna Briggs Institute Mixed Methods Systematic Review manual and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. We will search English language publications in EMBASE, Ovid MEDLINE, and Web of Science. Relevant peer-reviewed articles published since 2013 will be included, encompassing randomised controlled trials (RCTs), non-RCTs, pre- and post-intervention studies, cross-sectional studies, qualitative studies, social network analysis, and mixed-methods studies. Data will be synthesised using a convergent integrated approach, transforming quantitative data into textual descriptions and aggregating where possible to produce integrated findings. PROSPERO Registration Number: CRD420251025798. Primary Care Practitioners, such as general practitioners and family physicians, have an important role in providing care for children. Despite the importance of their role, they face numerous challenges that impact the quality of care children receive. These challenges are often linked and occur across all levels of the health system, including the practitioner, clinic, and the broader health system. Primary care practitioners sometimes reach out to other healthcare providers for advice when they encounter these challenges, but we don’t know much about who they contact or how. If we want to improve care for children and better support primary care providers, we first need to understand how they get advice when they need it and what we can do to make it easier for them to get the advice they need. In this paper, we outline our plan to review and analyse research on how primary care practitioners seek advice about care for children. The researchers will be guided by the Joanna Briggs Institute Mixed Methods Systematic Review manual and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. We will search English language publications in EMBASE, Ovid MEDLINE, and Web of Science. A range of study types, including trials, surveys, mixed-methods and qualitative studies, will be included if they are relevant, peer-reviewed, and published since 2013. We will analyse and combine the findings from the research studies we find by comparing the findings from different studies, and grouping the findings together into categories when we can to create key findings and overall results. The researchers will publish a study that summarises their findings on the networks of people through which primary care practitioners seek advice about providing healthcare for children. It will also cover how these networks are measured, the benefits they provide, and the factors primary care practitioners encounter when seeking advice.

This is a protocol for a Campbell Systematic Review. The objective of this paper is to report a protocol for a systematic review and meta-analysis aiming to synthesise and evaluate the evidence on the determinants of weight gain within forensic psychiatric care. This protocol has been registered in PROSPERO (CRD42024586403) and developed in accordance with the PRISMA-P guidelines. Based on the Population, Exposure, Outcome framework, our study will explore demographic, behavioural, psychological, environmental, and pharmacological determinants of weight gain for individuals within forensic inpatient care. We will include adults within forensic inpatient mental health settings and synthesise data on any variable that is measured in accordance with weight gain. Quality of studies will be assessed by the relevant JBI tool. Screening will be undertaken independently by two reviewers, with a third reviewer available to address discrepancies. Data will be extracted using a standardised data extraction tool. Both screening and data extraction will be preceded by a piloting process to ensure consistency between reviewers. This will be the first study to synthesise the evidence and advance understanding of the determinants of weight gain within inpatient settings. The results of this systematic review and meta-analysis will have important implications for the design and development of weight management interventions within services offering inpatient forensic psychiatric care.

Financial stress is a widespread and significant problem in the U.S., affecting a variety of populations. The long-term health/well-being effects of financial stress are well-documented (Shippee et al., 2012). The health problems associated with inadequate income are one of the social determinants of health, which refers to a broad range of social and environmental conditions that affect health/well-being (Francis et al., 2018; U.S. Department of Health and Human Services, n.d). Financial stress is also a result of financial exploitation, and a growing public policy and public health concern. In response to financial stress and financial exploitation, the intervention of financial coaching is growing in popularity. However, the effectiveness of financial coaching on financial and health outcomes is unclear. The purpose of this review was to inform policy and practice relevant to financial coaching by analyzing and synthesizing empirical evidence related to its financial outcomes and secondarily, to its health outcomes. The primary objectives of this review were to answer the following research questions:1. What is the extent and quality of financial coaching intervention research?2. What are the effects on financial outcomes of financial coaching embedded within community settings?3. What are the effects on financial outcomes of financial coaching embedded within healthcare settings?4. What are the effects on health/well-being-related outcomes of financial coaching embedded within community settings?5. What are the effects on health/well-being-related outcomes of financial coaching embedded within healthcare settings? We conducted a comprehensive search for published and gray literature in September 2024. We searched for and retrieved published studies from Google, Google Scholar, and 10 Electronic databases. We also searched seven relevant websites