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[RESUMO]. Objetivo. Apresentar a experiência de um serviço de resposta rápida para apoiar a tomada de decisão em saúde. Método. São descritos os processos e resultados de um serviço de produção de revisões rápidas e mapas de evidências para apoiar a tomada de decisão no âmbito da Política Nacional de Promoção da Saúde, bem como a percepção dos autores sobre o processo de trabalho. Resultados. O serviço de resposta rápida teve início em 2020. Até dezembro de 2023, foram produzidas 54 revisões rápidas e cinco mapas de evidências, abrangendo nove temáticas de Promoção da Saúde. Estes produtos foram desenvolvidos em quatorze etapas por uma equipe composta por coordenador, supervisoras, revisores e bibliotecária. O desenvolvimento das respostas rápidas se configurou um processo de tradução do conhecimento e envolveu a interação contínua entre as equipes demandantes e de produção. O estabelecimento de comunicação efetiva foi um fator crítico para que os produtos fossem entregues em tempo oportuno e alinhados às necessidades dos tomadores de decisão e seus apoiadores. Conclusão. Os serviços de resposta rápida podem contribuir para melhorar o uso de evidências na tomada de decisão nas políticas e sistemas de saúde.

[ABSTRACT]. Objective. Present the experience of a rapid response service to support decision-making in health systems. Methodology. Description of the processes and results of a service that produces rapid reviews and evidence maps to support decision-making under the National Health Promotion Policy, as well as the authors' perception of the work process. Results. The rapid response service started in 2020. By December 2023, 54 rapid reviews and five evidence maps had been produced, covering nine health promotion topics. These products were developed in 14 stages by a team made up of a coordinator, supervisors, proofreaders, and a librarian. The development of rapid responses involved a knowledge translation process, with continuous interactions between the requesting teams and production teams. Establishing effective communication was a critical factor in delivering products on time and in line with the needs of decision-makers and their supporters. Conclusion. Rapid response services can help improve the use of evidence for decision-making in health policies and health systems.

[RESUMEN]. Objetivo. Presentación de la experiencia de un servicio de respuesta rápida para brindar apoyo a la toma de decisiones en materia de salud. Método. Se describen los procesos y resultados de un servicio de elaboración de revisiones rápidas y mapas de evidencia para brindar apoyo a la toma de decisiones en el marco de la Política Nacional de Promoción de la Salud, así como la percepción de los autores sobre el proceso de trabajo. Resultados. El servicio de respuesta rápida se inició en el 2020. Hasta diciembre del 2023, se habían elaborado 54 revisiones rápidas y cinco mapas de evidencia, que abarcaban nueve temas de promoción de la salud. Estos productos fueron elaborados en 14 etapas por un equipo formado por un coordinador, varios supervisores y revisores y un bibliotecario. La elaboración de respuestas rápidas fue un proceso de traducción del conocimiento e implicó una interacción continua entre los equipos solicitantes y el equipo de elaboración. El establecimiento de una comunicación eficaz fue un factor decisivo para entregar los productos a tiempo y en consonancia con las necesidades de los responsables de la toma de decisiones y su personal de apoyo. Conclusión. Los servicios de respuesta rápida pueden ayudar a mejorar el uso de evidencia en la toma de decisiones relacionadas con las políticas y los sistemas de salud.

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BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.

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Objective: To identify strategies to increase adherence to systemic arterial hypertension (SAH) treatment and describe the barriers and facilitators for implementing these strategies in primary health care (PHC). Method: A rapid evidence review was performed. We included systematic reviews with or without meta-analyses, published in English, Spanish or Portuguese, covering adults (age 18 to ≤ 60 years) with SAH followed in the PHC. Searches were performed in nine databases in December 2020 and updated in April 2022. The systematic reviews were assessed for methodological quality using the AMSTAR 2 tool. Results: Fourteen systematic reviews on treatment adherence strategies and three on barriers and facilitators for implementation were included. Regarding methodological quality, one systematic review was classified as moderate, four as low, and the others as critically low. Four strategies were identified as options for health policies: actions performed by pharmacists; actions performed by non-pharmaceutical health professionals; self-monitoring, use of mobile apps, and text messages; and subsidies for the purchase of medicines. Low digital literacy, limited access to the internet, work process and incipient training were barriers for professionals. The users' educational and health literacy levels, accessibility to health services and good relationships with professionals were facilitators. Conclusions: Positive effects of strategies related to pharmaceutical care, self-monitoring, and the use of cell phone applications and text messages were identified to increase adherence to the treatment of SAH in the context of PHC. However, for implementation purposes, it is necessary to consider barriers and facilitators, in addition to the methodological limitations of the analyzed systematic reviews.

