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LITERATURE REVIEW SOFTWARE FOR BETTER RESEARCH

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Literature Review Software MAXQDA Interface

As your all-in-one literature review software, MAXQDA can be used to manage your entire research project. Easily import data from texts, interviews, focus groups, PDFs, web pages, spreadsheets, articles, e-books, and even social media data. Connect the reference management system of your choice with MAXQDA to easily import bibliographic data. Organize your data in groups, link relevant quotes to each other, keep track of your literature summaries, and share and compare work with your team members. Your project file stays flexible and you can expand and refine your category system as you go to suit your research.

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Having used several qualitative data analysis software programs, there is no doubt in my mind that MAXQDA has advantages over all the others. In addition to its remarkable analytical features for harnessing data, MAXQDA’s stellar customer service, online tutorials, and global learning community make it a user friendly and top-notch product.

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All-in-one Literature Review Software MAXQDA: Import of documents

Easily import your literature review data

With a literature review software like MAXQDA, you can easily import bibliographic data from reference management programs for your literature review. MAXQDA can work with all reference management programs that can export their databases in RIS-format which is a standard format for bibliographic information. Like MAXQDA, these reference managers use project files, containing all collected bibliographic information, such as author, title, links to websites, keywords, abstracts, and other information. In addition, you can easily import the corresponding full texts. Upon import, all documents will be automatically pre-coded to facilitate your literature review at a later stage.

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Great ideas will often occur to you while you’re doing your literature review. Using MAXQDA as your literature review software, you can create memos to store your ideas, such as research questions and objectives, or you can use memos for paraphrasing passages into your own words. By attaching memos like post-it notes to text passages, texts, document groups, images, audio/video clips, and of course codes, you can easily retrieve them at a later stage. Particularly useful for literature reviews are free memos written during the course of work from which passages can be copied and inserted into the final text.

Using Literature Review Software MAXQDA to Organize Your Qualitative Data: Memo Tools

Find concepts important to your generated literature review

When generating a literature review you might need to analyze a large amount of text. Luckily MAXQDA as the #1 literature review software offers Text Search tools that allow you to explore your documents without reading or coding them first. Automatically search for keywords (or dictionaries of keywords), such as important concepts for your literature review, and automatically code them with just a few clicks. Document variables that were automatically created during the import of your bibliographic information can be used for searching and retrieving certain text segments. MAXQDA’s powerful Coding Query allows you to analyze the combination of activated codes in different ways.

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When conducting a literature review you can easily get lost. But with MAXQDA as your literature review software, you will never lose track of the bigger picture. Among other tools, MAXQDA’s overview and summary tables are especially useful for aggregating your literature review results. MAXQDA offers overview tables for almost everything, codes, memos, coded segments, links, and so on. With MAXQDA literature review tools you can create compressed summaries of sources that can be effectively compared and represented, and with just one click you can easily export your overview and summary tables and integrate them into your literature review report.

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Powerful and easy-to-use literature review tools

Quantitative aspects can also be relevant when conducting a literature review analysis. Using MAXQDA as your literature review software enables you to employ a vast range of procedures for the quantitative evaluation of your material. You can sort sources according to document variables, compare amounts with frequency tables and charts, and much more. Make sure you don’t miss the word frequency tools of MAXQDA’s add-on module for quantitative content analysis. Included are tools for visual text exploration, content analysis, vocabulary analysis, dictionary-based analysis, and more that facilitate the quantitative analysis of terms and their semantic contexts.

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As an all-in-one literature review software, MAXQDA offers a variety of visual tools that are tailor-made for qualitative research and literature reviews. Create stunning visualizations to analyze your material. Of course, you can export your visualizations in various formats to enrich your literature review analysis report. Work with word clouds to explore the central themes of a text and key terms that are used, create charts to easily compare the occurrences of concepts and important keywords, or make use of the graphical representation possibilities of MAXMaps, which in particular permit the creation of concept maps. Thanks to the interactive connection between your visualizations with your MAXQDA data, you’ll never lose sight of the big picture.

Daten visualization with Literature Review Software MAXQDA

AI Assist: literature review software meets AI

AI Assist – your virtual research assistant – supports your literature review with various tools. AI Assist simplifies your work by automatically analyzing and summarizing elements of your research project and by generating suggestions for subcodes. No matter which AI tool you use – you can customize your results to suit your needs.

Free tutorials and guides on literature review

MAXQDA offers a variety of free learning resources for literature review, making it easy for both beginners and advanced users to learn how to use the software. From free video tutorials and webinars to step-by-step guides and sample projects, these resources provide a wealth of information to help you understand the features and functionality of MAXQDA for literature review. For beginners, the software’s user-friendly interface and comprehensive help center make it easy to get started with your data analysis, while advanced users will appreciate the detailed guides and tutorials that cover more complex features and techniques. Whether you’re just starting out or are an experienced researcher, MAXQDA’s free learning resources will help you get the most out of your literature review.

Free Tutorials for Literature Review Software MAXQDA

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Get your maxqda license, compare the features of maxqda and maxqda analytics pro, faq: literature review software.

Literature review software is a tool designed to help researchers efficiently manage and analyze the existing body of literature relevant to their research topic. MAXQDA, a versatile qualitative data analysis tool, can be instrumental in this process.

Literature review software, like MAXQDA, typically includes features such as data import and organization, coding and categorization, advanced search capabilities, data visualization tools, and collaboration features. These features facilitate the systematic review and analysis of relevant literature.

Literature review software, including MAXQDA, can assist in qualitative data interpretation by enabling researchers to organize, code, and categorize relevant literature. This organized data can then be analyzed to identify trends, patterns, and themes, helping researchers draw meaningful insights from the literature they’ve reviewed.

Yes, literature review software like MAXQDA is suitable for researchers of all levels of experience. It offers user-friendly interfaces and extensive support resources, making it accessible to beginners while providing advanced features that cater to the needs of experienced researchers.

Getting started with literature review software, such as MAXQDA, typically involves downloading and installing the software, importing your relevant literature, and exploring the available features. Many software providers offer tutorials and documentation to help users get started quickly.

