PLAIN LANGUAGE SUMMARY

Most COVID-19 studies looked at the influence of sex, age and our perception of COVID-19 on social distancing, handwashing and face covering

Over the course of the COVID-19 pandemic there have been huge volumes of research looking at how different factors influence COVID-19 health protective behaviours: social distancing, face covering and handwashing. The majority of this research is focused on factors that cannot be altered through intervention, such as demographics (age and sex).

The interactive evidence and gap map (EGM) is available here.

What is this evidence and gap map (EGM) about?

In the early stages of the COVID-19 pandemic, health protective behaviours such as distancing and handwashing were the first line of defence to help limit the spread of COVID-19. Understanding why people do or do not engage in recommended behaviours is important to developing successful public health messaging, and to increase the number of people engaging in these behaviours.

This EGM summarises studies that measured one or more factors that might influence health protective behaviours, including handwashing, use of face coverings, social or physical distancing, and isolation or quarantine.

What is the aim of this EGM?

The aim of this EGM is to map the current research on different factors and health protective behaviours, such as social distancing, handwashing and face covering.

What studies are included?

The current map includes 1,034 pieces of evidence. This consists of 25 reviews (including 17 systematic reviews) and 1,009 primary studies. Of these, 860 were cross-sectional studies, 68 were longitudinal, and 78 were qualitative studies.

What are the main findings of this EGM?

There was lots of evidence on some behaviours (social distancing, handwashing, face covering) and very little on others (not touching your face, cleaning surfaces).

Social distancing had the most evidence (487 studies), followed by use of face coverings (382 studies) and handwashing (308 studies). Fewer studies looked at behaviours such as avoiding the T-zone (not touching your face), cleaning surfaces and respiratory hygiene practices (coughing into your elbow or tissue).

A large number of studies (333 studies) combined two or more protective behaviours within the one study. This makes it difficult to use these studies to look at how different factors may influence individual behaviours.

Across the studies there are significant differences in how different behaviours are defined. Some studies described social distancing as minimising contacts outside of the home, whereas others used the term to mean physical distancing from others (for example, keeping at least two metres apart).

In relation to the different factors influencing these behaviours, demographics was the most reported (730 studies), followed by cognitive factors (how people might perceive or think about COVID-19; 496 studies).

Fewer studies looked at the influence of factors such as interventions (for example, providing access to hand sanitiser), information on COVID-19 (for example, the different sources of information people received) and the impact of engaging in other protective behaviours (for example, if someone covered their face, would they be more or less likely to also social distance).

What do the findings of the map mean?

This EGM shows the available evidence on the different factors that may influence health protective behaviours such as distancing, face coverings and handwashing.

This EGM can be used to help guide future areas of research and public health policy during the current COVID-19 pandemic and any future outbreaks of respiratory viruses with pandemic potential.

Current evidence is largely focused on social distancing and the use of face coverings; and primarily on the influence of factors such as age or sex (demographics) on these behaviours. There are major gaps in the evidence base on other important health protective behaviours and the influence of factors other than age or sex.

How up-to-date is this EGM?

The authors searched for studies up to October 2021.

PLAIN LANGUAGE SUMMARY

Case management interventions improve housing stability for people experiencing homelessness and the effects may be increased with intensive support

Homelessness is an important problem and case management support may provide part of the solution. This review includes some guidance for current practice and policy and recommendations for future research, including an expansion of the research base outside North America.

What is this review about?

Many millions of people experience homelessness, potentially leading to poorer health and wellbeing outcomes, and a lower life expectancy. We present evidence on a wide range of interventions that include a case manager to help the individual client to find stable housing.

What is the aim of this review?

This Campbell systematic review examines studies of case management programmes for people experiencing homelessness to help identify the components most likely to increase the chances of improvements in housing, health and wider outcomes.

What studies are included?

We looked, specifically, for any findings to help identify the individual components of case management such as the period over which support is provided, the number of clients per case manager, and whether there are conditions attached to this support from the client’s point of view.

We explored the effects of these interventions on homelessness and other outcomes such as mental health, substance use, physical heath, wellbeing and employment.

What are the main findings of this review?

Case management effectiveness overall:

Any type of case management clearly improves homelessness outcomes for people with additional support needs, and this may be more effective for people who also have greater levels of additional need for support. Case management also increases wellbeing for the population in the included studies, at least in the short term.

Across the full body of evidence, it does not appear that the included interventions improve mental health, and there is no evidence of improvement in employment, physical health or substance use.

Time spent in stable housing may be increased when case management is more intensive. The multi-component Housing First approach may be more effective than other types of intensive case management.

Case management components:

In terms of housing outcomes, support for up to three years leads to improvements in stable housing. These benefits may be reduced over the longer term but still persist, suggesting that very long-term support should be provided.

In-person meetings with the case manager appear to be beneficial when compared with remote or mixed (remote/in-person) meetings but many studies did not describe meeting location(s).

Although there was not enough evidence from the intervention studies, there is consistent evidence from the implementation studies that any barriers attached to case management support (i.e. conditions that must be met to receive that support) should be minimised.

Supporting case managers:

A number of themes arise from the implementation studies that are relevant to the components of a case management programme. These include the importance of a close working relationship across agencies; provision for the non-housing support and training needs of clients experiencing homelessness; community support and development for the newly-housed; providing for the emotional support and training needs of case managers; and giving clients choice in relation to the type of housing provided.