Objetivo: Buscar estrategias para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica y describir las barreras y los elementos facilitadores para la implementación de esas estrategias en el ámbito de la atención primaria de salud. Métodos: Se realizó una revisión rápida de la evidencia. Se incluyeron revisiones sistemáticas, con o sin metaanálisis, publicadas en español, inglés o portugués, en las cuales se evaluaban a personas adultas (de 18 a ≤ 60 años) con hipertensión arterial sistémica observadas en el ámbito de la atención primaria de salud. Las búsquedas se realizaron en nueve bases de datos en diciembre del 2020 y se actualizaron en abril del 2022. Se evaluó la calidad metodológica de las revisiones sistemáticas incluidas con la herramienta AMSTAR 2. Resultados: Se incluyeron 14 revisiones sistemáticas sobre estrategias de adhesión al tratamiento y tres sobre obstáculos y elementos facilitadores para la implementación. La calidad metodológica fue moderada en una revisión sistemática, baja en cuatro y críticamente baja en las demás. Se identificaron cuatro estrategias como opciones para las políticas de salud: medidas tomadas por farmacéuticos; medidas tomadas por profesionales no farmacéuticos; autocontrol, uso de aplicaciones para teléfonos celulares y mensajes de texto; y oferta de subvenciones para la compra de medicamentos. La escasa alfabetización digital, el acceso limitado a internet y los procesos de trabajo y formación incipiente fueron obstáculos para los profesionales. Los elementos facilitadores fueron el nivel de educación y de conocimientos de los usuarios en materia de salud, la accesibilidad a los servicios de salud y las buenas relaciones con los profesionales. Conclusiones: Se observaron efectos positivos de las estrategias relacionadas con la atención farmacéutica, el autocontrol y el uso de aplicaciones de telefonía celular y mensajería de texto para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica en el ámbito de la atención primaria de salud. Sin embargo, para fines de implementación, es necesario considerar los obstáculos y los elementos facilitadores, además de las limitaciones metodológicas de las revisiones sistemáticas analizadas.

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Objective: To synthesize the evidence about the effects of telehealth interventions provided through smart-phone apps and text messages on the behavior of adults regarding healthy food consumption. Method: A rapid systematic review of the literature was performed through searches in nine electronic databases to identify systematic reviews published in English, Portuguese, and Spanish that evaluated telehealth strategies compared to face-to-face interventions to improve dietary intake in the adult population (18 to 59 years old). Searches were performed in November 2020 and updated in April 2022. The included systematic reviews were assessed for methodological quality using the AMSTAR 2 tool. Results: Five systematic reviews were included. Methodological quality was moderate in one review and critically low in four. There was a dearth of studies comparing the use of telehealth strategies with face-to-face interventions for the promotion of healthy eating in adults. The most consistent results refer to an increase in the consumption of fruits and vegetables with the use of an app or text messages, in addition to improvement in the dietary habits of people with diabetes or glucose intolerance with the use of text messages. Conclusion: Positive effects were observed on healthy eating outcomes for most interventions using mobile apps or text messages; however, the findings refer to a few clinical trials with small samples that were analyzed in the systematic reviews covered in the present rapid review, most of which had low methodological quality. Thus, the current knowledge gap warrants the performance of further methodologically robust studies.