For students, MAXQDA can be an excellent literature review software choice. Its user-friendly interface, comprehensive feature set, and educational discounts make it a valuable tool for students conducting literature reviews as part of their academic research.

MAXQDA is available for both Windows and Mac users, making it a suitable choice for Mac users looking for literature review software. It offers a consistent and feature-rich experience on Mac operating systems.

When it comes to literature review software, MAXQDA is widely regarded as one of the best choices. Its robust feature set, user-friendly interface, and versatility make it a top pick for researchers conducting literature reviews.

Yes, literature reviews can be conducted without software. However, using literature review software like MAXQDA can significantly streamline and enhance the process by providing tools for efficient data management, analysis, and visualization.

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Methodology

  • How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

  • Search for relevant literature
  • Evaluate sources
  • Identify themes, debates, and gaps
  • Outline the structure
  • Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

  • Quick Run-through
  • Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

  • Demonstrate your familiarity with the topic and its scholarly context
  • Develop a theoretical framework and methodology for your research
  • Position your work in relation to other researchers and theorists
  • Show how your research addresses a gap or contributes to a debate
  • Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

Literature review guide

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

  • Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
  • Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
  • Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
  • Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

  • Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
  • Body image, self-perception, self-esteem, mental health
  • Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

  • Your university’s library catalogue
  • Google Scholar
  • Project Muse (humanities and social sciences)
  • Medline (life sciences and biomedicine)
  • EconLit (economics)
  • Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

  • What question or problem is the author addressing?
  • What are the key concepts and how are they defined?
  • What are the key theories, models, and methods?
  • Does the research use established frameworks or take an innovative approach?
  • What are the results and conclusions of the study?
  • How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
  • What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

  • Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
  • Themes: what questions or concepts recur across the literature?
  • Debates, conflicts and contradictions: where do sources disagree?
  • Pivotal publications: are there any influential theories or studies that changed the direction of the field?
  • Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

  • Most research has focused on young women.
  • There is an increasing interest in the visual aspects of social media.
  • But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

  • Look at what results have emerged in qualitative versus quantitative research
  • Discuss how the topic has been approached by empirical versus theoretical scholarship
  • Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

  • Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
  • Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
  • Critically evaluate: mention the strengths and weaknesses of your sources
  • Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

  • Sampling methods
  • Simple random sampling
  • Stratified sampling
  • Cluster sampling
  • Likert scales
  • Reproducibility

 Statistics

  • Null hypothesis
  • Statistical power
  • Probability distribution
  • Effect size
  • Poisson distribution

Research bias

  • Optimism bias
  • Cognitive bias
  • Implicit bias
  • Hawthorne effect
  • Anchoring bias
  • Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

  • To familiarize yourself with the current state of knowledge on your topic
  • To ensure that you’re not just repeating what others have already done
  • To identify gaps in knowledge and unresolved problems that your research can address
  • To develop your theoretical framework and methodology
  • To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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McCombes, S. (2023, September 11). How to Write a Literature Review | Guide, Examples, & Templates. Scribbr. Retrieved February 22, 2024, from https://www.scribbr.com/dissertation/literature-review/

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At Jenni AI, we are deeply committed to the principles of academic integrity. We understand the importance of honesty, transparency, and ethical conduct in the academic community. Our tool is designed not just to assist in your research, but to do so in a way that respects and upholds these fundamental values.

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Start by creating your account on Jenni AI. The sign-up process is quick and user-friendly.

Define Your Research Scope

Enter the topic of your literature review to guide Jenni AI’s focus.

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Use Jenni AI’s suggestions to structure your literature review, organizing it into coherent sections.

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Receive assistance in citing sources correctly, maintaining the academic standard.

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Export your literature review to LaTeX, HTML, or .docx formats

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Often provide generic suggestions that may not align closely with individual research topics.

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Provides access to a vast and up-to-date range of academic literature, ensuring comprehensive research coverage.

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7 open source tools to make literature reviews easy

Open source, library schools, libraries, and digital dissemination

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A good literature review is critical for academic research in any field, whether it is for a research article, a critical review for coursework, or a dissertation. In a recent article, I presented detailed steps for doing  a literature review using open source software .

The following is a brief summary of seven free and open source software tools described in that article that will make your next literature review much easier.

1. GNU Linux

Most literature reviews are accomplished by graduate students working in research labs in universities. For absurd reasons, graduate students often have the worst computers on campus. They are often old, slow, and clunky Windows machines that have been discarded and recycled from the undergraduate computer labs. Installing a flavor of GNU Linux will breathe new life into these outdated PCs. There are more than 100 distributions , all of which can be downloaded and installed for free on computers. Most popular Linux distributions come with a "try-before-you-buy" feature. For example, with Ubuntu you can make a bootable USB stick that allows you to test-run the Ubuntu desktop experience without interfering in any way with your PC configuration. If you like the experience, you can use the stick to install Ubuntu on your machine permanently.

Linux distributions generally come with a free web browser, and the most popular is Firefox . Two Firefox plugins that are particularly useful for literature reviews are Unpaywall and Zotero. Keep reading to learn why.

3. Unpaywall

Often one of the hardest parts of a literature review is gaining access to the papers you want to read for your review. The unintended consequence of copyright restrictions and paywalls is it has narrowed access to the peer-reviewed literature to the point that even Harvard University is challenged to pay for it. Fortunately, there are a lot of open access articles—about a third of the literature is free (and the percentage is growing). Unpaywall is a Firefox plugin that enables researchers to click a green tab on the side of the browser and skip the paywall on millions of peer-reviewed journal articles. This makes finding accessible copies of articles much faster that searching each database individually. Unpaywall is fast, free, and legal, as it accesses many of the open access sites that I covered in my paper on using open source in lit reviews .

Formatting references is the most tedious of academic tasks. Zotero can save you from ever doing it again. It operates as an Android app, desktop program, and a Firefox plugin (which I recommend). It is a free, easy-to-use tool to help you collect, organize, cite, and share research. It replaces the functionality of proprietary packages such as RefWorks, Endnote, and Papers for zero cost. Zotero can auto-add bibliographic information directly from websites. In addition, it can scrape bibliographic data from PDF files. Notes can be easily added on each reference. Finally, and most importantly, it can import and export the bibliography databases in all publishers' various formats. With this feature, you can export bibliographic information to paste into a document editor for a paper or thesis—or even to a wiki for dynamic collaborative literature reviews (see tool #7 for more on the value of wikis in lit reviews).

