hpaa 220 - unc gillings school of global public...

HPM 951 Lara Lorenzetti

Spring 2018 UNC – Chapel Hill

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HPM 951

Literature Reviews and Appraisal (Credit Hours: 2)

Department of Health Policy and Management

School of Public Health

Spring 2018 Syllabus

Faculty: Lara Lorenzetti

Email: [email protected]

Phone:

Office Hours: Mon, Wed, Thurs: 5 – 6:30pm

Course Overview

This 2.0 credit course is the second in a sequence of courses in research design and methods in

the executive DrPH. This course is designed to help students identify a topic and begin to

develop the background section for their dissertation. Well-conducted research can provide

important information for practitioners, policy makers, and service users. However, in order to

be useful, researchers and non-researchers must have the skills to seek out, critically analyze,

and synthesize research findings.

Learning Objectives and HPM Competencies

This course explores the nature and process of scientific inquiry in the field of public health.

Specifically, the course will establish a foundation for methodically identifying, exploring, and

evaluating literature relevant to students’ proposed dissertation topics. The course will also help

prepare students for productively reviewing literature in their future roles as senior leaders.

The primary goal of a systematic literature review is to develop a comprehensive picture of the

current knowledge about a specific topic. This course is taught from the perspective that a systematic

approach is “best” in all situations, including the practice-oriented situations more common to DrPH

students. For this reason, much of the language used is based on this systematic approach. However,

the characteristics of DrPH study questions do not always lend themselves to perfect adherence to a

systematic review model. Combined with the time constraints of a single semester, the ultimate goal

for students is to develop a literature review that examines a well-defined problem using an approach

based on the principles of a systematic review, while understanding how practical implementation of

the methods affects the final product.

mailto:[email protected]



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Course Learning Objective

Competencies

1 Discuss how research and practice can

(and in some cases, cannot) inform one

another

Integrate scientific information, legal and

regulatory approaches, ethical frameworks, and

varied stakeholder interests in policy

development and analysis

2 Identify the purposes of literature

reviews in public health and the various

types of literature syntheses

Integrate knowledge, approaches, methods,

values, and potential contributions from multiple

professions and systems in addressing public

health programs

3 Conduct a literature search of a relevant

dissertation topic/issue using systematic

principles

Integrate knowledge, approaches, methods,

values, and potential contributions from multiple

professions and systems in addressing public

health programs

4 Accurately apply current knowledge to a

specific problem

Integrate scientific information, legal and

regulatory approaches, ethical frameworks, and

varied stakeholder interests in policy

development and analysis

5 Explain the concepts of construct and

external validity

Explain qualitative, quantitative, mixed methods

and policy analysis research and evaluation

methods to address health issues

6 Recognize common threats to construct

and external validity




7 Critically analyze the published literature




8 Synthesize findings of the published

literature

Communicate public health science to diverse

stakeholders for purposes of influencing behavior

and policies

Resources

Website

HPM 951 has its own website via Sakai, see: http://sakai.unc.edu. This syllabus is on the

website. Although I will not make major changes to due dates or course structure, you should

consider this syllabus a dynamic document. We can add or remove readings, add goals for

specific classes, and make clarifications to assignments. You should feel free to offer

suggestions as the class progresses.

Text

I do not have a required text book for this class. However, one very useful resource is the

Research Methods Knowledge Base by William Trochim. It is available for free at:

http://www.socialresearchmethods.net/kb/index.php.

http://www.socialresearchmethods.net/kb/index.php



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Articles

Journal articles will be assigned throughout the semester, listed for each class date. The

purposes of the readings are to either 1) provide information and background on literature

reviews as a whole, or 2) to serve as examples of different types of reviews and those with

varying strengths and weaknesses. The articles that should be given first priority and read most

thoroughly are in bold. Other articles should be read not with a goal of understanding the

specific topic, but to understand the review process within them, while also keeping in mind the

learning objectives for that class. As such, I may note that you should focus on particular

sections of these articles.

All articles are available electronically via the Library/Reserves tab on our class Sakai site. All

articles are not yet on this website, but all can be found by searching for them on the UNC

Library web site.