Objetivo: Sintetizar la evidencia sobre los efectos de las intervenciones de telesalud ofrecidas por medio de aplicaciones de telefonía móvil y mensajes de texto en el comportamiento de la población adulta relacionado con una alimentación saludable. Métodos: Se realizó un examen rápido mediante búsquedas en nueve bases bibliográficas electrónicas para localizar revisiones sistemáticas publicadas en español, inglés y portugués en las que se evaluaran estrategias de telesalud en comparación con atención presencial para mejorar la alimentación de la población adulta (de 18 a 59 años). Las búsquedas se realizaron en noviembre del 2020 y se actualizaron en abril del 2022. La calidad metodológica de las revisiones sistemáticas incluidas se evaluó con la herramienta AMSTAR 2. Resultados: Se incluyeron cinco revisiones sistemáticas, una con un grado de confianza moderado y las otras con un grado de confianza sumamente bajo. Se comprobó una falta de estudios en los que se compararan el uso de estrategias de telesalud con la atención presencial para promover la alimentación saludable de la población adulta. Los resultados más coherentes se refieren al aumento del consumo de frutas y verduras con el uso de aplicaciones móviles o de mensajes de texto, así como a la mejora del patrón alimentario de las personas con diabetes o con intolerancia a la glucosa con el uso de mensajes de texto. Conclusión: La mayoría de los análisis de las intervenciones en las que se emplearon aplicaciones de telefonía móvil o mensajes de texto mostraron efectos positivos en los resultados relativos a una alimentación saludable. Sin embargo, estos hallazgos se refieren a unos pocos ensayos clínicos con pequeñas muestras de participantes incluidos en las revisiones sistemáticas del presente examen rápido, en su mayoría de baja calidad metodológica. En conclusión, existe una laguna en los conocimientos y es importante realizar estudios con una metodología más sólida.

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BACKGROUND: Theory of Change (ToC) has become an established approach to design and evaluate interventions. While ToC should-in line with the growing international focus on evidence-informed health decision-making-consider explicit approaches to incorporate evidence, there is limited guidance on how this should be done. This rapid review aims to identify and synthesize the available literature on how to systematically use research evidence when developing or adapting ToCs in the health sector. METHODS: A rapid review methodology using a systematic approach, was designed. Eight electronic databases were consulted to search for peer-reviewed and gray publications detailing tools, methods, and recommendations promoting the systematic integration of research evidence in ToCs. The included studies were compared, and the findings summarized qualitatively into themes to identify key principles, stages, and procedures, guiding the systematic integration of research evidence when developing or revising a ToC. RESULTS: This review included 18 studies. The main sources from which evidence was retrieved in the ToC development process were institutional data, literature searches, and stakeholder consultation. There was a variety of ways of finding and using evidence in ToC. Firstly, the review provided an overview of existing definitions of ToC, methods applied in ToC development and the related ToC stages. Secondly, a typology of 7 stages relevant for evidence integration into ToCs was developed, outlining the types of evidence and research methods the included studies applied for each of the proposed stages. CONCLUSION: This rapid review adds to the existing literature in two ways. First, it provides an up-to-date and comprehensive review of the existing methods for incorporating evidence into ToC development in the health sector. Second, it offers a new typology guiding any future endeavors of incorporating evidence into ToCs.

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Abstract Objective: To develop a rapid review on effective actions for the promotion of breastfeeding and healthy complementary feeding in primary health care and to summarize a list of actions and their elements for implementation. Data source: The review included systematic reviews on the effectiveness of interventions to promote breastfeeding and/or healthy complementary feeding for mothers and other caregivers, and/or professionals who work with this population, in comparison with any usual approach or none. Data synthesis: A total of 32 systematic reviews were included in the evidence synthesis. Ten types of interventions were evaluated in systematic reviews on promotion of breastfeeding and four types of interventions on promotion of healthy complementary feeding. The synthesis allowed six aspects to be discussed, and these must be considered to increase the chances of interventions' impact: type of intervention, target audience, timing of intervention, actors that can implement it, strategies and methods of intervention, and intensity of intervention. Conclusions: It was possible to assemble a list of actions whose effectiveness has already been demonstrated, providing elements for local adaptations. Evidence is expected to support and strengthen the implementation of programs aimed at promoting breastfeeding and complementary feeding in primary health care.

