School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
BMJ Open. 2023 Sep 29;13(9):e074336. doi: 10.1136/bmjopen-2023-074336.
The burden of non-communicable diseases (NCDs) is increasing rapidly, particularly in low- and middle-income countries (LMIC), accounting for 85% of premature deaths in the region. LMICs have been facing an increasing trend of a double burden of disease (infectious diseases and NCDs) that has led to multiple challenges in prioritising strategies for NCDs control amidst limited resources. Evidence indicates that measures such as the WHO's package of essential non-communicable (PEN) diseases interventions can prevent and control NCDs. However, because of the complexity of such health interventions, there is limited evidence that explains how the intervention works, for whom and in what context. We aim to unpack the causal mechanisms explaining how, why, for whom and in what context PEN prevents and controls NCDs.
We propose a realist review to understand how, why, for whom and under what circumstances PEN works or does not work. The review process includes five steps applied iteratively throughout the study: clarification of review scope, searching for evidence, appraising and extracting data, synthesising evidence and drawing conclusions, and disseminating the findings. Programme theories will be developed using the realist logic for theory formulation-Retroductive Theorising. The context-mechanism-outcome (CMO) heuristic tool will be used to develop the programme theories. Portions of the reviewed documents describing constructs of context, mechanism and outcomes will be coded inductively and extracted. These extracted constructs will then be linked abductively to formulate CMO configurations.
Formal ethical approval is not required for this review. Study findings will be disseminated through publications in peer-reviewed journals, conference presentations and formal and informal reports.
非传染性疾病（NCDs）的负担正在迅速增加，特别是在低收入和中等收入国家（LMIC），占该地区过早死亡人数的 85%。LMIC 一直面临着疾病双重负担（传染病和 NCDs）的增加趋势，这导致在资源有限的情况下，优先考虑 NCD 控制策略面临多重挑战。有证据表明，世卫组织基本非传染性疾病（PEN）疾病干预一揽子计划等措施可以预防和控制 NCDs。然而，由于这些卫生干预措施的复杂性，有限的证据解释了干预措施如何发挥作用、为谁以及在什么情况下发挥作用。我们旨在剖析解释 PEN 如何、为何、为谁以及在什么情况下预防和控制 NCD 的因果机制。
我们提出了一项真实审查，以了解 PEN 如何、为何、为谁以及在什么情况下有效或无效。审查过程包括五个步骤，在整个研究中迭代应用：澄清审查范围、搜索证据、评估和提取数据、综合证据和得出结论以及传播研究结果。将使用理论构建的真实主义逻辑-回溯理论化来制定方案理论。上下文-机制-结果（CMO）启发式工具将用于制定方案理论。将对审查文件中描述上下文、机制和结果构建的部分进行归纳编码和提取。然后，这些提取的构建将通过推断联系起来，以形成 CMO 配置。
本审查不需要正式的伦理批准。研究结果将通过在同行评议期刊上发表、会议报告以及正式和非正式报告进行传播。
