The quality of the screened articles will be graded, not with the intention of excluding the poorer studies or weighting the studies, but rather to identify the overall quality of studies in the sample. The studies and their characteristics will also be summarized.
The findings will then be presented as an initial concept and further broken down into the emerging and final themes within that concept see Multimedia Appendix 2. Analysis will focus on detecting the key concepts among studies. The concepts will then be synthesized and refined to determine core themes; directed content analysis and thematic analysis will be undertaken to classify the data [ 29 - 31 ]. It is also anticipated that this multi-layer synthesis will identify novel concepts not suggested by the individual studies.
Using this approach, we will identify research available in this area, the gaps in literature, and whether there is a need for a systematic review of the literature or other future reviews. Need for a systematic review will be determined by the content and methods of the studies and whether they are conducive to performing a systematic review, as the topic is very broad. The results will then be reported in descriptive tables, frequency tables, and diagrams.
The characteristics of the studies, including participants, study setting, study design, and study outcomes will be described.
A summary table will also provide the identified themes. This approach will involve a series of consultations with research experts and the community advisory committee in our team to engage them in the development of the study outcome, action plan and research agenda, and to provide opportunities for knowledge exchange. All comments and feedback will be recorded and will be integrated into the study. Using the final results, a summary of possible implications to practice, including the areas that may require action in the medium and longer term, will be developed.
The summary will be presented in the annual meeting of the LHIV Innovation Team for brainstorming, developing the research questions, identifying appropriate strategies, and the production of an action plan and research agenda for the LHIV Innovation Team. The search terms that were selected for the literature search can be found in Multimedia Appendix 3.
The literature search strategy for PubMed is outlined in Table 1 see Multimedia Appendix 4 for search strategies for all other databases. After an extensive literature search, 20, articles were found using the appropriate search terms. After assessing eligibility based on title and abstract, a total of articles were deemed to be relevant Figure 1. These articles were re-assessed based on title and abstract. Of the , 9 articles were found to be relevant and therefore added to the to be reviewed by full text.
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A total of articles were reviewed in full text. A full description of the exclusion process can be found in Figure 1. The final version of the data extraction tool can be viewed in Multimedia Appendix 5. During extraction, two articles were found to not be relevant to this scoping review and therefore were not included in any analysis, which left a total of 64 articles.
Throughout the extraction process, a comparison of quality assessment and extraction were done by two independent reviewers. Quality assessment scores were deemed comparable if they were within 1 point of each other. If differences in extraction results were found, a discussion between the two reviewers was initiated and either a common conclusion was made, or a third party was consulted. The majority of assessments and extractions were similar between the reviewers, with all differences being discussed and decided upon together.
Looking at the articles more closely, there were some general initial quantitative results available. In Figure 3 , it is possible to see a visual representation of the proportion of research there has been in each country. The other category includes the 11 countries that are only represented in one article of this review. A large number of search results are anticipated, so proactive steps are taken during the review, including 1 working closely with a librarian at Memorial University of Newfoundland to ensure that the review will be manageable, and 2 categorizing the studies in terms of their quality and the proper knowledge synthesis methods.
We have a strong team with expertise in research methods, review methods, and content. Our team conducts regular meetings and communications with stakeholders to obtain their comments and iteratively modify the study methodology as required. Throughout the process there have been some challenges. As there are a large number of articles identified for review, not all are initially accessible electronically through databases, and many have to be found individually.
This issue adds to the workload of the research librarian, who has to manually obtain these records. However, the core results sections eg, 5 A's remain the same, so all important results will be accounted for. Data extraction has been completed and compared by both graduate student reviewers. The next step in the process is to collate and summarize that data found, in order to answer the objectives within this study. A scoping review will record and characterize the extensive body of literature on perspectives of PLHIV regarding access to health care.
Without a systematic and well-documented protocol, the scoping reviews are subject to biases. A repeatable and evidence-based protocol is required to broadly and systematically identify, classify, and synthesize literature. A valid protocol will help to identify the issues, resolve some problems, and reduce the risk of bias.
Conflicts of Interest: None declared. National Center for Biotechnology Information , U. Published online May Claire Kendall 5 C. Matthew Hogel 5 C. Clare Liddy 5 C.
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Corresponding Author: Shabnam Asghari ac. Abstract Background Strategies to improve access to health care for people living with human immunodeficiency virus PLHIV have demonstrated limited success. Objective We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research.
Methods This scoping review includes peer-reviewed and grey literature from to May using double data extraction. Conclusions This scoping review will record and characterize the extensive body of literature on perspectives of PLHIV regarding access to health care. Introduction Within the topic of access to health care for people living with human immunodeficiency virus PLHIV there are four key ideas which are very important to the conception and planning of research in this area.
Concept of Access to Health Care Access to health care is a complex concept that is usually measured using multiple dimensions, including the characteristics and expectations of health care providers, customers, or patients. Scope of the Review We aimed to summarize the perspectives of PLHIV concerning access to health care, as identified in previous studies.
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Goals and Aims In response to the research question, the main goal of this review is to explore the depth, breadth, and quality of evidence about the perspectives of PLHIV regarding access to health care services internationally, with a particular focus on Canadian studies. Objectives We have five main objectives in this study: Map the literature on the perspectives of PLHIV about access to health care services. Outcomes Outcomes will be restricted to any measures of PLHIV-stated satisfaction, implied needs, beliefs, and desires concerning access to health care.
Stage 2: Identifying Relevant Studies Selection of Search Terms Significant terms from the research question will be selected, and a list of possible synonyms or alternate terms will be compiled. Building Search Terms Strategy To determine the best search strategy, different combinations of words will be tested across databases. Sources of Relevant Studies To identify all sources of information, this review will begin with a comprehensive mapping of peer-reviewed publications referenced in electronic databases.
Validation of Search Protocol To validate the search protocol and calibrate our search strategy, the protocol will be tested on the gold standard studies and journals suggested by content experts.
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Directory of the Identified Studies A directory of publications and grey literature will be created in Refworks [ 26 ]. Eligibility Criteria Decisions about review process methodology will be undertaken by members of our team who will be blinded to the results of the studies in question, and who have expertise in health care services for PLHIV.
Study Selection Process Step 1: Pre-screening The titles and abstracts of all articles identified during database searches will be examined by a trained undergraduate student to evaluate eligibility, after duplicates are removed. Stage 4: Data Extraction A data extraction tool in Excel will be prepared for data abstraction to systematically collect data from identified articles.
Results Stage 2: Identifying Relevant Studies The search terms that were selected for the literature search can be found in Multimedia Appendix 3. Table 1 The literature search strategy for PubMed and number of identified articles. Open in a separate window. Stage 3: Study Selection After assessing eligibility based on title and abstract, a total of articles were deemed to be relevant Figure 1.
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Stage 4: Data Extraction The final version of the data extraction tool can be viewed in Multimedia Appendix 5. Stage 5: Collating, Summarizing and Reporting the Results Looking at the articles more closely, there were some general initial quantitative results available. Figure 2. Figure 3. Discussion Anticipated Challenges A large number of search results are anticipated, so proactive steps are taken during the review, including 1 working closely with a librarian at Memorial University of Newfoundland to ensure that the review will be manageable, and 2 categorizing the studies in terms of their quality and the proper knowledge synthesis methods.