Requirements and Expectations

Course Conduct and Responsibilities:

This course invokes an adult learning model. As instructor, my role is to help create an

effective learning environment, act as an expert resource, help students find other resources, and

facilitate learning.

Your role as class participants is to learn and help each other learn. You will do this by

preparing for class, participating in class discussion, and completing required assignments. You

are also expected to add value to the course by helping each other and serving as a resource to

your classmates.



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Evaluation Method

Grade Components

Deliverables Cumulative %

Presentation of paper section 1 presentation 10

Paper development assignments 4 assignments @ 10% each 40

Term paper 1 term paper 50

Grading Scale

95 or above (H)

75-94 (P)

60-74 (L)

Below 60 (F)

Overview

The objective of this course is for students to develop their dissertation topics, which will be

aided by a literature review. The primary deliverable for this course is a term paper consisting

of a literature review on an approved topic. Additional papers assigned throughout the semester

are designed to aid in the development of your final term papers.

All written assignments should be submitted no later than 4pm the day class convenes. Late

assignments will be penalized 10% per day. This means paper development assignments will be

penalized 1 point per day. Late submission of the final paper will result in a deduction of 5

points per day. I understand that life happens and am willing to consider accepting late

assignments without penalty for unique circumstances. Work travel does not constitute a unique

circumstance.

Assignment and term paper requirements are detailed below.



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Presentation of Literature Review Section

Once during the semester, you will present the current status of your paper on one of three

sections: background, methods, or results/discussion. The purpose of this is to give an

opportunity to receive feedback from classmates on your topic, as well as generate discussion

that is useful for everyone. You can present this in any way you like, with a few PowerPoint

slides or discussion only. Plan for about 15-20 minutes for the presentation and discussion.

You will be assigned ONE of the three presentation dates.

Although graded, these are considered works in progress. The grade is based more on your

presentation and effort at generating discussion, and less on the quality of the topic itself. These

are graded on a scale of 10/10.

Paper Development Assignments

Four papers are due throughout the semester. These assignments represent each of the major

sections of a literature review (see below). The purpose of these papers is to allow me to give

you feedback at various stages in the process. By the end of the semester, you will have

received feedback on each section of your term paper. (So your term papers should be very,

very good!)

These are graded on a scale of 10/10.

Term Paper

Your term paper will be a literature review on a topic of your choosing. This should be the

same as your dissertation topic. The literature review should help you become more familiar

with the work in the area, define the gaps in current knowledge, and, from that, help you

pinpoint the specific goal of your dissertation. The completed paper should resemble the first

chapter of your dissertation. This is DUE MAY 10th.

Although the final paper will not be a typical systematic literature review, it will still include

the basic components. Below is the grading scheme that will be used in assessing the final

paper. You should refer to this when completing the final paper and the individual sections

in the paper development assignments.



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Term Paper Grading Rubric

I. Background

a. Background supports need for literature review 10 points

b. Clearly stated research question/objective 10 points

20 Points

II. Methods

a. Search methods are well-described and valid 5 points

b. Inclusion and exclusion criteria are comprehensive and reasonable 10 points

c. Process for reviewing articles is well-described and adequate 5 points

20 Points

III. Results

a. Overall search results are described 5 points

b. Findings are grouped into coherent themes or subjects 5 points

c. Studies are clearly and objectively described 10 points

20 Points

IV. Discussion

a. Findings discussed by theme to develop a cohesive description of current

knowledge 5 points

b. Quality of the studies are discussed 5 points

c. Study characteristics and quality are used to describe gaps in the current

literature 5 points

d. Limitations of the review process are discussed 5 points

20 Points

V. General

a. Tables and figures are used appropriately 5 points

b. Clarity of writing 15 points

20 Points

100 Points total

Assignment Submission

You will submit your assignments by posting to SAKAI.



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UNC Honor Code

The principles of academic honesty, integrity, and responsible citizenship govern the

performance of all academic work and student conduct at the University as they have during

the long life of this institution. Your acceptance of enrollment in the University presupposes a

commitment to the principles embodied in the Code of Student Conduct and a respect for this

most significant Carolina tradition. Your reward is in the practice of these principles.

Your participation in this course comes with the expectation that your work will be completed

in full observance of the Honor Code. Academic dishonesty in any form is unacceptable,

because any breach in academic integrity, however small, strikes destructively at the

University's life and work.

