Using the theoretical domains framework and the behavioural change wheel in an overarching synthesis of systematic reviews

OBJECTIVE: Synthesis that can filter the evidence from multiple sources to inform the choice of intervention components is highly desirable yet, at present, there are few examples of systematic reviews that explicitly define this type of synthesis using behaviour change frameworks. Here, we demonstrate how using the Theoretical Domains Framework (TDF) and the Behaviour Change Wheel (BCW) made it possible to bring together the findings from a series of three interconnected systematic reviews on the self-care of minor ailments (MAs) to inform the choice of intervention components. METHOD: The TDF and the capability, opportunity, motivation model of behaviour at the hub of the BCW were used to synthesise the findings from the three reviews, including syntheses of service-user views in interviews (review 1, 20 studies) and surveys (review 2, 13 studies), and evaluations of a range of interventions and services (review 3, 21 studies). RESULTS: The TDF and BCW approach provided a systematic, structured and replicable methodology for retrospectively integrating different types of evidence within a series of systematic reviews. Several intervention strategies, grounded in theory and discussed with key stakeholders, were suggested, which can be implemented and tested. CONCLUSIONS: This novel application of the TDF/BCW approach illustrates how it can be used to bring together quantitative and qualitative evidence to better understand self-care behaviour for MAs within a systematic review context. The TDF/BCW approach facilitated exploration of the contradictions and gaps between the separate review syntheses, and supported the identification of possible intervention strategies, grounded in theory. The ongoing development and refinement of this method is supported. PROSPERO REGISTRATION NUMBER: CRD42017071515

Reviews on Long COVID: a scope of the literature. : Update October 2022

Summary • For this update, we identified 29 published reviews; two completed reviews that are yet to be published; and 63 new protocols for ongoing reviews on Long COVID. • Most published reviews were focused on the frequency or risk of persistent symptoms/effects, which has been a consistent finding in all our reports. • We identified more published and ongoing reviews with a focus on treatment/rehabilitation compared to our last update

Treatment and rehabilitation of Long COVID:A scope of the literature. Update July 2024

We identified 19 randomised controlled trials published between March and June 2024 that were focused on Long COVID treatment or rehabilitation. Across our nine reports produced to date, we have identified and assessed 140 trials published between January 2022 and June 2024. • Eight of the 19 trials focused on treating generalised or multiple symptoms of Long COVID. Four trials focused specifically on respiratory or cardiovascular function or physical fitness. Four other trials focused solely on treating persistent problems with the sense of smell or taste (olfactory/gustatory dysfunction) and three trials evaluated treatments for fatigue. • Two trials were rated positively for 10 out of the 13 quality criteria that we assessed. The other 17 trials gained a positive rating for between four and nine criteria

Treatment and rehabilitation of Long COVID: a scope of the literature. : Update October 2022

Summary • We identified 11 randomised controlled trials published since June 2022 that were focused on Long COVID treatment or rehabilitation. Across two reports, we have now identified and assessed 25 trials published in 2022. • A majority of trials focused on evaluating treatments for people with persistent problems with their sense of smell (olfactory dysfunction). • Trial quality varied and inadequate reporting of methods often prevented a full assessment of the risk of bias. However, six trials were rated positively for at least 11 out of the 13 criteria that we assessed

Reviews on Long COVID: A scope of the literature:Update July 2024

• For this update, we identified 33 published reviews and 43 review protocols for Long COVID. • The number of reviews (n=33) is fewer than in April 2024 (n=36), January 2024 (n=42), and October 2023 (n=46), but more than in July 2023 (n=31). • The largest category of reviews focused on treatment or rehabilitation (13/33), whereas the prevalence of symptoms or effects (n=7, for this update) was the largest category within all previous reports. • We identified four reviews on risk factors with or without prevalence, three on pathobiology or mechanisms, and two on prevention; the other four were on treatment with: prevalence (n=2), prevention (n=1), or risk factors (n=1). • We identified fewer protocols (n=43) than in the previous update (April 2024, n=63) and July 2023 (n=53), but a similar number to January 2024 (n=42) and October 2023 (n=44). • As in previous reports, the largest two categories of protocols focused on the prevalence of symptoms or effects (16/43), and treatment or rehabilitation (11/43). • Six protocols were focused on risk factors with or without prevalence, and four were on prevention; these numbers are similar to those in previous reports. Three protocols were on experiences of Long COVID with or without prevalence, and three protocols were on pathobiology; pathobiology and treatment; and prevalence and treatment