Cost effectiveness:

The available studies vary in their findings. It is likely that case management is more costly than usual care but may be cost-effective if society is ‘willing to pay’ a certain amount to support people experiencing homelessness into stable housing.

What do the findings of this review mean?

Case management helps people experiencing homelessness who have additional support needs to obtain stable accommodation, and is even more helpful for those with higher levels of support needs.

High intensity multicomponent approaches such as Housing First may lead to greater benefits. There is also some evidence for improvements to capabilities and wellbeing but, notably, they do not appear to impact mental health outcomes any more than usual care.

There is some evidence that case management support should be long term, that meetings in person with clients are beneficial, and any conditions associated with provision of the service should be minimised.

How up-to-date is this review?

The review authors searched for studies that were reported up to March 2021.

PLAIN LANGUAGE SUMMARY

Diets, exercise and digital approaches may improve frailty, social isolation or loneliness in older adults

Exercise alone and in combination with diet may prevent frailty and improve social functioning in community-dwelling older adults. Similarly, digital tools like connecting with others through the internet may be effective in reducing loneliness. However, there is no clear evidence that such programmes are effective in groups including the LGBTQ2+ community and ethnic minorities.

What is this review of reviews about?

Social isolation, loneliness and frailty are a serious public health risks that that affect many older adults, specifically people living in their own homes. Several interventions have been proposed to reduce these vulnerabilities. However, the effectiveness of these interventions is inconsistent in the general population, and unknown in specific populations.

What is the aim of this review?

This review of reviews summarises evidence on the effectiveness of interventions aimed at improving social isolation, loneliness and frailty among older adults. It also identifies gaps in evidence where further systematic review evidence is needed.

What studies are included?

We included 27 reviews that were comprised of 372 unique primary studies. The vast majority of the reviews included studies that were conducted in high-income countries. Most reviews talked about either social isolation or loneliness.

Half of the reviews included studies with simple interventions, while the other half were more complicated, with many components.

Many of the studies had important weaknesses.

What are the main findings of this review?

Systematic reviews suggest that exercise combined with nutritional supplementation have the highest odds of decreasing frailty, compared to nutritional supplementation of proteins alone at 3-4 months of follow-up.

Similarly, grip strength significantly improves when participants exercise and take protein supplements. Physical activity interventions also improve social functioning and reduce social isolation and loneliness.

There is a lot of conflicting evidence and inadequate reporting of results to determine effectiveness.

We were unable to find studies that looked at minority groups.

What do the findings of this review mean?

Even though there is evidence in support of some interventions, only a small number of reviews systematically compared effects of interventions on social isolation and loneliness.

More studies are needed addressing other vulnerable groups or older adults living with vulnerabilities. This would allow for more definitive recommendations regarding the effectiveness of interventions for reducing frailty, social isolation and loneliness.

How up-to-date is this review?

The search was conducted up to December 2022.

PLAIN LANGUAGE SUMMARY

There is scattered evidence on the effectiveness of social and behaviour change communication interventions for HIV prevention among adolescent girls and young women

Interest in socio-behavioural interventions to support demand and uptake of HIV services is on the rise. Therefore, the evidence of their effectiveness needs to be systematically mapped to enable informed decision-making by sponsors, researchers, policymakers and public health experts.

This evidence and gap map (EGM) presents a consolidated evidence base of existing social and behaviour change communication interventions, and the end-user behaviours they target, in low- and middle-income countries. It looks at a range of strategies including mass media, community-based interventions, interpersonal interventions, and ICT and digital media-based interventions, and identifies gaps in programming.

The interactive evidence and gap map (EGM) is available here.

What is this EGM about?

Adolescent girls and young women around the world face challenges to achieving their sexual and reproductive health rights, including vulnerability to HIV and sexually-transmitted diseases. Evidence-informed interventions for HIV prevention, care and uptake of services targeting girls and women are critical in addressing these challenges.

What is the aim of this evidence and gap map (EGM)?

This EGM identifies, maps and presents all available evidence from systematic reviews and impact evaluations of interventions to strengthen the adoption of HIV prevention measures and participation in research among adolescent girls and young women in low- and middle-income countries.

What studies are included?

The EGM includes 458 studies – 43 systematic reviews and 415 impact evaluations – published in English since 2000.

The evidence is unevenly distributed across intervention and outcome categories. The most common interventions are on interpersonal communication, followed by community-based interventions. Most of these interventions were delivered by healthcare providers and educators.

In terms of geography, most of the identified research concentrates on Sub-Saharan Africa.

What are the main findings of this EGM?

The included studies mainly focus on enhancing knowledge-related capabilities to create behavioural and health impacts. There is a need for more studies to focus on interventions that help achieve envisioned behavioural and health outcomes.

Few studies explore the effectiveness of these interventions across diverse groups – such as pregnant women and new mothers, sex workers and people living with HIV. This scarcity of research leads to a limited understanding of the use of these interventions across critical sub-populations and multiple user segments.

Given the value of communication channels in shaping behaviour change discourse, this EGM looks at evidence across different communication strategies and platforms. However, we found little evidence on the use of digital media tools such as social media and mobile-based services.

There are also relatively few studies on the use of popular culture tools – including mass-media, theatre and other arts-based approaches.

What do the findings of this EGM mean?

The EGM underscores the need for better quality evidence to understand what interventions work, for whom, and towards what outcome.

How up-to-date is this EGM?

The authors searched for studies published up to April 2021.