If you have any questions about your responsibility or the responsibility of faculty members

under the Honor Code, please consult with someone in either the Office of the Student

Attorney General (966-4084) or the Office of the Dean of Students (966-4042).

Read “The Instrument of Student Judicial Governance” (http://instrument.unc.edu).

You are encouraged to collaborate on class assignments unless instructed otherwise. To

emphasize the importance of integrity and intellectual property in the profession, you are

required on each assignment to list those individuals with whom you collaborated.

Course Evaluation

The statement below describes the official course evaluation process. I find formal evaluations

critical to the ongoing development of my teaching. However, I also want you to feel that you

can provide feedback to me at any point throughout the semester. You can do this in-person, by

email, or you can drop an anonymous note in my mailbox. I want you to feel that you are

getting the education you deserve; so please let me know of concerns while I still have a chance

to remedy them.

The Department of Health Policy and Administration is participating in the Carolina Course

Evaluation System (CES), the university's new online course evaluation tool, enabled at the end

of each semester. Your responses will be anonymous, with feedback provided in the aggregate;

open-ended comments will be shared with instructors, but not identified with individual

students. Your participation in CES is a course requirement, as providing constructive feedback

is a professional expectation. Such feedback is critical to improving the quality of our courses,

as well as providing input to the assessment of your instructors.

http://instrument.unc.edu/



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CLASS SCHEDULE Session 1

January 5th Introduction to Literature Reviews & Appraisal

(LECTURE & DISCUSSION)

Session

Learning

Objectives:

What is research? Why is it important?

What are your experiences with literature reviews?

What databases are available for literature searches?

What reference managers are useful?

Readings: Pubmed: http://guides.lib.unc.edu/pubmedtentips

Systematic Reviews: http://guides.lib.unc.edu/systematic-reviews

Trochim W. (2006) Research Methods Knowledge Base, 2nd Edition.

Language of research and philosophy of research.


Gough, D. A., Oliver, S., & Thomas, J. (2013). Learning from research:

systematic reviews for informing policy decisions: a quick guide. London:

Nesta.

http://www.alliance4usefulevidence.org/assets/Alliance-FUE-reviews-

booklet-3.pdf

Reeves, S, Koppel I, et al. (2002) Twelve tips for undertaking a systematic

review. Medical Teacher; 24(4): 358-363.

Assignments None.

Session 2

January 9th Literature Reviews & Choosing a Topic

(LECTURE & DISCUSSION)

Session

Learning

Objectives:

Literature Reviews

What is a literature review and what purpose(s) does it serve in science,

public health, and research development?

What are the stages of a literature review?

Compare different types of literature reviews

Choosing a Topic

Moving from a broad research topic to a manageable research question.

What makes a research question interesting?

How do you design a good question?

Making a topic specific enough to manage.

Readings:

Albanese, M and Norcini J. (2002) Systematic Reviews: What are they

and why should we care? Advances in Health Sciences Education; 7:

147-151.

Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14

review types and associated methodologies. Health Information &

Libraries Journal, 26(2), 91-108.

http://guides.lib.unc.edu/pubmedtentips

http://guides.lib.unc.edu/systematic-reviews



http://www.alliance4usefulevidence.org/assets/Alliance-FUE-reviews-booklet-3.pdf

http://www.alliance4usefulevidence.org/assets/Alliance-FUE-reviews-booklet-3.pdf



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Cooper, HM. (1998) Synthesizing Research: A guide for Literature Reviews,

third edition: 1-40. Thousand Oaks, CA: Sage Publications.

Cochrane Collaboration. (2005) Chapter 4: Formulating the problem.

Cochrane Handbook for Systematic Reviews of Interventions. May 2005.

Watt, Cameron, Sturm, Lathlean, Babidge, Blamey, et al. Rapid versus full

systematic reviews: validity in clinical practice? ANZ J Surg 2009; 78:

1037.1040.

Skim these: Focus on what questions are being asked and whether the

questions are too narrow or too broad.

Anderson RM. (1995) Revisiting the behavioral model and access to medical

care: Does it matter? Journal of Health and Social Behavior; 36(1): 1-10.