5. LibreOffice

Your thesis or academic article can be written conventionally with the free office suite LibreOffice , which operates similarly to Microsoft's Office products but respects your freedom. Zotero has a word processor plugin to integrate directly with LibreOffice. LibreOffice is more than adequate for the vast majority of academic paper writing.

If LibreOffice is not enough for your layout needs, you can take your paper writing one step further with LaTeX , a high-quality typesetting system specifically designed for producing technical and scientific documentation. LaTeX is particularly useful if your writing has a lot of equations in it. Also, Zotero libraries can be directly exported to BibTeX files for use with LaTeX.

7. MediaWiki

If you want to leverage the open source way to get help with your literature review, you can facilitate a dynamic collaborative literature review . A wiki is a website that allows anyone to add, delete, or revise content directly using a web browser. MediaWiki is free software that enables you to set up your own wikis.

Researchers can (in decreasing order of complexity): 1) set up their own research group wiki with MediaWiki, 2) utilize wikis already established at their universities (e.g., Aalto University ), or 3) use wikis dedicated to areas that they research. For example, several university research groups that focus on sustainability (including mine ) use Appropedia , which is set up for collaborative solutions on sustainability, appropriate technology, poverty reduction, and permaculture.

Using a wiki makes it easy for anyone in the group to keep track of the status of and update literature reviews (both current and older or from other researchers). It also enables multiple members of the group to easily collaborate on a literature review asynchronously. Most importantly, it enables people outside the research group to help make a literature review more complete, accurate, and up-to-date.

Wrapping up

Free and open source software can cover the entire lit review toolchain, meaning there's no need for anyone to use proprietary solutions. Do you use other libre tools for making literature reviews or other academic work easier? Please let us know your favorites in the comments.

Joshua Pearce

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Automate your literature review with AI

Shubham Dogra

Table of Contents

Traditional methods of literature review can be susceptible to errors . Whether it’s overcoming human bias ">human bias or sifting through an incredibly large amount of scientific research being published today. Not to forget all the papers that have already been published in the past 100 years. Putting both together makes a heap of information that is humanly impossible to sift through. At least do so in an efficient way.

Thanks to artificial intelligence, long and tedious literature reviews are becoming quick and comprehensive. No longer do researchers have to spend endless hours combing through stacks of books and journals.

In this blog post, we'll dive deep into the world of automating your literature review with AI, exploring what a literature review is, why it's so crucial, and how you can harness AI tools to make the process more effective.

What is a literature review?

A literature review is essentially the foundation of a scientific research project, providing a comprehensive overview of existing knowledge on a specific topic. It gives an overview of your chosen topic and summarizes key findings, theories, and methodologies from various sources.

This critical analysis not only showcases the current state of understanding but also identifies gaps and trends in the scientific literature. In addition, it also shows your understanding of your field and can help provide credibility to your research paper .

Types of literature review

There are several types of literature reviews but for the most part, you will come across five versions. These are:

1. Narrative review: A narrative review provides a comprehensive overview of a topic, usually without a strict methodology for selection.

2. Systematic review: Systematic reviews are a strategic synthesis of a topic. This type of review follows a strict plan to identify, evaluate, and critique all relevant research on a topic to minimize bias.

3. Meta-analysis: It is a type of systematic review that uses research data from multiple articles to draw quantitative conclusions about a specific phenomenon.

4. Scoping review: As the name suggests, the purpose of a scoping review is to study a field, highlight the gaps in it, and underline the need for the following research paper.

5. Critical review: A critical literature review assesses and critiques the strengths and weaknesses of existing literature, challenging established ideas and theories.

Benefits of using literature review AI tools?

Using literature review AI tools can be a complete game changer in your research. They can make the literature review process smarter and hassle-free. Here are some practical benefits:

AI tools for literature review can skim through tons of research papers and find the most relevant one for your topic in no time, thus saving you hours of manual searching.

Comprehensive insights

No matter how complex the topic is or how long the research papers are, AI tools can find key insights like methodology, datasets, limitations, etc, by simply scanning the abstracts or PDF documents.

Eliminate bias

AI doesn't have favorites. Based on the data it’s fed, it evaluates research papers objectively and reduces as much bias in your literature review as possible.

Faster research questions

AI tools present loads of research papers in the same place. Some AI tools let you create visual maps and connections, thus helping you identify gaps in existing literature and arriving at your research question faster.

Consistency

AI tools ensure your review is consistently structured and formatted . They can also check for proper grammar and citation style, which is crucial for scholarly writing.

Multilingual support

There are heaps of non-native English-speaking researchers who can struggle with understanding scientific jargon in English. AI tools with multilingual support can help such academicians conduct their literature review in their own language.

How to write a literature review with AI

Now that we understand the benefits of a literature review using artificial intelligence, let's explore how you can automate the process. Literature reviews with AI-powered tools can save you countless hours and allow a more comprehensive and systematic approach. Here's one process you can follow:

Choose the right AI tool

Several AI search engines like Google Scholar, SciSpace, Semantic Scholar help you find the most relevant papers semantically. Or in other words even without the right keywords. These tools understand the context of your search query and deliver the results.

Find relevant research papers

Once you input your research question or keywords into a search engine like Google Scholar, Semantic Scholar, or SciSpace, it scours millions of papers worth of databases to find relevant articles. After that, you can narrow your search results to a certain time period, journals, number of citations, and other parameters for more accuracy.

Analyze the search results

Now that you have your list of relevant academic papers, the next step would be reviewing these results. A lot of AI-powered tools for literature review will often provide summaries along with the paper. Some sophisticated tools also help you gather key points from multiple papers at once and let you ask questions regarding that topic. This way, you can get an understanding of the topic and further have a better understanding of your field.