and three trial registries for registered studies. We harvested from the reference lists of included studies and conducted forward citation searching using Google Scholar. Lastly, we contacted the first authors of the 11 included studies and requested information about unpublished studies, studies in progress, and published studies potentially missed in the other search activities. Studies eligible for this review met the following criteria. First, studies must have used a prospective randomized controlled trial (RCT) or quasi-experimental (QED) research design with parallel cohorts. Second, studies must have involved an intervention that provided financial coaching. Third, the study must explicitly discuss two of three criteria in their financial coaching intervention: a. client-led goal setting; b. action planning; and c. progress monitoring by the coach. Fourth, the studies must be focused on financial coaching for personal, rather than business, finances. Fifth, the studies must have measured a financial outcome. Health related outcomes were extracted and analyzed but were not required for eligibility. All settings and populations were eligible. Searches were saved in the reference management software EndNote, and duplicates were removed and uploaded to Rayyan. Another round of duplicates were removed in Rayyan. Three reviewers then completed title and abstract screening on 4,635 entries in Rayyan. Three reviewers independently reviewed the 23 articles that were moved forward for full-text screening. A fourth reviewer reviewed discrepancies and made the final decision to include or exclude. Eleven studies that satisfied the inclusion criteria were retained for data extraction using a standardized extraction form. Because the included studies did not measure and report sufficient data to calculate effects sizes for similar outcomes, quantitative synthesis was not possible. Effect sizes were calculated when possible, and author-reported study outcomes were described. Of the 11 unique studies included in this review, eight were randomized control trials and three were quasi-experimental designs. Eight of the 11 studies were conducted in community settings, and all studies involved adults. All studies offered financial coaching, with seven also providing financial education/literacy training. In addition to coaching, six provided credit/debt counseling and five offered budgeting or money management assistance. Seven of the studies combined financial education with financial coaching. All 11 studies reported at least one financial outcome, and four studies reported at least one health-related outcome. The evidence on the financial impacts of financial coaching is limited, as many studies did not report enough data to calculate effect sizes and or measure the same outcomes at the same points in time after the intervention. Most financial effects were small, with a mix of statistically significant and non-significant results. Some studies reported moderate effects on financial stress and financial self-efficacy, as well as small to moderate effects on smoking cessation. There were also some author-reported positive, statistically significant findings on financial and health-related outcomes. However, the risk of bias assessment indicated important methodological weaknesses across the included studies, and overall, the effectiveness of financial coaching remains uncertain. Although financial coaching interventions are becoming popular and have the potential to improve financial and health outcomes, there is an overall lack of evidence about whether financial goals can be achieved through financial coaching. Across studies that met inclusion criteria, outcomes, and measurement time periods varied so widely that we are unable to draw any conclusions regarding intervention effects on finances. In addition, the quality of the studies was only moderate. Given the nascent nature of the research, the high level of enthusiasm for financial coaching seems to be outpacing the evidence about its effectiveness on important outcomes. We advocate that financial coaching settings agree on outcome domains and measurement time periods post treatment, then invest first in rigorous research. Only after these steps are taken can a determination be made about further promoting financial coaching in practice and/or move ahead to integrate coaching into other types of services. Limited evidence of the effectiveness of financial coaching on financial and health outcomes. The review in brief: There is limited evidence about the effectiveness of financial coaching on financial and health outcomes. What is this review about? Financial stress is a common and serious problem in the United States that affects many different people. One approach that has been tried to help reduce this stress is financial coaching. In financial coaching, a person works with a coach to set goals for their money management, take steps to improve their situation, and get support and encouragement along the way. This review examined whether financial coaching can improve people’s financial situations and, when relevant, their health. What is the aim of this review? This Campbell Collaborative systematic review examines whether receiving financial coaching helps improve people’s financial situation and health compared to not receiving coaching. The review summarizes evidence from 11 high-quality studies, including eight randomized controlled trials and three quasi-experimental experiments. What are the main findings of this review? What studies are included? This review includes 11 studies that evaluated the financial and, when relevant, health effects of financial coaching. Most studies were conducted in community settings with adults, and many also offered related financial services. Studies gathered data about a wide range of financial outcomes. Quality of the Studies: The review includes evidence from 11 studies, all of which used strong designs like