Berkman LF. (2009). Social Epidemiology: Social Determinants of Health in

the United States: Are We Losing Ground? Annual Review of Public

Health; 30:27-41.

Bhutta ZA, Ali S, Cousens S, et al. Alma-Ata: Rebirth and revision 6 -

Interventions to address maternal, newborn, and child survival: what

difference can integrated primary health care strategies make? Lancet. Sep

13 2008;372(9642):972-989.

Jackson NW, Howes FS, Gupta S, Doyle JL, Waters E. (2005) Policy

interventions implemented through sporting organizations for promoting

healthy behaviour change. Cochrane Database of Systematic Reviews;

Issue 2 Article No: CD004809.pub2. DOI:

10.1002/14651858.CD004809.pub2.

Mavedzenge SMN, Doyle AM, Ross DA. HIV Prevention in Young People in

Sub-Saharan Africa: A Systematic Review. Journal of Adolescent Health.

Dec 2011;49(6):568-586.

Assignments: None.

Session 3

January 16th How research findings can inform practice & Research Methods, Part I

(LECTURE)

Session

Learning

Objectives:

Research Informing Practice

What are the implications of research findings on policy and practice?

How have these things been done in the published literature?

How can you use a conceptual model to consider research in the context

of practice?

Research Methods

Introduction to basic research methods.

What is makes research valid? Reliable?



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What are the different types of validity?

How are these important to literature reviews?

Readings:

Focus on the background and methods sections, paying particular

attention to the specificity of the question and the definitions of the key

ideas.

Anderson P, Chisholm D, Fuhr D. (2009) Effectiveness and cost-effectiveness

of policies and programmes to reduce the harm caused by alcohol. The

Lancet; 373:2234.

Chaudhry B, Wang J, Wu S, et al. Systematic review: impact of health

information technology on quality, efficiency, and costs of medical care.

Annals of internal medicine. May 16 2006;144(10):742-752.

Schuster MA, McGlynn EA, Brook RH. (1998) How good is quality of

health care in the United States? Milbank Quarterly; 76(4): 517-563.

Thompson Coon J, Boddy K, Stein K, Whear R, Barton J, Depledge MH.

Does participating in physical activity in outdoor natural environments

have a greater effect on physical and mental wellbeing than physical

activity indoors? A systematic review. Environ Sci Technol. Mar 1

2011;45(5):1761-1772.

Methods:

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzche P, Ioannidis J, et al.

(2009). The PRISMA Statement for Reporting Systematic Reviews

and Meta-Analyses of Studies That Evaluate Health Care

Interventions: Explanation and Elaboration. Annals of Internal

Medicine; 151: W-65

Assignments:

Ungraded assignment: Submit preliminary research question(s) to Lara for

review

Session 4

January 23st Searching for Literature

(LECTURE)

Session

Learning

Objectives:

Learning Session with Mary White, Global Public Health Librarian at the

Health Sciences Library

How do you identify, retrieve, and review the existing literature on a

research question?

What databases are available for literature searches?

How do you use keywords?

How do you develop inclusion/exclusion criteria?

Readings: Pubmed: http://guides.lib.unc.edu/pubmedtentips

Systematic Reviews: http://guides.lib.unc.edu/systematic-reviews

http://guides.lib.unc.edu/pubmedtentips

http://guides.lib.unc.edu/systematic-reviews



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Greenhalgh T, Peacock R. (2005) Effectiveness and efficiency of search

methods in systematic reviews of complex evidence: Audit of primary

sources. British Medical Journal; 331: 1064-1065.

Assignments:

1st Paper Development Assignment: State your review question and show

what variables (or concepts) will be compared and the nature of the

relationship. Include a conceptual model as a diagram or table. This should

be essentially a draft of the background section of your final paper.

Identify the problem

Relationship between the problem and the cause(s)

Conceptually define variables

Rationale for relationship

Importance

Session 5

January 30th Wading through the Literature

(LECTURE)

Session

Learning

Objectives:

Learning Session with Mary White, Global Public Health Librarian at the

Health Sciences Library

Refining your methods section and preparing to manage results.

What strategies can you use to abstract, review, and manage your articles?

How do you plan to organize the literature together into major findings?

