Integrating qualitative research with trials in systematic reviews

The review framework

The review question was: “What is known about the barriers to, and facilitators of, healthy eating among children aged 4-10 years?” The specific focus of the review was fruit and vegetable intake. We searched for two types of research: controlled trials (randomised or non-randomised) that examined interventions to promote healthy eating and studies that examined children's perspectives and understandings (views studies), often by using qualitative research methods—for example, in-depth interviews and focus groups.

But will she eat her greens?

Credit: PAUL DARRAH/REX

We used conventional systematic review methods: sensitive searching, systematic screening, and independent quality assessment. These methods found 33 trials and eight qualitative studies that met our prespecified inclusion criteria.

We assessed studies for quality and reliability according to standards for their specific study types; they were then synthesised individually by using methods appropriate to the study. We conducted a meta-analysis with the data extracted from trials, used qualitative methods to synthesise the textual data extracted from the qualitative studies, and then integrated the findings from the qualitative synthesis with those from the meta-analysis. This gave us one review with three syntheses (fig 1).

Quality assessment

We maintained the key principles of avoiding bias and maximising …