As the movement toward evidence-based health policy continues to emphasize the importance of including patient and public perspectives, syntheses of qualitative health research are becoming more common. In response to the focus on independent assessments of rigor in these knowledge products, over 100 appraisal tools for assessing the quality of qualitative research have been developed. The variety of appraisal tools exhibit diverse methods and purposes, reflecting the lack of consensus as to what constitutes appropriate quality criteria for qualitative research. It is a daunting task for those without deep familiarity of the field to choose the best appraisal tool for their purpose. This article provides a description of the structure, content, and objectives of existing appraisal tools for those wanting to evaluate primary qualitative research for a qualitative evidence synthesis. We then discuss common features of appraisal tools and examine their implications for evidence synthesis.

Summary: Examine the factors that promote vaccine hesitancy or acceptance during pandemics, major epidemics and global outbreaks. A systematic review and thematic analysis of 28 studies on the Influenza A/H1N1 pandemic and the global spread of Ebola Virus Disease. We found seven major factors that promote vaccine hesitancy or acceptance: demographic factors influencing vaccination (ethnicity, age, sex, pregnancy, education, and employment), accessibility and cost, personal responsibility and risk perceptions, precautionary measures taken based on the decision to vaccinate, trust in health authorities and vaccines, the safety and efficacy of a new vaccine, and lack of information or vaccine misinformation. An understanding of participant experiences and perspectives toward vaccines from previous pandemics will greatly inform the development of strategies to address the present situation with the COVID-19 pandemic. We discuss the impact vaccine hesitancy might have for the introduction and effectiveness of a potential COVID-19 vaccine. In particular, we believe that skepticism toward vaccines can still exist when there are no vaccines available, which is contrary to contemporary conceptualizations of vaccine hesitancy. We recommend conducting further research assessing the relationship between the accessibility and cost of vaccines, and vaccine hesitancy.

This is the second article of a three-part series that continues the discussion on the fundamentals of writing research protocols for quantitative, clinical research studies. In this editorial, the author discusses some considerations for including information in a research protocol on the study design and approach of a research study. This series provides a guide for undergraduate researchers interested in publishing their protocol in the Undergraduate Research in Natural and Clinical Sciences and Technology (URNCST) Journal.

The severe acute respiratory syndrome–coronavirus-2 pandemic has spread rapidly and has a growing impact on individuals, communities, and healthcare systems worldwide. At the core of any pandemic response is the ability of authorities and other stakeholders to react appropriately by promoting hygiene and social distancing behaviors. Successfully reaching this goal requires both individual and collective efforts to drastically modify daily routines and activities. There is a need to clarify how knowledge and awareness of disease influence risk perception, and subsequent behavior in the context of pandemics and global outbreaks. We conducted a scoping review of 149 studies spanning different regions and populations to examine the relationships between knowledge, risk perceptions, and behavior change. We analyzed studies on five major pandemics or outbreaks in the twenty-first century: severe acute respiratory syndrome, influenza A/H1N1, Middle East respiratory syndrome, Ebola virus disease, and coronavirus disease 2019.

Non-invasive prenatal testing (NIPT) can be used to accurately detect fetal chromosomal anomalies early in pregnancy by assessing cell-free fetal DNA present in maternal blood. The rapid diffusion of NIPT, as well as the ease and simplicity of the test raises concerns around informed decision-making and the potential for routinization. Introducing NIPT in a way that facilitates informed and autonomous decisions is imperative to the ethical application of this technology. We approach this imperative by systematically reviewing and synthesizing primary qualitative research on women’s experiences with and preferences for informed decision-making around NIPT. We searched multiple bibliographic databases including Ovid MEDLINE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and ISI Web of Science Social Sciences Citation Index (SSCI). Our review was guided by integrative qualitative meta-synthesis, and we used a staged coding process similar to that of grounded theory to conduct our analysis. Thirty empirical primary qualitative research studies were eligible for inclusion. Women preferred to learn about NIPT from their clinicians, but they expressed dissatisfaction with the quality and quantity of information provided during counselling and often sought information from a variety of other sources. Women generally had a good understanding of test characteristics, and the factors of accuracy, physical risk, and test timing were the critical information elements that they used to make informed decisions around NIPT. Women often described NIPT as easy or just another blood test, highlighting threats to informed decision-making such as routinization or a pressure to test. Women’s unique circumstances modulate the information that they value and require most in the context of making an informed decision. Widened availability of trustworthy information about NIPT as well as careful attention to the facilitation of counselling may help facilitate informed decision-making. PROSPERO 2018 CRD42018086261 .

Vaccines are some of the most cost-effective public health interventions for reducing disease burden and mortality. However, in recent years, health systems have faced a growing challenge with increasing number of parents who choose not to vaccinate their children. This decision has important implications for the health of communities worldwide, and despite a considerable amount of research that reinforces vaccine effectiveness and safety, there is uncertainty surrounding the factors that may encourage vaccine hesitancy in parents. In this interpretive review of 34 qualitative studies, we examine the factors that bolster vaccine hesitancy, rejection, and delay, and identify the overlaps and relationships between these factors. We depict our findings using the metaphor of a gear train where each gear represents one of seven factors: previous experiences; “natural” and “organic” living; perceptions of other parents; experiences interacting with health care providers; information sources, challenges, and preferences; distrust in health system players; and mandatory vaccine policies.