Readings: Greenhalgh T, Peacock R. (2005). Effectiveness and efficiency of search

methods in systematic reviews of complex evidence: Audit of primary

sources. British Medical Journal; 331: 1064-1065.

Assignments: None.

Session 6

February 13th Research Methods, Part II

(LECTURE)

Session

Learning

Objectives:

Consider research design and conclusion validity; use these to grade the

quality of your literature.

How do you make sense of the often confusing, contradictory, and

fragmentary literature on a research question?

How do you judge the quality of the evidence?

Readings:

Cochrane Collaboration. (2005) Chapter 6: Assessment of study quality.

Cochrane Handbook for Systematic Reviews of Interventions. May

2005.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzche P, Ioannidis J, et al.

(2009). The PRISMA Statement for Reporting Systematic Reviews

and Meta-Analyses of Studies That Evaluate Health Care

Interventions: Explanation and Elaboration. Annals of Internal

Medicine; 151: W-65.

Steinberg EP, Luce BR. (2005) Evidence based? Caveat emptor! Health

Affairs; 24(1): 80-92.



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Assignments:

2nd Paper Development Assignment: Basic strategy for how you will begin

searching for literature. This should essentially be a draft of the methods

section of your final paper.

Sources you will use

Key words, search strategies

Inclusion/exclusion criteria

Session 7

February 27th Presentation of Background and Methods Sections

(DISCUSSION)

Session

Learning

Objectives:

Presentation of Background and Methods Sections

Readings: None

Assignments:

Presentations of background and methods sections: For the students assigned

to this date, prepare a short presentation of your background and methods

sections.

For background, include:

Research question and rationale

Definitions of major concepts

Relevance of the question to informing practice.

Conceptual model, if applicable

For methods, include:

Sources

Search strategy

Inclusion / exclusion criteria

You should be prepared for discussion addressing:

Adequacy and appropriateness of the question—is the relationship

well-defined and specific?

Potential for useful findings—have the concepts been defined in a way

that can lead to sensible conclusions?

How the findings can inform practice—is the topic important?

Appropriateness of chosen source(s) and possible alternate sources.

Validity of search strategy.

Validity of inclusion criteria.

PRESENTERS: TBD

Session 8

March 20th Using Literature Reviews

(DISCUSSION)

Session

Learning

Objectives:

Using the literature review to inform your dissertation proposal.

Does your review of the literature expose any gaps in current knowledge

on your topic?



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Readings: Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C. Rapid Response Teams:

A Systematic Review and Meta-analysis. Arch Intern Med. Jan 11

2010;170(1):18-26.

Dusetzina SB, Higashi AS, Dorsey ER, Conti R, Huskamp HA, Zhu S,

Garfield CF, Alexander GC. (2012). Impact of FDA Drug Risk

Communications on Health Care Utilization and Health Behaviors: A

Systematic Review. Med Care. 2012 Jan 18. [Epub ahead of print].

PMID:22266704

Orizio G, Merla A, Schulz PJ, Gelatti U.(2011). Quality of online pharmacies

and websites selling prescription drugs: a systematic review. J Med

Internet Res. 2011 Sep 30;13(3):e74.

Wang CJ, Ellender SM, Textor T, Bauchner JH, Wu JY, Bauchner H, Huang

AT. (2011). A proposed framework for understanding the forces behind

legislation of universal health insurance: lessons from ten countries.

Health Serv Res. Dec; 46(6pt2):2101-18.

Wong WC, Luk CW, Kidd MR. Is there a role for primary care clinicians in

providing shared care in HIV treatment? A systematic literature review.

Sex Transm Infect. Mar 2012;88(2):125-131.

Assignments:

3rd Paper Development Assignment. Description of major findings. This

should essentially be a draft of the results section of your final paper.

Session 9

April 3rd Interpreting Findings from Literature Reviews

(DISCUSSION)

Session

Learning

Objectives:

Use the Doak article to examine how differences in methods can lead to

different conclusions.

Readings: Doak, Heitman, Summerbell, and Lissner. (2009). Prevention of

childhood obesity—what type of evidence should we consider

relevant? Obesity Reviews 10: 350-356.

Davis P, Howden-Chapman P. (1996) Translating research findings into

health policy. Social Science and Medicine; 43(5): 865-872.