Organize your collection

Whether you’re writing a literature review or your paper, you will need to keep track of your references. Using AI tools, you can efficiently organize your findings, store them in reference managers, and instantly generate citations automatically, saving you the hassle of manually formatting references.

Write the literature review

Now that you’ve done your groundwork, you can start writing your literature review. Although you should be doing this yourself, you can use tools like paraphrasers, grammar checkers, and co-writers to help you refine your academic writing and get your point across with more clarity.

Best AI Tools for Literature Review

Since generative AI and ChatGPT came into the picture, there are heaps of AI tools for literature review available out there. Some of the most comprehensive ones are:

SciSpace is a valuable tool to have in your arsenal. It has a repository of 270M+ papers and makes it easy to find research articles. You can also extract key information to compare and contrast multiple papers at the same time. Then, go on to converse with individual papers using Copilot, your AI research assistant.

Love using SciSpace tools? Enjoy discounts! Use SR40 (40% off yearly) and SR20 (20% off monthly). Claim yours here 👉 SciSpace Premium

Research Rabbit

Research Rabbit is a research discovery tool that helps you find new, connected papers using a visual graph. You can essentially create maps around metadata, which helps you not only explore similar papers but also connections between them.

Iris AI is a specialized tool that understands the context of your research question, lets you apply smart filters, and finds relevant papers. Further, you can also extract summaries and other data from papers.

If you already don’t know about ChatGPT , you must be living under a rock. ChatGPT is a chatbot that creates text based on a prompt using natural language processing (NLP). You can use it to write the first draft of your literature review, refine your writing, format it properly, write a research presentation, and many more things.

Things to keep in mind when using literature review AI tools

While AI-powered tools can significantly streamline the literature review process, there are a few things you should keep in mind while employing them:

Quality control

Always review the results generated by AI tools. AI is powerful but not infallible. Ensure that you do further analysis by yourself and determine that the selected research articles are indeed relevant to your research.

Ethical considerations

Be aware of ethical concerns, such as plagiarism and AI writing. Use of AI is still frowned upon so make sure you do a thorough check for originality of your work, which is vital for maintaining academic integrity.

Stay updated

The world of AI is ever-evolving. Stay updated on the latest advancements in AI tools for literature review to make the most of your research.

In conclusion

Artificial intelligence is a game-changer for researchers, especially when it comes to literature reviews. It not only saves time but also enhances the quality and comprehensiveness of your work. With the right AI tool and a clear research question in hand, you can build an excellent literature review.

literature review maker

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  • 04 December 2020
  • Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

Article   PubMed   Google Scholar  

Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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We generate robust evidence fast

What is silvi.ai    .

Silvi is an end-to-end screening and data extraction tool supporting Systematic Literature Review and Meta-analysis.

Silvi helps create systematic literature reviews and meta-analyses that follow Cochrane guidelines in a highly reduced time frame, giving a fast and easy overview. It supports the user through the full process, from literature search to data analyses. Silvi is directly connected with databases such as PubMed and ClinicalTrials.gov and is always updated with the latest published research. It also supports RIS files, making it possible to upload a search string from your favorite search engine (i.e., Ovid). Silvi has a tagging system that can be tailored to any project.

Silvi is transparent, meaning it documents and stores the choices (and the reasons behind them) the user makes. Whether publishing the results from the project in a journal, sending them to an authority, or collaborating on the project with several colleagues, transparency is optimal to create robust evidence.

Silvi is developed with the user experience in mind. The design is intuitive and easily available to new users. There is no need to become a super-user. However, if any questions should arise anyway, we have a series of super short, instructional videos to get back on track.

To see Silvi in use, watch our short introduction video.

  Short introduction video  

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Learn more about Silvi’s specifications here.

"I like that I can highlight key inclusions and exclusions which makes the screening process really quick - I went through 2000+ titles and abstracts in just a few hours"

Eishaan Kamta Bhargava 

Consultant Paediatric ENT Surgeon, Sheffield Children's Hospital

"I really like how intuitive it is working with Silvi. I instantly felt like a superuser."

Henriette Kristensen

Senior Director, Ferring Pharmaceuticals

"The idea behind Silvi is great. Normally, I really dislike doing literature reviews, as they take up huge amounts of time. Silvi has made it so much easier! Thanks."

Claus Rehfeld

Senior Consultant, Nordic Healthcare Group

"AI has emerged as an indispensable tool for compiling evidence and conducting meta-analyses. Silvi.ai has proven to be the most comprehensive option I have explored, seamlessly integrating automated processes with the indispensable attributes of clarity and reproducibility essential for rigorous research practices."

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M.Sc. Specialist in clinical adult psychology

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Silvi.ai was founded in 2018 by Professor in Health Economic Evidence, Tove Holm-Larsen, and expert in Machine Learning, Rasmus Hvingelby. The idea for Silvi stemmed from their own research, and the need to conduct systematic literature reviews and meta-analyses faster.

The ideas behind Silvi were originally a component of a larger project. In 2016, Tove founded the group “Evidensbaseret Medicin 2.0” in collaboration with researchers from Ghent University, Technical University of Denmark, University of Copenhagen, and other experts. EBM 2.0  wanted to optimize evidence-based medicine to its highest potential using Big Data and Artificial Intelligence, but needed a highly skilled person within AI.

Around this time, Tove met Rasmus, who shared the same visions. Tove teamed up with Rasmus, and Silvi.ai was created.

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What’s Included: Literature Review Template

This template is structure is based on the tried and trusted best-practice format for formal academic research projects such as dissertations and theses. The literature review template includes the following sections:

  • Before you start – essential groundwork to ensure you’re ready
  • The introduction section
  • The core/body section
  • The conclusion /summary
  • Extra free resources

Each section is explained in plain, straightforward language , followed by an overview of the key elements that you need to cover. We’ve also included practical examples and links to more free videos and guides to help you understand exactly what’s required in each section.

The cleanly-formatted Google Doc can be downloaded as a fully editable MS Word Document (DOCX format), so you can use it as-is or convert it to LaTeX.

PS – if you’d like a high-level template for the entire thesis, you can we’ve got that too .

FAQs: Literature Review Template

What format is the template (doc, pdf, ppt, etc.).

