Literature Search Task & Analysis of a sample of qualitative data. Illustrate your essay with specific examples.

Even a cursory glance at the wider literature shows that Public Health and Health Promotion is a vast field with many specialisms. Indeed, the field is so large that a search requires a strong focus within a specific subject or sub-field.
In this case the decision was made to focus on smoking cessation. Smoking cessation and health has received large amounts of attention over the last few decades and thus there is likely to be an extensive literature on the topic.
This piece of work will provide an overview of smoking cessation programmes in relation to public health and health promotion using the principles of systematic review and showing how this can be applied to the topic. Note that it is not a full systematic review. (A full systematic review requires a high level of resource; e.g. see Jackson (no date).)
A set of basic principles of a systematic review were followed using the guidelines provided by (Jackson and Waters, 2005). These principles, and the way they were followed, are given below.
As the review began it was realized that the databases used contained mainly, if not completely, systematic reviews. That is, this review became a review of systematic reviews. Not only that, it became clear that there are databases of reviews of systematic reviews. This means that it is now possible to do a review of systematic reviews of systematic reviews.
Scope of the review
The review was limited to smoking cessation programmes over the last five years. The study was limited to quantitative studies.
Question
The question was ‘How effective have smoking cessation programmes been?’
Population
The population encompassed all smokers.
Outcomes
The outcome was smoking cessation
Designs
At first the intention was to consider only Randomized Control Trials (RCTs). This was changed and it was decided that the search would be limited to RCTs only if a sufficient number of RCTs were found. If not other studies would be included. However, the study was limited to quantitative studies.
Key words
Initially the key words considered were:
smoking + cessation
smoking + progam(me)
smoking + intervention
The word ‘prevention’ was deliberately excluded as the search was concerned with smoking cessation not smoking prevention. An initial search of the Cochrane database revealed that the database could be searched by topic and the smoking related topic appeared to be tobacco addiction. This called the above word set into question. However, given the whole Cochrane database can be browsed by topic and that the topic had been identified there was not any reason to modify the word set at this stage. similarly the EPPI database could be searched by topic (see below)
Databases
Three databases were identified from the Cochrane Collaboration website. They were
the Cochrane Health Promotion andPublic Health Field website:
The reason for selecting this database is that it is concerned with reviews or studies relevant to health promotion and public health.
The Evidence for Practice Information and Co-ordinating Centre (EPPI‐Centre):
The reason for selecting these databases is that it is concerned with reviews or studies relevant to health promotion and public health in relation to education. It was reasoned that health promotion would play an important role here.
Effective Public Health Practice Project:
While this is a Canadian database it is concerned specifically with public health practice and studies are to a high standard. An initial scan of this database showed a number of reviews of smoking cessation. However, upon returning to the database, the website had been modified and the links no longer worked making this database unavailable.
The Cochrane database was revisited and the CPC database selected in its place The systematic reviews by the Guide to Community Preventive Services (Community Guide) of the effectiveness of interventions to reduce or prevent tobacco use focused on three areas:

1. Preventing tobacco product use initiation
2. Increasing cessation
3. Reducing exposure to environmental tobacco smoke

As such, it is a very focussed set of reviews on reducing or preventing tobacco usage. It does deviate from the initial criteria to some extent in that it also covers prevention (and not just cessation).
These databases were selected over academic journal databases because: a) they are in the public domain; and b) they contain large scale studies on public health that may not be presented as journal articles. If they are presented as journal articles they will probably have less detail and more focus on one particular aspect of the study.
Inclusion and exclusion criteria
Ideally The Quality Assessment Tool for Quantitative Studies would have been used but the number and detail of the criteria is extensive. In addition, the intention was to select studies based on their abstracts. Using the above tool would probably require a more extensive analysis of the full report/article/paper.
An interesting question is how this tool could be applied to assessing actual reviews rather than primary studies.
Listed Studies
The Cochrane database listed 46 studies on smoking cessation. All of these appear to be systematic reviews. Not all the abstracts are available. The abstracts clearly state the criteria for selection (that is, did the study consider RCTs only or other studies as well). Thus it is possible to select only reviews that considered RCTs.
The Evidence for Practice Information and Co-ordinating Centre (EPPI‐Centre) database also contained systematic reviews. They were clearly focussed on education. Despite the reasoning that this database might contain studies on smoking cessation none were apparent. This was surprising given historic and more recent attention paid to young people smoking and the potential importance of ‘teaching’ people, and especially young people, not to smoke. It may be that if the studies are considered in more depth some may contain smoking cessation studies. (For example, Peersman G, Harden A, Oliver S, Oakley A (1999) Effectiveness reviews in health promotion. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, and Kavanagh J, Trouton A, Oakley A, Powell C (2006) A systematic review of the evidence for incentive schemes to encourage positive health and other social behaviours in young people. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, may contain studies on smoking cessation.)
The community practice database listed two reviews on ‘Reducing Tobacco Use Initiation’, seven reviews on ‘Restricting minors’ access to tobacco products, (which reiterates the point made about the EPPI database), 10 studies on ‘Increasing Tobacco Use Cessation’ and one study on ‘ Reducing Environmental Tobacco Smoke’. Not all the details for all studies (all systematic reviews) were available from the database. For those that were available it was not always clear if they considered only RCTs or also considered other forms of trial. Presumably, the full reports and/or published papers will reflect this.
Critical reflection
One of the first reflections is on the use of key words. In a future study greater care would be taken to refine the key words and to either focus or expand the words. It would be useful to have input from an information scientist in relation to this. Further methods might include the use of a thesaurus (library based) and scanning abstracts to discover key words used in a wide variety of studies (see above in relation to this). It would also be helpful to know how to use word endings in searching databases. For example using $ and # with smok$/#. Further consideration also needs to be given to the words ‘Tobacco’ and ‘addiction’.
Also, how to combine words for different logic searches. For example, the use of ‘and’ and ‘or’ depending on the database. It would also be helpful to become familiar with the databases and to know if a ‘hand search’ was worthwhile. It is assumed that all of this would be fairly well known by an information scientist and that some training would make one familiar with this sort of thing. Training could include following the training package on the Cochrane website as this training could then be extended to cover more ‘relaxed’ or ‘expert’ forms of search.
Initially it wasn’t realized that only abstracts were available in the public domain for the Cochrane library. This does lead to the consideration of whether or not other, more public, sources should have been accessed. However, this, in turn, raises questions of quality. It is certainly a vexing consideration.
It would be useful to consider whether or not to select/reject studies based on abstracts alone. Does an abstract provide sufficient information to select/reject? Certainly it seems difficult to make full use of the tool noted if only the abstracts are considered. Presumably this would have to be balanced against resources.
There are concerns about which studies to consider with regard to rigour and standards. There is a strong argument for only considering RCT studies. But what if there is a good study with meaningful and insightful findings that has not made use of RCTs? These needs to be considered carefully before the review begins and the decision made at a very early stage. This consideration is reflected in the use of the community practice database.
It was clear from this study that web-based studies sources quickly become unavailable resulting in key studies being ‘lost’. Out of interest, a Google Scholar search was conducted on ‘smoking cessation + RCT’ and ‘tobacco addiction + RCT’. They resulted in ‘about 1,550’ and ‘abut 334’ hits respectively.