Brownson R, Fielding J, and Maylahn C. (2009). Evidence-Based Public

Health: A Fundamental Concept for Public Health Practice.

Assignments: None.

Session 10

April 10th Literature Reviews – Results and Interpretation

(PRESENTATIONS)

Session

Learning

Objectives:

Student presentations of results and discussion sections.

Readings: None



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Assignments:

Presentations of results and discussion sections: For the students assigned to

this date, prepare a short presentation of your results and discussion sections.

Summarize your research question and results, but focus on your main

findings, potential limitations, and threats to validity throughout the research

process.

Be prepared for discussion related to:

Whether you were able to answer your original research question.

Possible limitations to your search strategy and limitations of the

articles you’ve included.

How threats to validity affect your ability to draw conclusions that are

relevant to practice.

PRESENTERS: TBD

Session 11

April 17th Peer Review Session

(WORKING SESSION)

Session

Learning

Objectives:

During class, students will review and provide feedback on a partner’s

paper, paying particular attention to interpretation of findings.

Readings: None

Assignments:

4th Paper Development Assignment: Summarize the current state of

knowledge, what’s lacking, and how you will use this to inform your

dissertation. This should essentially be a draft of the discussion section of

your final paper.



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COURSE TOPICS MAPPING

Session Session Topic

CAHME

Content Areas

1 Introduction to Literature Reviews &

Appraisal

III.B.11 Written, verbal, and

interpersonal communication skills

III.B.12 Statistical analysis and

application

2 Literature Reviews & Choosing a Topic III.B.2 Health policy formulation,

implementation, and evaluation

3 How research findings can inform practice &

Research Methods, Part I

III.B.12 Statistical analysis and

application

4 Searching for Literature III.B.11 Written, verbal, and

interpersonal communication

5 Wading through the Literature III.B.11 Written, verbal, and


6 Research Methods, Part 2 III.B.12 Statistical analysis and

application

7 Presentation of Background and Methods

Sections



8 Using Literature Reviews III.B.17 Strategy formulation and

implementation

III.B.2 Health policy formulation,


9 Interpreting Findings from Literature

Reviews

III.B.17 Strategy formulation and

implementation

III.B.2 Health policy formulation,


10 Literature Reviews – Results and

Interpretation



11 Peer Review Session III.B.11 Written, verbal, and




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Mapping of review components, skills needed, class sessions, and assignments.

Review Component

Skills Needed Class sessions Assignments

Overall Understand a literature review and types What is a literature review?

Topic Narrowing to a manageable size Choosing a topic

Statement of topic (not graded)

Presentation of Background Section

What is an interesting question? How do reviews inform practice?

Background

Identify a problem Choosing a topic

Background section (draw a conceptual model)

Conceptually define/consider variables and relationships

How do reviews inform practice? Understand how topic is important and will inform practice

Methods

Basic research methods

Research methods, I

Methods section Presentation of Methods

Section

Operationally define variables

Inclusion criteria

Plan search strategy Searching for literature

Plan review strategy

Results

Review findings Wading through the literature

Results section

Organize findings

Research methods, II

Assess validity and quality of findings

Discussion

Assess overall validity of literature

Discussion section Presentation of Discussion

Section

Determine gaps relevant to research question

Identify ways to improve/fill gaps Using literature reviews

Identify weaknesses in search strategy

Complete Review

Final Paper



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Dates, Assignments, and Topics

1/5

/20

18

1/9

/20

18

1/16

/20

18

1/2

3/2

018

1/3

0/2

018

2/6

/20

18

2/1

3/2

018

2/2

0/2

018

2/2

7/2

018

3/6

/20

18

3/1

3/2

018

3/2

0/2

018

3/2

7/2

018

4/3

/20

18

4/1

0/2

018

4/1

7/2

018

4/2

4/2

018

5/1

/20

18

5/1

0/2

018

Class 1 2 3 4 5 6 7 8 9 10 11

Ass

ign

men

ts

Student Presentations

Background

Methods

Results

Discussion

Final Paper

Pa

per

Se

ctio

ns Topic

Background

Methods

Results

Discussion

hpaa 220 - unc gillings school of global public...

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