Facilitating evidence uptake: development and user testing of a systematic review summary format to inform public health decision-making in German-speaking countries

• Main Authors: Laura K. Busert, Margot Mütsch, Christina Kien, Aline Flatz, Ursula Griebler, Manfred Wildner, Jan M. Stratil, Eva A. Rehfuess, on behalf of Cochrane Public Health Europe
• Format: Article
• Language: English
• Published: BMC 2018-07-01
• Series: Health Research Policy and Systems
• Subjects: Systematic review; public health; decision-making; knowledge dissemination; knowledge translation; evidence synthesis
• Online Access: http://link.springer.com/article/10.1186/s12961-018-0307-z

Abstract Background Systematic reviews are an important source of evidence for public health decision-making, but length and technical jargon tend to hinder their use. In non-English speaking countries, inaccessibility of information in the native language often represents an additional barrier. In line with our vision to strengthen evidence-based public health in the German-speaking world, we developed a German language summary format for systematic reviews of public health interventions and undertook user-testing with public health decision-makers in Germany, Austria and Switzerland. Methods We used several guiding principles and core elements identified from the literature to produce a prototype summary format and applied it to a Cochrane review on the impacts of changing portion and package sizes on selection and consumption of food, alcohol and tobacco. Following a pre-test in each of the three countries, we carried out 18 user tests with public health decision-makers in Germany, Austria and Switzerland using the ‘think-aloud’ method. We analysed participants’ comments according to the facets credibility, usability, understandability, usefulness, desirability, findability, identification and accessibility. We also identified elements that hindered the facile and satisfying use of the summary format, and revised it based on participants’ feedback. Results The summary format was well-received; participants particularly appreciated receiving information in their own language. They generally found the summary format useful and a credible source of information, but also signalled several barriers to a positive user experience such as an information-dense structure and difficulties with understanding statistical terms. Many of the identified challenges were addressed through modifications of the summary format, in particular by allowing for flexible length, placing more emphasis on key messages and relevance for public health practice, expanding the interpretation aid for statistical findings, providing a glossary of technical terms, and only including graphical GRADE ratings. Some barriers to uptake, notably the participants’ wish for actionable recommendations and contextual information, could not be addressed. Conclusions Participants welcomed the initiative, but user tests also revealed their problems with understanding and interpreting the findings summarised in our prototype format. The revised summary format will be used to communicate the results of Cochrane reviews of public health interventions.