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      Diverse Approaches to Creating and Using Causal Loop Diagrams in Public Health Research: Recommendations From a Scoping Review

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          Abstract

          Objectives: Complex systems thinking methods are increasingly called for and used as analytical lenses in public health research. The use of qualitative system mapping and in particular, causal loop diagrams (CLDs) is described as one promising method or tool. To our knowledge there are no published literature reviews that synthesize public health research regarding how CLDs are created and used.

          Methods: We conducted a scoping review to address this gap in the public health literature. Inclusion criteria included: 1) focused on public health research, 2) peer reviewed journal article, 3) described and/or created a CLD, and 4) published in English from January 2018 to March 2021. Twenty-three articles were selected from the search strategy.

          Results: CLDs were described as a new tool and were based upon primary and secondary data, researcher driven and group processes, and numerous data analysis methods and frameworks. Intended uses of CLDs ranged from illustrating complexity to informing policy and practice.

          Conclusion: From our learnings we propose nine recommendations for building knowledge and skill in creating and using CLDs for future public health research.

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          Most cited references65

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          Three approaches to qualitative content analysis.

          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach

            Background Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate. Results Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. Conclusions Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.
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              Action Research and Minority Problems

              Kurt Lewin (1946)
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                Author and article information

                Contributors
                Journal
                Public Health Rev
                Public Health Rev
                Public Health Rev
                Public Health Reviews
                Frontiers Media S.A.
                0301-0422
                2107-6952
                14 December 2021
                2021
                : 42
                : 1604352
                Affiliations
                Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
                Author notes

                Edited by: Kasia Czabanowska, Maastricht University, Netherlands

                Reviewed by: Robin van Kessel, Maastricht University, Netherlands

                Brian Li Han Wong, Independent Researcher, London, United Kingdom

                *Correspondence: Cory Neudorf, cory.neudorf@ 123456usask.ca
                Article
                1604352
                10.3389/phrs.2021.1604352
                8712315
                35140995
                485891a5-a0d6-40f2-9c41-59b6c5dde5fa
                Copyright © 2021 Baugh Littlejohns, Hill and Neudorf.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. PHR is edited by the Swiss School of Public Health (SSPH+) in a partnership with the Association of Schools of Public Health of the European Region (ASPHER)+

                History
                : 16 July 2021
                : 25 November 2021
                Funding
                Funded by: Canadian Institutes of Health Research , doi 10.13039/501100000024;
                Categories
                Public Health Archive
                Review

                scoping review,causal loop diagrams,public health research,methods,complex systems thinking

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