Users' experience of frameworks to support evidence-informed decision-making in public health : a scoping review

Background: Evidence-informed decision-making in public health (PH) is a complex process requiring the consideration of multiple perspectives and contextual factors. Evidence-to-decision (EtD) frameworks are structured approaches aiming to improve decision-making by considering critical criteria, but users' experience has not been systematically synthesised. Aim: We aim to summarise users' experiences of EtD frameworks used for PH. Methods: As part of a broader scoping review, we identified 15 EtD frameworks for PH decision-making. We searched MEDLINE and Health Systems Evidence, conducted a hand search and citation search strategy for documents reporting users' experience of EtD frameworks and surveyed key stakeholders. We conducted a descriptive thematic synthesis, identifying main barriers and facilitators, complementing with surveys to relevant stakeholders. Results: We identified 12 studies reporting users' experience of two EtD frameworks: Grading of Recommendations Assessment, Development and Evaluation (n = 9) and World Health Organization INTEGRATe Evidence (n = 3). Both were perceived as structured approaches that enhanced the use of evidence while including contextual factors and facilitating consensus-building processes. Main barriers were lack of high-quality evidence for the effectiveness of PH interventions, limitations of the terminology or unclear boundaries between specific criteria, perceptions of missing criteria and the need for more guidance. Survey responses (n = 13) were consistent with these findings. Conclusion: Users of the two frameworks had an overall positive perception of the approaches, but several barriers remain. These experiences may change over time as the frameworks evolve. There is an evidence gap regarding users' experience for other EtD frameworks.