Reviews on Long COVID: A scope of the literature.:Update April 2024

• For this update, we identified 36 published reviews and 63 review protocols for Long COVID. • The number of reviews (n=36) is fewer than in January 2024 (n=42), and October 2023 (n=46) but more than in July 2023 (n=31), and similar to April 2023 (n=37). • Most reviews were focused on the prevalence of symptoms or effects (21/36), which remains consistent with earlier reports. • We identified five reviews on treatment or rehabilitation, and five on risk factors with or without prevalence; both numbers are lower than last quarter (treatment n=7 and risk n=9). • We identified two reviews on pathobiology or mechanisms; the same number as in the January 2024 report. • The number of protocols (n=63) was greater than in January 2024 (n=42), October (n=44) and July (n=53), but less than in April 2023 (n=73). • As in previous reports, the largest two categories of protocols focused on the prevalence of symptoms or effects (24/63), and treatment or rehabilitation (21/63). • Eight protocols were focused on risk factors with or without prevalence, and four were on pathobiology or mechanisms; these numbers are similar to those in previous reports

Reviews on Long COVID: A scope of the literature:Update January 2024

• For this update, we identified 42 published reviews and 42 review protocols for Long COVID. The number of published reviews Is less than in October (n=46) but more than in July (n=31) and April (n=37), 2023. • Most published reviews were focused on the prevalence of symptoms or effects (18/42), which remains consistent with the earlier reports. • This update includes more published reviews with a primary focus on Long COVID risk factors (n=9) than in each of the previous reports. We identified fewer on treatment or rehabilitation (n=7) than in the October 2023 report (n=11), but more than in the four previous reports (n=5). • We identified fewer reviews on pathobiology or mechanisms (n=2), than for the October 2023 report (n=6), but a similar number to previous reports (e.g., July 2023, n=1). • Similar numbers of protocols were focused on the prevalence of symptoms or effects (15/42), and treatment or rehabilitation (13/42). These have consistently been the largest two categories across all the previous reports. • Seven protocols were focused on risk factors with or without prevalence; the same number as in the October 2023 report

Treatment and rehabilitation of Long COVID:A scope of the literature. Update January 2024

Summary • We identified 21 randomised controlled trials published between September and December 2023 that were focused on Long COVID treatment or rehabilitation. Across our seven reports produced to date, we have identified and assessed 106 trials published between January 2022 and December 2023. • Eight of the 21 trials focused on treating generalised or multiple symptoms of Long COVID/Post COVID condition. Four trials had a primary focus on persistent problems with the sense of smell or taste (olfactory/gustatory dysfunction) and three others evaluated treatments specifically for fatigue. Two trials had a focus on respiratory or cardiovascular function and physical fitness; one of which also focused on post COVID anxiety and depression. Other trials focused on individuals with post COVID depressive symptoms (n=1); post COVID gastro-oesophageal reflux disease (n=1); and persistent memory impairment (n=1). One trial focused on improving the resilience and quality of life of individuals with Long COVID. • Two trials were rated positively for 12 out of the 13 quality criteria that we assessed. Three trials met 11 criteria and three others met ten criteria. The remaining 13 trials gained a positive rating for between three and nine criteria

Treatment and rehabilitation of Long COVID:A scope of the literature. Update April 2024

We identified 15 randomised controlled trials published between December 2023 and March 2024 that were focused on Long COVID treatment or rehabilitation. Across our eight reports produced to date, we have identified and assessed 121 trials published between January 2022 and March 2024. • Seven of the 15 trials focused on treating generalised or multiple symptoms of Long COVID/Post COVID condition. Three trials evaluated treatments for fatigue, one of which also focused on individuals with other neuropsychiatric sequalae. Two trials had a focus on respiratory or cardiovascular function or physical fitness. Two other trials focused on persistent problems with the sense of smell or taste (olfactory/gustatory dysfunction). One trial focused on people with decreased functioning and participation in daily life following COVID-19. • Two trials were rated positively for 12 out of the 13 quality criteria that we assessed. Two trials met ten criteria and 11 gained a positive rating for between six and nine criteria

Reviews on Long COVID: A scope of the literature. : Update July 2022

This report is the second quarterly update of the rapid scope of published and ongoing systematic reviews related to Long COVID that was originally conducted for the Department of Health and Social Care in England in November 2021.1 The first update covered the period November 2021 to the end of March 2022.2 For the current update, we identified systematic reviews and review protocols focused on Long COVID that were published between the start of April and the end of June 2022. Long COVID was conceptualised broadly as any symptoms or effects that persist or develop after acute COVID-19 infection