Resumo Objetivo: Desenvolver uma revisão rápida sobre intervenções efetivas para a promoção do aleitamento materno e da alimentação complementar saudável na Atenção Primária à Saúde e sintetizar um cardápio de ações e seus elementos para implementação. Fontes de dados: Foram incluídas revisões sistemáticas que avaliaram a efetividade de intervenções para promoção do aleitamento materno e/ou alimentação complementar saudável com mães e outros cuidadores e/ou profissionais que atuam com essa população em comparação com qualquer abordagem usual ou nenhuma. Síntese dos dados: Na síntese das evidências, foram incluídas 32 revisões sistemáticas. Nas revisões sistemáticas, foram avaliados dez tipos de intervenções no tema "promoção do aleitamento materno" e quatro tipos de intervenções no tema "promoção da alimentação complementar saudável". A síntese dos resultados permitiu discutir seis aspectos da implementação que devem ser considerados para aumentar as chances de impacto das intervenções: tipo de intervenção, público-alvo, momento da intervenção, atores que podem implementar, estratégias e métodos para conduzir a intervenção, e intensidade da intervenção. Conclusões: Os resultados permitiram apresentar um cardápio de ações cuja efetividade já foi demonstrada, fornecendo elementos para adaptações locais. Espera-se que as evidências apresentadas possam apoiar e fortalecer a implementação de programas de promoção do aleitamento materno e da alimentação complementar saudável na Atenção Primária à Saúde.

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OBJECTIVE: To develop a rapid review on effective actions for the promotion of breastfeeding and healthy complementary feeding in primary health care and to summarize a list of actions and their elements for implementation. DATA SOURCE: The review included systematic reviews on the effectiveness of interventions to promote breastfeeding and/or healthy complementary feeding for mothers and other caregivers, and/or professionals who work with this population, in comparison with any usual approach or none. DATA SYNTHESIS: A total of 32 systematic reviews were included in the evidence synthesis. Ten types of interventions were evaluated in systematic reviews on promotion of breastfeeding and four types of interventions on promotion of healthy complementary feeding. The synthesis allowed six aspects to be discussed, and these must be considered to increase the chances of interventions' impact: type of intervention, target audience, timing of intervention, actors that can implement it, strategies and methods of intervention, and intensity of intervention. CONCLUSIONS: It was possible to assemble a list of actions whose effectiveness has already been demonstrated, providing elements for local adaptations. Evidence is expected to support and strengthen the implementation of programs aimed at promoting breastfeeding and complementary feeding in primary health care.

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BACKGROUND: Maintaining sufficient health care workforce is a global priority to achieve universal health coverage. Therefore this study addresses the availability of physiotherapists in Brazil. OBJECTIVE: To describe secular trends of the physiotherapy workforce-to-population ratio in the Unified Health System, considering public and private sector and care level (primary, secondary, tertiary) in Brazil and its regions. METHOD: Descriptive exploratory quantitative study based on secondary sources. All data related to the distribution of physiotherapists between August 2007 and September 2016 regarding facilities types, location and public and private sectors was obtained from the Brazilian National Registry of Health Care Facilities. Data related to the population of Brazil was extracted from Brazilian Institute of Geography and Statistics. The physiotherapy workforce-to-population ratio was calculated by the number of physiotherapists per 1000 population (public and private sector and care level) by ANOVA test. The distribution trends are represented on maps. Annual growth rates were estimated with Prais-Winsten linear regression models, with a significance level of 0.05, autocorrelation was checked by the Durbin-Watson test. RESULTS: The physiotherapists ratio in Brazil was 0.22/1000 population in 2007 and 0.41 in 2016, showing growth of 86%, with an increasing trend of 0.5% on an annual average. The public sector had the biggest physiotherapy workforce in the country in 2007 and 2016. The primary health care had the smallest physiotherapy workforce-to-population ratio (2007: p > 0.001 and 2016: p = 0.003), even though it had the largest growth trend in annual average (0.9% p > 0.001), followed by public and private tertiary health care sectors (0.8% p > 0.001). The workforce in secondary health care was bigger in the private sector than in the public sector (0.6% p > 0.001 vs. 0.2% p = 0.004). Overall, all regions had greater growth of physiotherapy workforce-to-population ratio in public primary and tertiary health care sectors, and private secondary health care sector, mainly the Southeast, South and Central-West regions. CONCLUSION: Although the physiotherapy workforce in Brazil is relatively small, there was a trend towards growth with differences among care levels, and public and private sectors. The physiotherapy workforce-to-population ratio is bigger in the private secondary health care sector, followed by public tertiary, secondary and primary health care sectors. Sub-national regions show similar trends to the national estimates, with minor variations by region.