The literature review chapter template is provided as a Google Doc. You can download it in MS Word format or make a copy to your Google Drive. You’re also welcome to convert it to whatever format works best for you, such as LaTeX or PDF.

What types of literature reviews can this template be used for?

The template follows the standard format for academic literature reviews, which means it will be suitable for the vast majority of academic research projects (especially those within the sciences), whether they are qualitative or quantitative in terms of design.

Keep in mind that the exact requirements for the literature review chapter will vary between universities and degree programs. These are typically minor, but it’s always a good idea to double-check your university’s requirements before you finalize your structure.

Is this template for an undergrad, Master or PhD-level thesis?

This template can be used for a literature review at any level of study. Doctoral-level projects typically require the literature review to be more extensive/comprehensive, but the structure will typically remain the same.

Can I modify the template to suit my topic/area?

Absolutely. While the template provides a general structure, you should adapt it to fit the specific requirements and focus of your literature review.

What structural style does this literature review template use?

The template assumes a thematic structure (as opposed to a chronological or methodological structure), as this is the most common approach. However, this is only one dimension of the template, so it will still be useful if you are adopting a different structure.

Does this template include the Excel literature catalog?

No, that is a separate template, which you can download for free here . This template is for the write-up of the actual literature review chapter, whereas the catalog is for use during the literature sourcing and sorting phase.

How long should the literature review chapter be?

This depends on your university’s specific requirements, so it’s best to check with them. As a general ballpark, literature reviews for Masters-level projects are usually 2,000 – 3,000 words in length, while Doctoral-level projects can reach multiples of this.

Can I include literature that contradicts my hypothesis?

Yes, it’s important to acknowledge and discuss literature that presents different viewpoints or contradicts your hypothesis. So, don’t shy away from existing research that takes an opposing view to yours.

How do I avoid plagiarism in my literature review?

Always cite your sources correctly and paraphrase ideas in your own words while maintaining the original meaning. You can always check our plagiarism score before submitting your work to help ease your mind. 

Do you have an example of a populated template?

We provide a walkthrough of the template and review an example of a high-quality literature research chapter here .

Can I share this literature review template with my friends/colleagues?

Yes, you’re welcome to share this template in its original format (no editing allowed). If you want to post about it on your blog or social media, all we ask is that you reference this page as your source.

Do you have templates for the other dissertation/thesis chapters?

Yes, we do. You can find our full collection of templates here .

Can Grad Coach help me with my literature review?

Yes, you’re welcome to get in touch with us to discuss our private coaching services , where we can help you work through the literature review chapter (and any other chapters).

Free Webinar: Literature Review 101

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  • Write a Literature Review
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  • Find This link opens in a new window
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Get Organized

  • Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

  • Step-by-Step Approach
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Research Sources Log Research Sources Log

Welcome aboard, how to get started, how to use the template, starting with research sources log, it’s okay if you don’t fill out all of the fields. the more fields filled out, the more accurate the analysis., hint: to view a bigger view of the field. click on the field and click on the “ ‹ ” icon..

literature review maker

Writing in the Health and Social Sciences: Literature Reviews and Synthesis Tools

  • Journal Publishing
  • Style and Writing Guides
  • Readings about Writing
  • Citing in APA Style This link opens in a new window
  • Resources for Dissertation Authors
  • Citation Management and Formatting Tools
  • What are Literature Reviews?
  • Conducting & Reporting Systematic Reviews
  • Finding Systematic Reviews
  • Tutorials & Tools for Literature Reviews

Systematic Literature Reviews: Steps & Resources

literature review maker

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

  • The different types of literature reviews, including systematic reviews and other evidence synthesis methods
  • Tools & Tutorials

Literature Review & Systematic Review Steps

  • Develop a Focused Question
  • Scope the Literature  (Initial Search)
  • Refine & Expand the Search
  • Limit the Results
  • Download Citations
  • Abstract & Analyze
  • Create Flow Diagram
  • Synthesize & Report Results

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

  • PICO Question Help
  • Stillwell, Susan B., DNP, RN, CNE; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Williamson, Kathleen M., PhD, RN Evidence-Based Practice, Step by Step: Asking the Clinical Question, AJN The American Journal of Nursing : March 2010 - Volume 110 - Issue 3 - p 58-61 doi: 10.1097/01.NAJ.0000368959.11129.79

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

  • Background sources (books, point-of-care tools)
  • Article databases
  • Trial registries
  • Grey literature
  • Cited references
  • Reference lists

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

  • Combine separate concepts with AND  (resulting in a narrower search)
  • Connecting synonyms with OR  (resulting in an expanded search)

Search:  pilates AND ("low back pain"  OR  backache )

Video Tutorials - Translating PICO Questions into Search Queries

  • Translate Your PICO Into a Search in PubMed (YouTube, Carrie Price, 5:11) 
  • Translate Your PICO Into a Search in CINAHL (YouTube, Carrie Price, 4:56)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:

  • database thesauri
  • reference lists
  • relevant studies

Example: 

(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

  • a personal database account (e.g., MyNCBI for PubMed)
  • Log in with your NYU credentials
  • Open and "Make a Copy" to create your own tracker for your literature search strategies

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

  • Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
  • Limit by publication years, age groups, language, etc.

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

  • Filters in PubMed
  • CINAHL Advanced Searching Tutorial

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

File structure of a Zotero library, showing a combined pooled set, and sub folders representing results from individual databases.

  • Citation Managers - General Guide

6. Abstract and Analyze

  • Migrate citations to data collection/extraction tool
  • Screen Title/Abstracts for inclusion/exclusion
  • Screen and appraise full text for relevance, methods, 
  • Resolve disagreements by consensus

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

Screenshot of the Covidence interface, showing Title and abstract screening phase.

  • Covidence Support
  • Critical Appraisal Tools
  • Data Extraction Tools

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example PRISMA diagram showing number of records identified, duplicates removed, and records excluded.