randomized controlled trials or studies with comparison groups. However, 10 of the 11 studies had important methodological weaknesses, so the results should be interpreted with caution. Research Question #1: Extent and quality of financial coaching intervention research. There are relatively few studies that have examined financial coaching as an intervention. Even though the way the small number of included studies were set up was generally strong, most of them had problems that make it hard to fully trust the results. Research Question #2: Effects on financial outcomes of financial coaching embedded within community settings and Research Question #3: Effects on financial outcomes of financial coaching embedded within healthcare settings. There was no single answer about whether financial coaching works. The programs were quite different from each other, and the results varied too. Some studies showed very small effects, while others showed medium effects. Because the interventions and results were so mixed, we could not combine them into one overall estimate for a more conclusive answer. Overall, the findings suggest that financial coaching might have only limited benefits for people’s finances. Research Question #4: Effects on health/well-being-related outcomes of financial coaching embedded within community settings and Research Question #5: Effects on health/well-being-related outcomes of financial coaching embedded within healthcare settings. There was no clear answer about the effects of financial coaching on health. The programs and measures of health-related outcomes were different across studies, and the results varied from no benefits to small to medium improvements in health outcomes. What do the findings of this review mean? The findings of this review suggest that while financial coaching may hold promise for improving financial and health outcomes, there is currently insufficient robust evidence to support its effectiveness. This lack of clear evidence calls for cautious implementation of financial coaching in community and other types of human service settings until further rigorous research can confirm their benefits. How up-to-date is this review? We searched for the included studies up to September 2024. This Campbell Systematic Review was published in May, 2026.

Women's economic empowerment is a key development goal; yet, significant gender inequalities in employment, income, and economic decision-making persist in low- and middle-income countries, particularly in sub-Saharan Africa. Even with economic growth, women are often stuck in informal and precarious jobs, facing structural barriers related to labor markets, access to finance, asset ownership, and restrictive legal frameworks. Most existing research on Women's economic empowerment has focused on micro-level interventions, such as financial support, training, and mentorship, providing limited insights into the impact of macro-level and structural policies. New research suggests that macroeconomic, fiscal, and labor market policies are not gender-neutral; they can shape employment opportunities and income security differently, particularly in contexts with unequal unpaid care responsibilities. However, evidence on macro-level, gender-responsive policies and their effects on women's economic empowerment remains scattered across various policy areas and outcomes in sub-Saharan Africa. This Evidence and Gap Map systematically identifies, categorizes, and maps the existing evidence to facilitate informed policy-making, prioritize research, and guide future synthesis. To map evidence on gender-responsive macro-level policies and their impact on women's economic empowerment in sub-Saharan Africa. From January to September 2024, we searched the following databases, limiting our results to English language publications: CAB Abstracts, Web of Science, Dimensions, and Scopus. We also utilized gray literature sources, including organizational databases, Google Scholar, and registries. Two reviewers independently screened the titles, abstracts, and full texts of potentially eligible articles to determine their inclusion based on the specified eligibility criteria. Studies were included if they focused on populations in sub-Saharan Africa, examined macro-level gender-responsive policies, reported outcomes related to women's economic empowerment, and utilized either primary or systematic or scoping review study designs. We developed and pilot-tested a data extraction code set in EPPI-Reviewer, where data were extracted and coded in duplicate. To evaluate the quality of the reviews, we employed the AMSTAR2 tool; however, we did not assess the quality of the primary studies. This Evidence and Gap Map includes a total of 245 articles made up of 224 primary studies and 21 systematic and scoping reviews that evaluate the impact of gender-responsive macro-level policies on women's economic empowerment. The majority of the studies focused on social protection and informal economy policy interventions, with women's economic opportunities and well-being being the most frequently examined outcomes. Most of the research was conducted in South Africa (about 17% of the included studies) Significant gaps were identified in advocacy interventions for women's economic empowerment, as well as in the exploration of women's agency as an outcome related to their economic empowerment. Additionally, most of the evidence is based on non-experimental and qualitative study designs, indicating a substantial gap for future research. The systematic reviews incorporated in this EGM are predominantly of moderate quality, with less than 30% categorized as high quality. The Evidence and Gap Map reveals a substantial yet uneven body of evidence regarding women's economic empowerment interventions in sub-Saharan African countries. The evidence is most concentrated around social protection policies and interventions in the informal economy, with strong coverage of outcomes