Protocol and Registration
This rapid evidence assessment is informed by publications on best practice for such work from the World Health Organisation (WHO) and UK Department for Environment, Food & Rural Affairs (DEFRA). This protocol has been submitted to the International Prospective Register for Systematic Reviews - PROSPERO and is pending formal registration. At present, there is no universally recognised reporting process for rapid reviews and consequently this protocol has adapted the PRISMA-P and associated checklist (Additional File 2) as a framework to report on the findings of the review that typically underpin systematic reviews.
Inclusion & Exclusion Criteria
The research team are interested in identifying, synthesising and considering evidence of the impact of initiatives, interventions or programmes that have the potential to support inclusive web accessibility. The research team is primarily interested in the impact of initiatives, interventions or programmes in four key areas: accessing emergency resources; life skill development; self-development through education; and health services and related support.
The research team will consider studies that are qualitative, quantitative or mixed methods. Studies that do not include imperial data will be considered for inclusion in this review as extant programmes that are not be imperial in nature may offer useful insights into best practice or experience particular to individual cognitive impairments or combinations of cognitive impairments that individuals experience. The project team will consider with such studies for inclusion on a case-by-case basis. Following on from this the following inclusion and exclusion criteria have been structured using the PICO (Population, Intervention, Comparison and Outcome) model. These criteria are set out here:
The review will focus on citizens ages 9 and up who live with cognitive impairment. The lower age limit of 9 years was set to capture the year prior to the transition from primary school to secondary school across the multiple jurisdictions represented in this research partnership. No upper age limit was set, because the need for web accessibility when living with cognitive impairment does not diminish or stop at any particular age. In the instance where studies include participants that are determined to be outside of the study age range, if the mean age range of the study is 9 years of age or greater, the study will be included subject to agreement by the project team members. Studies that are returned that do not focus exclusively on citizens with cognitive impairments and where the datasets presented by the study are not presented separately, such studies will be excluded from this review.
For the purpose of this review, interventions will only be considered if they adhere to the target population parameters set out in the previous section. Studies that report on interventions implemented within the lifeworld experiences of citizens who experience cognitive impairment such as those set out by WC3. Studies that incorporate combinations of the above will also be included.
While it is unlikely that studies with concurrent control or comparison groups will emerge in the review process, if they do present then they will be included. If sub-group analysis is possible this will be explored in relation to the specific impact of initiatives, interventions and programmes on citizens who experience cognitive impairment.
The impact of initiatives, interventions and programmes on citizens who experience cognitive impairment. will be included as will studies that report on the impact of initiatives, interventions and programmes on the holistic wellbeing of the target population.
At the outset of this study the research team carried out a search for existing systematic reviews and meta-analysis in this area. This initial search revealed that no reviews or meta-analysis focusing on initiatives, interventions or programmes that support web accessibility for people with cognitive impairment exists. This systematic, rapid evidence assessment, review will employ a search strategy using defined terms within agreed search strings (Additional File 1). Databases deemed most likely by the research team to return a high number of relevant results will be searched. It is acknowledged by the research team that additional searches may be warranted. Initially, the following databases will be searched: Web of Science, SCOPUS, EBSCOhost, ERIC and ProQuest.
Internet searching through Google Scholar will be carried out as well as forward and backward tracking of citations from studies that are included in the review. Hand searches of journals will be carried out if warranted. Where necessary additional follow up contact with authors, experts and research groups will further inform this review. The review will only include peer reviewed studies published in English, however, if a study published in an alternate language is deemed relevant it will be included. The results of the search will be downloaded and saved to Mendeley and duplicates will be removed. The titles and abstracts of all remaining studies will be screened by two independent reviewers informed by the study inclusion and exclusion criteria. Where a decision to include or exclude cannot be agreed an additional reviewer will adjudicate. All results, screening process results will be documented in tabular form and communicated in a PRISMA flow diagram.
In addition, the research team considered it necessary to carry out a grey literature search due to the nature of the work being investigated. The expertise within the research team indicated that many programmes that support people with cognitive impairments do not formally report their work through academic dissemination pathways. Consequently it is intended that a grey literature search will be carried out to supplement that findings of study. In contrast to the focus on studies published in English for peer review returns, the grey literature search will actively seek out returns across all languages of the European Union.
Data Extraction and Quality Appraisal
After the final research returns have been collated two independent reviewers will read all titles and abstracts after duplicates have been removed. The titles and abstracts will be screened in accordance with inclusion and exclusion criteria. Where it is not possible to determine relevance from the title and abstract alone, at this stage the full paper will be accessed to determine whether it should be included. Where there is disagreement between reviewers a third independent reviewer will review the paper and attempts will be made to resolve the disagreement through discussion. If at this point there is still disagreement the paper will be retained for future reference.
The next step in this process will be full paper screening. Where a paper is deemed not to meet the review inclusion criteria it will be rejected following the dual appraisal method as described above. Papers that meet the inclusion criteria will have the following data extracted and highlighted in table format with brief descriptions where appropriate:
- Year of publication will be listed. This will be a time limited study of 10 years.
- Aims of the study
- Sampling strategy and characteristics (also process of recruitment, drop out)
- Description of the interventions
- Key findings/outcomes
- Overall quality rating of the study using the CASP Appraisal Tool Checklist (2018).
Data Analysis and Synthesis
It is anticipated by the research team that a wide range of study designs and outcomes will be returned as part of this review. The data extracted from this review will be presented in a thematic narrative format. It is hoped that this will include graphics and/or evidence tables. Where the review team determines that the best course of action is to use statistical summaries this approach will be implemented however, it is the view of the review team, informed by domain expertise, that this is unlikely.
Assessing the Risk of Bias
Initially, each study will be reviewed by two independent reviewers for quality using the CASP Appraisal Tool Checklist (2018). The intention of the review is not to exclude studies on the basis of bias rather it is to note the quality of the studies being reviewed. To examine for selective reporting of results, papers will be examined for indicators of multiple use of samples included in the papers. For example, this may include indicators that data has been drawn from larger projects, a published thesis or other papers. Papers that are determined to fall under this category will be checked against alternate sources, where available, to outcomes relevant to this review are being presented. Finally, GRADE-CERQual guidelines will also be followed in the assessment of outcome quality for methodological limitations, coherence, adequacy of data and relevance.
Amendments to the Protocol
Where there are unavoidable significant deviations from this protocol, such amendments will be recorded and reported within the result of the review.