When making decisions about complex interventions, guideline development groups need to factor in the sociocultural acceptability of an intervention, as well as contextual factors that impact on the feasibility of that intervention. Qualitative evidence synthesis offers one method of exploring these issues. This paper considers the extent to which current methods of question formulation are meeting this challenge. It builds on a rapid review of 38 different frameworks for formulating questions. To be useful, a question framework should recognise context (as setting, environment or context); acknowledge the criticality of different stakeholder perspectives (differentiated from the target population); accommodate elements of time/timing and place; be sensitive to qualitative data (eg, eliciting themes or findings). None of the identified frameworks satisfied all four of these criteria. An innovative question framework, PerSPEcTiF, is proposed and retrospectively applied to a published WHO guideline for a complex intervention. Further testing and evaluation of the PerSPEcTiF framework is required.
- systematic review
- qualitative study
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Handling editor Soumyadeep Bhaumik
Contributors AB, JN, KF and GM conceptualised the paper. ÖT and ES interpreted the paper in the context of guideline and decision-making processes. AB conducted the rapid review and devised the original PerSPEcTiF framework. JN, KF, GM and ÖT helped to revise the framework. AB wrote all drafts of the paper. All authors revised the drafts critically and approved the final version for publication.
Funding Funding provided by the World Health Organization Department of Maternal, Newborn, Child and Adolescent Health through grants received from the United States Agency for International Development and the Norwegian Agency for Development Cooperation.
Disclaimer ÖT is a staff member of WHO. The author alone is responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of WHO.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data supporting this article is available in the text, supporting tables within the text or the online supporting tables.
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