Facilitating optimized decision-making using a knowledge user driven synthesis approach in a scoping review of social frailty interventions
2North York General Hospital, Canada
3North York General Hospital and University of Toronto, Canada
Background: Knowledge syntheses are foundational to knowledge translation, but their results are not always represented or intentionally synthesized for optimized knowledge uptake or to support healthcare decision-making. As such, we conducted a scoping review to identify social frailty interventions that have the best potential to help older adults during difficult situations requiring further isolation (e.g., COVID-19, flu), and to determine how the results of this scoping review could best be synthesized and organized to support rapid and optimized decision-making of healthcare professionals.
Objectives: To use a knowledge user decision-making driven approach to synthesizing and representing results of a scoping review of social frailty interventions.
Methods: MEDLINE, CINAHL, EMBASE, COVID-19 databases and grey literature were comprehensively searched for social frailty terms and its related concepts (e.g., social isolation, social vulnerability, loneliness). Experienced reviewer pairs screened titles and abstracts and full text articles in duplicate. Data abstraction involved an auditing process whereby one reviewer abstracted data and a second reviewer checked for accuracy and consistency. Data was analyzed thematically guided by a social frailty conceptual model. Data synthesis involved organizing the data by social frailty intervention type, considering only those that had the best potential for impact. We created and presented a knowledge product (synthesis table) to our knowledge users in a modified Delphi procedure to help them decide which intervention could be considered to help socially frail older adults during difficult situations.
Results: 112 articles containing 170 interventions were included representing three main intervention categories: (1) social behaviours and activities (n=47), (2) social resources (n=64), (3) self-management (n=59). Data synthesis identified self-management interventions as having the most promise for reducing social frailty related outcomes in older adults, which informed the knowledge product for our knowledge users (clinicians, researchers, patients).
Conclusions: The resulting knowledge product facilitated swift decision-making, which is a technique that may be ideal for use in rapid reviews where making quick decisions is the priority.
Patient, public and/or healthcare consumer involvement: An integrated knowledge translation team involving researchers, clinicians and patients helped define the scoping review objectives, eligibility criteria, methods, and interpretation of findings.