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

  • PRISMA Flow Diagram Generator (ShinyApp.io, Haddaway et al. )
  • PRISMA Diagram Templates  (Word and PDF)
  • Make a copy of the file to fill out the template
  • Image can be downloaded as PDF, PNG, JPG, or SVG
  • Covidence generates a PRISMA diagram that is automatically updated as records move through the review phases

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

Example of a review matrix, using Microsoft Excel, showing the results of a systematic literature review.

  • Reporting Guidelines for Systematic Reviews
  • Download a sample template of a health sciences review matrix  (GoogleSheets)

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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  • Literature review tool

The following tool will help you learn how to conduct a solid review of literature. To do so, you will have to answer the questions posed in the form you will find on the lower left side, while checking the resources provided on the right side.

Positionality is the notion that identity , paradigmatic views , and location in time and space influence how one understands the world. Consequently, it is essential to take into account positionality before engaging in research, including research synthesis. Learn more about identity, approaches or paradigmatic views such as positivism, interpretivism, constructivism, and others here

The second step in the generation of the literature review design is setting purposes and objectives that will drive the review process.  Your searching strategies, the literature analysis, and even a review structure depend on the purposes of a review, the same way as the goals and research questions in a research study shape its design. Learn more about the purposes and objectives of a traditional literature "nested" in a research study and a research synthesis.

There are key things to think about before you start searching for literature or conduct research synthesis.  You should define and narrow your topic. Since each disciplinary domain has its own thesaurus, index, and databases,  contemplate in which disciplines or areas of study your research synthesis will be conducted. Formulate the initial research question that you will develop further during the search for the literature and the design step. Learn more here.

The conceptual & theoretical framework of your study is the system of concepts, assumptions, expectations, beliefs, and theories that supports and informs your research. It is a formulation of what you think is going on with what you are studying—a tentative theory of what is happening and why. Read more about "concepts" and how to search for and clarify them, how to find a relevant theory,   here .

Secondary data analysis and review of literature involve collecting and analyzing a vast array of information and sources.  To help you stay focused, your first step should be to develop a research design or a step-by-step plan or a protocol that guides data collection and analysis. Get familiar with different types if the research designs on this page .

As with any research study, the basic purpose of data collection is to create a systematically organized set of materials that will be analyzed or interpreted. Any type of reviews, not only a systematic review,  benefit from applying relatively systematic methods of searching and collecting secondary data. In this part of the guide , I describe sampling methods, instruments (or searching techniques), and organization of sources.

The seventh step regards the selection and definition of the data analysis strategies that will be used in your study, depending on the research approach followed. You can find here resources that might be of help to better understand the way data analysis work. 

After analyzing studies or literature in a depth and the systematic way one should move to the iterative process of exploring, commonalities and contradictions across relevant studies, emergent themes in order to build a theory, frame future research, or creating a final integrated presentation of finding. Find out more here.

Ethical considerations of conducting literature reviews and the issues of quality are not widely discussed in the literature. Consult t his guide where you will find references to work on ethics of conducting systematic reviews, checklists for quality of meta-analysis and research synthesis.

literature review maker

The following AI tools can assist you in step 9 of the process of generating your design:

Google Bard can be used to identify potential ethical principles a researcher could define to ethically conduct a given study.

For instance, we could use the following prompt: What principles could a researcher define to ethically conduct a qualitative case study regarding the long-term impact of competency-based assessment on secondary education students in a secondary school in Marietta (Georgia)?

literature review maker

The following AI tools can assist you in step 8 of the process of generating your design:

Google Bard can be used to identify potential strategies we could implement as researchers to ensure the trustworthiness/validity of a given study.

For instance, we could use the following prompt: What strategies could a researcher use to ensure the trustworthiness qualitative case study regarding the long-term impact of competency-based assessment on secondary education students in a secondary school in Marietta (Georgia).

literature review maker

The following AI tools can assist you in step 7 of the process of generating your design:

AI data analysis is on the rise. For instance,  the AI module of Atlas.ti can be used to analyze qualitative data.

The following AI tools can assist you in step 5 of the process of generating your design:

Consensus could be used to identify research questions that have been used in previously published studies. Consensus is an AI-powered search engine designed to take in research questions, find relevant insights within research papers, and synthesize the results using large language models. It is not a chatbot. Consensus only searches through peer-reviewed scientific research articles to find the most credible insights to your queries.

AI: Google Bard could be used to identify potential questions for a particular research tradition or design.

For instance, we could use the following prompt: Generate examples of research questions that could be used to drive a qualitative case study regarding the long-term impact of competency-based assessment on secondary education students in a secondary school in Marietta (Georgia).

The following AI tools can assist you in step 4 of the process of generating your design:

Google Bard could be used to help users of Hopscotch understand the differences between research traditions for a certain topic.

For instance, we could use the following prompt:   Generate a brief description of the key elements of a qualitative case study research design regarding the long-term impact of competency-based assessment on secondary education students in a secondary school in Marietta (Georgia). To do this, use the following nine steps proposed by the Hopscotch Model:

Step 1: Paradigmatic View of the Researcher

Step 2: Topics & Goals of the Study

Step 3: Conceptual framework of the study

Step 4: Research Design/tradition

Step 5: Research Questions

Step 6: Data Gathering Methods

Step 7: Data Analysis

Step 8: Trustworthiness/Validity

Step 9: Ethics driving the study

The following AI tools can assist you in step 3 of the process of generating your design:

AI: ResearchRabbit is a scholarly publication discovery tool supported by artificial intelligence (AI). The tool is designed to support your research without you switching between searching modes and databases, a process that is time-consuming and often escalates into further citation mining; a truly unpleasant rabbit hole (and that’s what inspired the name ResearchRabbit)

AI: 2Dsearch  is a radical alternative to conventional ‘advanced search’. Instead of entering Boolean strings into one-dimensional search boxes, queries are formulated by manipulating objects on a two-dimensional canvas. This eliminates syntax errors, makes the query semantics more transparent, and offers new ways to collaborate, share, and optimize search strategies and best practices.

Welcome to ResearchRabbit from ResearchRabbit on Vimeo .

