Methods for the health technology assessment of complex interventions: a protocol for a scoping review

Introduction In healthcare policy and economic literature, research on the health technology assessment (HTA) of complex interventions (CIs) is becoming increasingly important. In many developed countries, HTA guides decision-making to help achieve greater value for money when funding health care. However, research has yet to identify the forms of evidence and evaluation criteria that should be used in the HTA of CIs. Previous research has established that the HTA of CIs requires multiple factors to be evaluated but there is no agreement on which factors ought always to be considered. There is equally little agreement on which forms of evidence ought to be collected or synthesised and how. We plan to perform a systematic scoping review in order to identify the range of evaluation criteria and types of evidence currently used in the HTA of CIs.Method and analysis This protocol was developed to guide the methodological framework for the conduct of a scoping review on health technology assessment (HTA) of complex interventions (CIs), using the Joanna Briggs Institute guidelines and the six-stage framework proposed by Arksey and O’Malley, in addition to more recent innovations in scoping review methodology. A grey literature search will supplement the primary searches of seven electronic databases for studies available in English between January 2000 and August 2020. Two reviewers will independently screen all search results for inclusion and data will be extracted using a customised data extraction or charting form. Any dispute will be resolved by consensus or through arbitration by a third author. The mnemonic Population, Concept and Context will be adopted to establish criteria for selecting relevant literature, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Review will be used for reporting the results. Several explanatory-descriptive methods will be used for analysing the extracted data including frequency and trend analyses as well as reflexive thematic coding and analysis.Mapping evidence on the HTA of CIs will allow us to gain a better understanding of both established and emerging practices, including the information types, requirements, values and parameters that are incorporated in the HTA of CIs. We also expect the findings of the scoping review to help identify research gaps that will guide future studies. As healthcare becomes more complex in its delivery, it is timely to determine how these complex interventions should be assessed so that policy decisions can be made about whether implementation and public funding is warranted.Ethics and Dissemination This scoping review will involve secondary analysis of already collected data, and thus, does not require ethics approval. The research findings will be submitted to peer-reviewed journals for publication and will also be disseminated at conferences and seminars

Contraception decision making by Culturally and Linguistically Diverse (CALD) Australian youth : an exploratory study

Context: Culturally and Linguistically Diverse (CALD) youth may become early parents, with some aspiring to parenthood. Yet, the factors that influence CALD youths contraceptive decision-making are less well known, although important for designing appropriate contraception use support programmes for this population. This study aimed to explore the contraception decision-making patterns of CALD Australian youth, in-addition to investigating the factors that influence their use of contraception services. Methods: We conducted focus groups with 27 CALD youth (ages 16-24) to explore their 1) their contraception use 1) decision-making, 2) information sources, and 3) priority services. For the data synthesis, we utilized thematic analysis to characterize the CALD youth contraception use orientation. Results: Three themes emerged from the data: 1) the prevalent use of fail-safe contraception methods to minimize personal anxiety, 2) the reliance on online rather than in-person information sources, and 3) the importance to minimize risk for social stigma from use of contraception. Conclusions: CALD Australian youth reported being competent in self-managing their contraception use decisions. Contraption decision support for CALD youth should address their anxieties about the risk of contraception failure and concerns regarding social stigmas. KEY POINTS What is already known: (1) Australian young females from racial and language minority background communities become parents at younger ages than those from the general Australian population. (2) Some look forward to becoming parents earlier rather than later in their lives. What this topic adds: (1) We unraveled decision making processes and tools the teenagers prefer to use outside conventional understandings. (2) Cultural psychology beliefs rooted in family social protections are an overriding decision influence in contraception choices. (3) Peers were less trusted partners in sexual decisions compared to use of online services

Insight Into Provider Payment Mechanisms In Healthcare Industry: A Case Of Iran

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