related to women's economic opportunities and well-being. These areas are comparatively well-researched and provide opportunities for further evidence synthesis to guide policy and program design. In contrast, there is limited evidence on agency-related outcomes and implementation processes, which hampers understanding of how and why interventions foster empowerment. Additionally, macroeconomic policies and women's economic empowerment advocacy interventions are underrepresented, despite their importance in addressing structural barriers to women's economic participation. Methodologically, the evidence base is primarily composed of non-experimental and summative evaluations, with fewer studies using rigorous designs that can identify causal effects or track long-term empowerment trajectories. Overall, the map highlights both well-established evidence clusters and significant gaps, especially concerning structural interventions, empowerment processes, and methodological diversity. The Evidence and Gap Map (EGM) on gender-responsive macro-level policies and women’s economic empowerment revealed studies that were disproportionately concentrated in sub-Saharan African countries. Additionally, the existing reviews were generally of moderate quality. The EGM in brief This EGM examines and discusses the evidence on macro-level policy interventions that are gender-responsive and designed to promote women’s economic empowerment. It emphasizes that much of the existing evidence centers on social protection policies, particularly childcare policies, and their impact on physical well-being outcomes. Most of this evidence comes from Southern Africa. What Is this EGM about? Women in low- and middle-income countries (LMICs), particularly in sub-Saharan Africa, are often confined to informal and low-quality jobs because of structural, legal, and macroeconomic barriers that cannot be overcome by economic growth alone. This intervention aims to tackle these constraints by synthesizing evidence on gender-responsive macro-level policies that foster inclusive labor markets and promote sustainable economic empowerment for women. What Is the aim of this EGM? To provide evidence from studies on macro-level policy interventions that are gender-responsive and aimed at promoting women’s economic empowerment in sub-Saharan Africa. What studies are included? The EGM included 245 studies, consisting of 224 primary studies and 21 review studies, all evaluating macro-level policy interventions designed to promote women’s economic empowerment. These studies specifically targeted gender-responsive interventions in sub-Saharan Africa. What Are the main findings of this Gap Map? The evidence presented in this EGM underscores the importance of macroeconomic and social protection policies in promoting women’s economic empowerment. Specifically, it highlights clusters of evidence related to fiscal, childcare, and healthcare policies. Additionally, there is significant evidence concerning decent work and unpaid care work policies within the informal economy. Most of the evidence is drawn from Southern African countries, including South Africa, Malawi, Zambia, and Zimbabwe. The systematic reviews included in this EGM are primarily of moderate quality, with fewer than 30% classified as high quality. Over 45% of the studies reported outcomes related to well-being. Furthermore, there were 29 studies evaluating policy interventions on women’s employment opportunities and 48 studies focusing on income-related interventions. While all regions of sub-Saharan Africa were represented, the majority of studies originated from Southern Africa (37%), with only a small percentage coming from Central Africa (2.7%). Most interventions in Eastern and Western Africa concentrated on social protection policies, with fewer studies addressing advocacy initiatives for women’s economic empowerment. What do the Findings of the Map Mean? This EGM aims to identify gender-responsive macro-level policy interventions that promote women’s economic empowerment. The EGM is limited by uneven evidence across geographies, and it is overrepresented in terms of interventions related to social protection and macroeconomic interventions compared to other interventions, such as advocacy. Evidence is more represented in Southern Africa. , with a notable number of studies also available from Western and Eastern Africa. This map helps establish an evidence base in the field, allowing funders and researchers to identify existing gaps and prioritize future research efforts. How up-to-date is this EGM? We conducted a search for relevant studies up to September 25, 2024.

This protocol describes a systematic review that will examine the effects of organizational transparency interventions on trust in AI-assisted decision-making and in human decision-makers. The review addresses a dual-trust dynamic - cognition-based trust in AI-assisted decisions and affect-based trust in human decision-makers - that existing reviews have not synthesised together. Eligible studies will involve organizational decision-makers interacting with AI-assisted systems and will measure trust-related outcomes in response to transparency interventions such as disclosure protocols, process transparency, or leader communication strategies. Database searches will span psychology, management, information systems, and AI literatures from 2015 to present across PsycINFO, Scopus, Web of Science, ACM Digital Library, IEEE Xplore, and grey literature sources. A convergent segregated mixed-methods synthesis will be used: random-effects meta-analysis for quantitative evidence and thematic synthesis following Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) for qualitative evidence. Findings will be integrated in a cross-interpretation stage to produce theory-informed conclusions on mechanisms and moderators of trust asymmetry. The review is registered with the Campbell Collaboration Business and Management Coordinating Group.