The following AI tools can assist you in step 2 of the process of generating your design:

AI: Consensus could be used to assist users in the identification of relevant topics that have been published in peer-reviewed articles. Consensus is an AI-powered search engine designed to take in research questions, find relevant insights within research papers, and synthesize the results using large language models. It is not a chatbot. Consensus only searches through peer-reviewed scientific research articles to find the most credible insights to your queries.

AI: Carrot2 could be used to identify potential research topics. Carrot2  organizes your search results into topics. With an instant overview of what’s available, you will quickly find what you’re looking for.

The following AI tools can assist you in step 1 of the process of generating your design:

You could use Google Bard , Perplexity , or ChatGPT , to ask for the differences between the key wordlviews that a researcher can bring to a given study.

For instance, we could use the following prompt:   What are the defining characteristics of the main worldviews or paradigmatic positioning (positivistic worldviews, post-positivistic worldview; constructivistic worldview; transformative worldview, and; pragmatic worldview) a researcher can bring to a given study?

literature review maker

The following AI tools can assist you in step 6 of the process of generating your design:

We could use Google Bard to develop a draft of a data collection protocol for a given study.

For instance, we could use the following prompt: Generate an interview protocol for students involved in a qualitative case study regarding the long-term impact of competency-based assessment on secondary education students in a secondary school in Marietta (Georgia).

literature review maker

You can use the following AI tools to assist you in the process of generating your design:

Step 1: Paradigmatic View of the Researcher 

AI: You could use Google Bard , Perplexity , or ChatGPT , to ask for the differences between the key wordlviews that a researcher can bring to a given study.  

Step 2: Topics & Goals of the Study

AI: Google Bard could be used to help users of Hopscotch understand the differences between research traditions for a certain topic.  

AI: Consensus could be used to identify research questions that have been used in previously published studies. Consensus is an AI-powered search engine designed to take in research questions, find relevant insights within research papers, and synthesize the results using large language models. It is not a chatbot. Consensus only searches through peer-reviewed scientific research articles to find the most credible insights to your queries.

AI: We could use Google Bard to develop a draft of a data collection protocol for a given study.

AI: We could use the AI module of Atlas.ti to analyze qualitative data

AI: Google Bard could be used to identify potential strategies we could implement as researchers to ensure the trustworthiness/validity of a given study.

AI: Google Bard   could be used to identify potential ethical principles a researcher could define to ethically conduct a given study.

Consensus uses AI to find answers in research papers. You can search for previous research in your field of study that might be helpful to better support the relevance of your research topic and the need to conduct the study that you are proposing. The best way to search is to ask a question.

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  • v.9(7); 2013 Jul

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Ten Simple Rules for Writing a Literature Review

Marco pautasso.

1 Centre for Functional and Evolutionary Ecology (CEFE), CNRS, Montpellier, France

2 Centre for Biodiversity Synthesis and Analysis (CESAB), FRB, Aix-en-Provence, France

Literature reviews are in great demand in most scientific fields. Their need stems from the ever-increasing output of scientific publications [1] . For example, compared to 1991, in 2008 three, eight, and forty times more papers were indexed in Web of Science on malaria, obesity, and biodiversity, respectively [2] . Given such mountains of papers, scientists cannot be expected to examine in detail every single new paper relevant to their interests [3] . Thus, it is both advantageous and necessary to rely on regular summaries of the recent literature. Although recognition for scientists mainly comes from primary research, timely literature reviews can lead to new synthetic insights and are often widely read [4] . For such summaries to be useful, however, they need to be compiled in a professional way [5] .

When starting from scratch, reviewing the literature can require a titanic amount of work. That is why researchers who have spent their career working on a certain research issue are in a perfect position to review that literature. Some graduate schools are now offering courses in reviewing the literature, given that most research students start their project by producing an overview of what has already been done on their research issue [6] . However, it is likely that most scientists have not thought in detail about how to approach and carry out a literature review.

Reviewing the literature requires the ability to juggle multiple tasks, from finding and evaluating relevant material to synthesising information from various sources, from critical thinking to paraphrasing, evaluating, and citation skills [7] . In this contribution, I share ten simple rules I learned working on about 25 literature reviews as a PhD and postdoctoral student. Ideas and insights also come from discussions with coauthors and colleagues, as well as feedback from reviewers and editors.

Rule 1: Define a Topic and Audience

How to choose which topic to review? There are so many issues in contemporary science that you could spend a lifetime of attending conferences and reading the literature just pondering what to review. On the one hand, if you take several years to choose, several other people may have had the same idea in the meantime. On the other hand, only a well-considered topic is likely to lead to a brilliant literature review [8] . The topic must at least be:

  • interesting to you (ideally, you should have come across a series of recent papers related to your line of work that call for a critical summary),
  • an important aspect of the field (so that many readers will be interested in the review and there will be enough material to write it), and
  • a well-defined issue (otherwise you could potentially include thousands of publications, which would make the review unhelpful).

Ideas for potential reviews may come from papers providing lists of key research questions to be answered [9] , but also from serendipitous moments during desultory reading and discussions. In addition to choosing your topic, you should also select a target audience. In many cases, the topic (e.g., web services in computational biology) will automatically define an audience (e.g., computational biologists), but that same topic may also be of interest to neighbouring fields (e.g., computer science, biology, etc.).

Rule 2: Search and Re-search the Literature

After having chosen your topic and audience, start by checking the literature and downloading relevant papers. Five pieces of advice here:

  • keep track of the search items you use (so that your search can be replicated [10] ),
  • keep a list of papers whose pdfs you cannot access immediately (so as to retrieve them later with alternative strategies),
  • use a paper management system (e.g., Mendeley, Papers, Qiqqa, Sente),
  • define early in the process some criteria for exclusion of irrelevant papers (these criteria can then be described in the review to help define its scope), and
  • do not just look for research papers in the area you wish to review, but also seek previous reviews.

The chances are high that someone will already have published a literature review ( Figure 1 ), if not exactly on the issue you are planning to tackle, at least on a related topic. If there are already a few or several reviews of the literature on your issue, my advice is not to give up, but to carry on with your own literature review,

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The bottom-right situation (many literature reviews but few research papers) is not just a theoretical situation; it applies, for example, to the study of the impacts of climate change on plant diseases, where there appear to be more literature reviews than research studies [33] .

