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Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation
BACKGROUND: Over the past decade, the World Health Organization (WHO) has implemented a standardized, evidence-informed guideline development process to assure technically sound and policy-relevant guidelines. This study is an independent evaluation of the adaptability of the guidelines produced by...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361729/ https://www.ncbi.nlm.nih.gov/pubmed/28327198 http://dx.doi.org/10.1186/s13012-017-0571-2 |
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author | Dedios, Maria Cecilia Esperato, Alexo De-Regil, Luz Maria Peña-Rosas, Juan Pablo Norris, Susan L. |
author_facet | Dedios, Maria Cecilia Esperato, Alexo De-Regil, Luz Maria Peña-Rosas, Juan Pablo Norris, Susan L. |
author_sort | Dedios, Maria Cecilia |
collection | PubMed |
description | BACKGROUND: Over the past decade, the World Health Organization (WHO) has implemented a standardized, evidence-informed guideline development process to assure technically sound and policy-relevant guidelines. This study is an independent evaluation of the adaptability of the guidelines produced by the Evidence and Programme Guidance unit, at the Department of Nutrition for Health and Development (NHD). The study systematizes the lessons learned by the NHD group at WHO. METHODS: We used a mixed methods approach to determine the adaptability of the nutrition guidelines. Adaptability was defined as having two components; methodological quality and implementability of guidelines. Additionally, we gathered recommendations to improve future guideline development in nutrition actions for health and development. Data sources for this evaluation were official documentation and feedback (both qualitative and quantitative) from key stakeholders involved in the development of nutrition guidelines. The qualitative data was collected through a desk review and two waves of semi-structured interviews (n = 12) and was analyzed through axial coding. Guideline adaptability was assessed quantitatively using two standardized instruments completed by key stakeholders. The Appraisal Guideline for Research and Evaluation questionnaire, version II was used to assess guideline quality (n = 6), while implementability was assessed with the electronic version of the GuideLine Implementability Appraisal (n = 7). RESULTS: The nutrition evidence-informed guideline development process has several strengths, among them are the appropriate management of conflicts of interest of guideline developers and the systematic use of high-quality evidence to inform the recommendations. These features contribute to increase the methodological quality of the guidelines. The key areas for improvement are the limited implementability of the recommendations, the lack of explicit and precise implementation advice in the guidelines and challenges related to collaborative work within interdisciplinary groups. CONCLUSIONS: Overall, our study found that the nutrition evidence-informed guidelines are of good methodological quality but that the implementability requires improvement. The recommendations to improve guideline adaptability address the guideline content, the dynamics shaping interdisciplinary work, and actions for implementation feasibility. As WHO relies heavily on a standardized procedure to develop guidelines, the lessons learned may be applicable to guideline development across the organization and to other groups developing guidelines. |
format | Online Article Text |
id | pubmed-5361729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53617292017-03-24 Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation Dedios, Maria Cecilia Esperato, Alexo De-Regil, Luz Maria Peña-Rosas, Juan Pablo Norris, Susan L. Implement Sci Research BACKGROUND: Over the past decade, the World Health Organization (WHO) has implemented a standardized, evidence-informed guideline development process to assure technically sound and policy-relevant guidelines. This study is an independent evaluation of the adaptability of the guidelines produced by the Evidence and Programme Guidance unit, at the Department of Nutrition for Health and Development (NHD). The study systematizes the lessons learned by the NHD group at WHO. METHODS: We used a mixed methods approach to determine the adaptability of the nutrition guidelines. Adaptability was defined as having two components; methodological quality and implementability of guidelines. Additionally, we gathered recommendations to improve future guideline development in nutrition actions for health and development. Data sources for this evaluation were official documentation and feedback (both qualitative and quantitative) from key stakeholders involved in the development of nutrition guidelines. The qualitative data was collected through a desk review and two waves of semi-structured interviews (n = 12) and was analyzed through axial coding. Guideline adaptability was assessed quantitatively using two standardized instruments completed by key stakeholders. The Appraisal Guideline for Research and Evaluation questionnaire, version II was used to assess guideline quality (n = 6), while implementability was assessed with the electronic version of the GuideLine Implementability Appraisal (n = 7). RESULTS: The nutrition evidence-informed guideline development process has several strengths, among them are the appropriate management of conflicts of interest of guideline developers and the systematic use of high-quality evidence to inform the recommendations. These features contribute to increase the methodological quality of the guidelines. The key areas for improvement are the limited implementability of the recommendations, the lack of explicit and precise implementation advice in the guidelines and challenges related to collaborative work within interdisciplinary groups. CONCLUSIONS: Overall, our study found that the nutrition evidence-informed guidelines are of good methodological quality but that the implementability requires improvement. The recommendations to improve guideline adaptability address the guideline content, the dynamics shaping interdisciplinary work, and actions for implementation feasibility. As WHO relies heavily on a standardized procedure to develop guidelines, the lessons learned may be applicable to guideline development across the organization and to other groups developing guidelines. BioMed Central 2017-03-21 /pmc/articles/PMC5361729/ /pubmed/28327198 http://dx.doi.org/10.1186/s13012-017-0571-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Dedios, Maria Cecilia Esperato, Alexo De-Regil, Luz Maria Peña-Rosas, Juan Pablo Norris, Susan L. Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title | Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title_full | Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title_fullStr | Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title_full_unstemmed | Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title_short | Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
title_sort | improving the adaptability of who evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361729/ https://www.ncbi.nlm.nih.gov/pubmed/28327198 http://dx.doi.org/10.1186/s13012-017-0571-2 |
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