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OBJECTIVE: To identify effective interventions to manage antimicrobial resistance in hospital settings and potential barriers to their implementation. METHOD: A synthesis of evidence for health policy was performed using SUPPORT tools. Literature searches were performed in November and December 2018 in 14 databases. A face-to-face deliberative dialogue workshop to identify implementation barriers was performed with 23 participants (manager, researchers, and health care professionals) and 14 listeners divided into three groups. Researchers with experience in deliberative dialogue acted as facilitators. RESULTS: Twenty-seven systematic reviews focusing on antimicrobial stewardship using combined or individual strategies were identified. The interventions included education, electronic systems, use of biomarkers, and several strategies of antimicrobial management. The main barriers to the implementation of interventions, identified in the literature and deliberative dialogue workshop, were poor infrastructure and insufficient human resources, patient complaints regarding the treatment received, cultural differences within the multidisciplinary team, work overload, and lack of financing/planning. CONCLUSION: Most of the strategies identified were effective for antimicrobial stewardship in hospital settings. The reliability of results may be strengthened with the performance of additional research of higher methodological quality.

OBJETIVO: Determinar cuáles son las intervenciones eficaces para enfrentar la resistencia a los antimicrobianos en los hospitales y los posibles obstáculos para su implementación. MÉTODOS: Se hizo una síntesis de la evidencia encontrada para la elaboración de políticas con base en la metodología propuesta en las herramientas SUPPORT. Se efectuaron búsquedas bibliográficas en 14 bases de datos en noviembre y diciembre del 2018. Con el fin de determinar los obstáculos para la implementación de las intervenciones, se llevó a cabo un diálogo deliberativo en modalidad presencial con 23 participantes (gerentes, investigadores y profesionales de salud) y 14 oyentes, divididos en tres grupos. Varios investigadores con experiencia en la realización de diálogos deliberativos integraron el grupo de moderadores. RESULTADOS: Se encontraron 27 revisiones sistemáticas conjuntas e individuales de intervenciones para la gestión de los antimicrobianos (programas de rectoría). En esas intervenciones se abordaron estrategias de educación, sistemas electrónicos, biomarcadores y diversas formas de manejo de los antimicrobianos. Los principales obstáculos para la implementación de las intervenciones, detectadas por medio de la literatura y del diálogo deliberativo, fueron la falta de infraestructura y de recursos humanos, la insatisfacción del paciente con el comportamiento terapéutico, las diferencias culturales y la sobrecarga de trabajo del equipo multidisciplinario, así como la falta de financiamiento y planificación. CONCLUSIÓN: En su mayoría, las estrategias encontradas demostraron ser eficaces para la gestión de la resistencia a los antimicrobianos en el ámbito hospitalario. Cabe destacar que con nuevas investigaciones de mejor calidad metodológica podría aumentarse la confianza en los resultados.

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- Preventing prescribing errors is critical to improving patient safety.- We developed an evidence brief for policy to identify effective interventions to avoid or reduce prescribing errors.- Four options were raised: promoting educational actions on prudent prescribing directed to prescribers; incorporating computerized alert systems into clinical practice; implementing the use of tools for guiding medication prescribing; and, encouraging patient care by a multidisciplinary team, with the participation of a pharmacist.- These options can be incorporated into health systems either alone or together, and for that, it is necessary that the context be considered.- Aiming to inform decision makers, we included considerations on the implementation of these options regarding upper-middle income countries, like the Brazilian, and we also present considerations regarding equity.