Inclusive governance ensures that institutions, policies, and practices allow marginalized and underserved groups to participate meaningfully in decision-making at all levels. It is defined by equitable participation, transparency, accountability, responsiveness, and effectiveness. Historically, women, youth, ethnic minorities, persons with disabilities, and low-income rural and urban populations have faced exclusion due to structural inequalities and weak institutions, resulting in poverty, disempowerment, and social unrest. However, inclusive governance fosters peace, empowerment, and economic growth. In sub-Saharan Africa, it is a key priority in Sustainable Development Goals (SDG) 16 and Agenda 2063, although interventions have yielded mixed results. Therefore, it is essential to enhance the discoverability of research on these interventions. To map evidence on inclusive governance interventions for underserved populations in sub-Saharan Africa. In 2024, the following databases were searched, limited to English language results: CAB Abstract, Web of Science, Dimensions, and Scopus. Additionally, gray literature sources, including organizational databases, Google Scholar, and registries, were utilized. Two reviewers independently screened the titles, abstracts, and full texts of potentially eligible articles for inclusion based on the outlined eligibility criteria. We developed and pilot-tested a data extraction tool in EPPI-Reviewer, where data was extracted and coded individually. We did not assess the quality of the reviews, as there were none available, nor did we evaluate the quality of the primary studies. A total of 88 articles (all primary studies) were included in this Evidence and Gap Map which assessed the interventions for underserved populations aimed at inclusive governance. Most studies looked at CSO's advocacy, and public policy and government agencies interventions. Civic participation, and movement and coalitions, & CSO's activities and achievement were the most studies outcomes leading to inclusive governance. Most research was conducted in Eastern Africa, particularly in Kenya and Uganda. Major gaps were identified in access to information and capacity building initiatives interventions, in addition to use of key government information as an outcome that address inclusive governance. Most of the evidence relies on non-experimental studies, and we could not identify any experimental or systematic review studies, highlighting a significant gap for future research. The Evidence and Gap Map (EGM) consolidates and enhances the visibility of research on inclusive governance interventions, providing a single, accessible resource for policymakers, researchers, and funders. It primarily draws from impact and summative evaluations, encompassing over two decades of studies across 48 sub-Saharan African countries, particularly in Kenya, South Africa, Uganda, and Ghana. The findings indicate evidence concerning civic participation, movements, coalitions, and civil society organization (CSO) activities, while areas such as the use of government information remain under-researched. Furthermore, regional imbalances persist, with Eastern Africa dominating the research landscape. Overall, the EGM identifies evidence clusters, highlights significant gaps, and offers guidance for future evaluations and policy planning. This Evidence and Gap Map on interventions aimed at promoting inclusive governance for underserved populations found the evidence is distributed disproportionately and lacks comprehensive systematic reviews. This EGM reviews and discusses the available evidence on interventions aimed at underserved populations to promote inclusive governance in SSA. Sub-Saharan Africa has a significant number of underserved populations, with notable challenges in service delivery and in government accountability to its citizens. By concentrating on this region, the EGM identifies context-specific interventions and evidence in areas where enhancing inclusive governance is essential for promoting equity, participation, and sustainable development. It highlights that much of the evidence focuses on the advocacy efforts of civil society organizations (CSOs) and their initiatives to achieve inclusive governance outcomes, particularly in civic participation. Most of this evidence originates from countries in Eastern Africa. What is this EGM about? Due to structural inequalities, weak institutional capacity, and a lack of transparency, many underserved populations are often excluded from political, economic, and social decision-making processes. Inclusive governance interventions can help these marginalized groups have their voices heard and empower them. Policymakers increasingly seek to identify effective interventions that promote equitable and non-discriminatory participation, accountability, transparency, responsiveness, and overall effectiveness in inclusive governance. This EGM addresses that need by systematically identifying and organizing research on inclusive governance interventions for underserved populations in sub-Saharan Africa. What is the aim of this EGM? To present evidence from studies on interventions that promote inclusive governance for underserved populations in sub-Saharan Africa. What studies are included? The EGM comprised 88 articles, all of which were primary studies evaluating interventions aimed at achieving inclusive governance. These studies specifically focused on interventions designed for underserved populations in sub-Saharan Africa. What are the main findings of this gap map? The evidence presented in this EGM highlights the role of Civil Society Organizations (CSOs) in advocacy, particularly in public policy, government agency engagement, and grassroots movements that promote inclusive governance. Specifically, there are clusters of evidence focusing on alliance building, advocacy and lobbying efforts, and the active participation of women and youth in CSO advocacy. Additionally, multiple studies have examined the development and strengthening of grassroots movements through collective actions and campaigns. Most of the evidence originates from Eastern African countries, including Kenya, Uganda, and Tanzania, with no systematic reviews included in the mapping. Over 35% of the studies reported outcomes related to civic participation. Furthermore, there were 7 and 8 studies assessing interventions aimed at enhancing the use of key government information and influencing policy and policymakers, respectively. While all regions of sub-Saharan Africa were represented, the majority of studies came from Eastern Africa (44.9%), with only a small proportion from Central Africa (4.1%). Most interventions in Eastern and Western Africa focused on CSO advocacy, with fewer studies addressing access to information and capacity-building initiatives. What do the findings of the map mean? This EGM aims to identify effective interventions for achieving inclusive governance among underserved populations. While there is limited evidence available, much of the research is concentrated in Eastern Africa, although Western and Southern Africa also have a significant number of studies, albeit without comprehensive reviews. This map helps build an evidence base in the field, enabling funders and researchers to identify existing gaps and prioritize future research efforts. How up-to-date is this EGM? We conducted a search for relevant studies up to September 17, 2024.

The COVID-19 pandemic demanded evidence synthesis approaches that could keep pace with rapidly evolving science and urgent policy needs. Rapid reviews and living evidence syntheses (LES) emerged as critical methodological responses, yet limited guidance exists for teams undertaking such work, particularly regarding the operational challenges of sustained production, multi-team coordination, and the transition from rapid reviews to living formats under emergency conditions. This paper aims to document and appraise methodological decisions made across each component of the synthesis process and their rationale; identify the contextual factors, coordination mechanisms, and infrastructure that enabled or constrained synthesis implementation under emergency conditions; and derive practical recommendations for evidence synthesis teams, funders and commissioners, and methodologists. We present a structured reflective process evaluation of our experience producing three rapid LESs on COVID-19 vaccine effectiveness as part of COVID-END in Canada, addressing vaccine effectiveness in adults (short-term and long-term) and children/adolescents, collectively producing 79 versions over approximately two years. Drawing on a Context-Mechanism-Outcome (CMO) lens, we examine eight core methodological processes, each time highlighting: the methodological decision and its rationale; the challenges encountered; and the lessons learned. Key insights include: decision-maker engagement played a central role in methodological decisions, directly determining scope boundaries, update frequency, and presentation formats; the multi-team coordination structure was essential to quality under streamlined methods, with cross-team verification partially offsetting the validity risks of single-reviewer screening; choosing between narrative synthesis (compared to meta-analytic approaches) in two of three products reflected capacity constraints during emergency production, a distinction with implications for how such adaptations are evaluated against existing guidance; automation produced considerable efficiency gains but required added development capacity and resources, demonstrating that teams should plan and budget for automation from the outset rather than absorbing its demands reactively during production; and coverage was acceptable for decision timelines. External cross-checks identified five studies not captured by our searches across the entire project, of which only two were ultimately eligible for synthesis. Emergency production meant that key process records, including change logs, per-cycle search records, and pilot screening agreement data, were not systematically captured. Future teams should plan to assemble a minimal transparency package from the outset. A minimum viable LES framework is proposed comprising minimum infrastructure, minimum methods, and optional enhancers. The successful implementation of rapid LES requires pre-existing or rapidly mobilisable infrastructure, sustained and explicitly resourced decision-maker engagement, transparent documentation of methodological adaptations across update cycles, effective coordination in multi-team contexts, and realistic sustainability planning. These lessons, derived from a specific emergency context, offer transferable guidance for evidence synthesis teams preparing for future health emergencies and for standards bodies considering how existing guidance accommodates emergency and living synthesis conditions.