  • discussing in your review the approaches, limitations, and conclusions of past reviews,
  • trying to find a new angle that has not been covered adequately in the previous reviews, and
  • incorporating new material that has inevitably accumulated since their appearance.

When searching the literature for pertinent papers and reviews, the usual rules apply:

  • be thorough,
  • use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and
  • look at who has cited past relevant papers and book chapters.

Rule 3: Take Notes While Reading

If you read the papers first, and only afterwards start writing the review, you will need a very good memory to remember who wrote what, and what your impressions and associations were while reading each single paper. My advice is, while reading, to start writing down interesting pieces of information, insights about how to organize the review, and thoughts on what to write. This way, by the time you have read the literature you selected, you will already have a rough draft of the review.

Of course, this draft will still need much rewriting, restructuring, and rethinking to obtain a text with a coherent argument [11] , but you will have avoided the danger posed by staring at a blank document. Be careful when taking notes to use quotation marks if you are provisionally copying verbatim from the literature. It is advisable then to reformulate such quotes with your own words in the final draft. It is important to be careful in noting the references already at this stage, so as to avoid misattributions. Using referencing software from the very beginning of your endeavour will save you time.

Rule 4: Choose the Type of Review You Wish to Write

After having taken notes while reading the literature, you will have a rough idea of the amount of material available for the review. This is probably a good time to decide whether to go for a mini- or a full review. Some journals are now favouring the publication of rather short reviews focusing on the last few years, with a limit on the number of words and citations. A mini-review is not necessarily a minor review: it may well attract more attention from busy readers, although it will inevitably simplify some issues and leave out some relevant material due to space limitations. A full review will have the advantage of more freedom to cover in detail the complexities of a particular scientific development, but may then be left in the pile of the very important papers “to be read” by readers with little time to spare for major monographs.

There is probably a continuum between mini- and full reviews. The same point applies to the dichotomy of descriptive vs. integrative reviews. While descriptive reviews focus on the methodology, findings, and interpretation of each reviewed study, integrative reviews attempt to find common ideas and concepts from the reviewed material [12] . A similar distinction exists between narrative and systematic reviews: while narrative reviews are qualitative, systematic reviews attempt to test a hypothesis based on the published evidence, which is gathered using a predefined protocol to reduce bias [13] , [14] . When systematic reviews analyse quantitative results in a quantitative way, they become meta-analyses. The choice between different review types will have to be made on a case-by-case basis, depending not just on the nature of the material found and the preferences of the target journal(s), but also on the time available to write the review and the number of coauthors [15] .

Rule 5: Keep the Review Focused, but Make It of Broad Interest

Whether your plan is to write a mini- or a full review, it is good advice to keep it focused 16 , 17 . Including material just for the sake of it can easily lead to reviews that are trying to do too many things at once. The need to keep a review focused can be problematic for interdisciplinary reviews, where the aim is to bridge the gap between fields [18] . If you are writing a review on, for example, how epidemiological approaches are used in modelling the spread of ideas, you may be inclined to include material from both parent fields, epidemiology and the study of cultural diffusion. This may be necessary to some extent, but in this case a focused review would only deal in detail with those studies at the interface between epidemiology and the spread of ideas.

While focus is an important feature of a successful review, this requirement has to be balanced with the need to make the review relevant to a broad audience. This square may be circled by discussing the wider implications of the reviewed topic for other disciplines.

Rule 6: Be Critical and Consistent

Reviewing the literature is not stamp collecting. A good review does not just summarize the literature, but discusses it critically, identifies methodological problems, and points out research gaps [19] . After having read a review of the literature, a reader should have a rough idea of:

  • the major achievements in the reviewed field,
  • the main areas of debate, and
  • the outstanding research questions.

It is challenging to achieve a successful review on all these fronts. A solution can be to involve a set of complementary coauthors: some people are excellent at mapping what has been achieved, some others are very good at identifying dark clouds on the horizon, and some have instead a knack at predicting where solutions are going to come from. If your journal club has exactly this sort of team, then you should definitely write a review of the literature! In addition to critical thinking, a literature review needs consistency, for example in the choice of passive vs. active voice and present vs. past tense.

Rule 7: Find a Logical Structure

Like a well-baked cake, a good review has a number of telling features: it is worth the reader's time, timely, systematic, well written, focused, and critical. It also needs a good structure. With reviews, the usual subdivision of research papers into introduction, methods, results, and discussion does not work or is rarely used. However, a general introduction of the context and, toward the end, a recapitulation of the main points covered and take-home messages make sense also in the case of reviews. For systematic reviews, there is a trend towards including information about how the literature was searched (database, keywords, time limits) [20] .

How can you organize the flow of the main body of the review so that the reader will be drawn into and guided through it? It is generally helpful to draw a conceptual scheme of the review, e.g., with mind-mapping techniques. Such diagrams can help recognize a logical way to order and link the various sections of a review [21] . This is the case not just at the writing stage, but also for readers if the diagram is included in the review as a figure. A careful selection of diagrams and figures relevant to the reviewed topic can be very helpful to structure the text too [22] .

Rule 8: Make Use of Feedback

Reviews of the literature are normally peer-reviewed in the same way as research papers, and rightly so [23] . As a rule, incorporating feedback from reviewers greatly helps improve a review draft. Having read the review with a fresh mind, reviewers may spot inaccuracies, inconsistencies, and ambiguities that had not been noticed by the writers due to rereading the typescript too many times. It is however advisable to reread the draft one more time before submission, as a last-minute correction of typos, leaps, and muddled sentences may enable the reviewers to focus on providing advice on the content rather than the form.

Feedback is vital to writing a good review, and should be sought from a variety of colleagues, so as to obtain a diversity of views on the draft. This may lead in some cases to conflicting views on the merits of the paper, and on how to improve it, but such a situation is better than the absence of feedback. A diversity of feedback perspectives on a literature review can help identify where the consensus view stands in the landscape of the current scientific understanding of an issue [24] .

Rule 9: Include Your Own Relevant Research, but Be Objective

In many cases, reviewers of the literature will have published studies relevant to the review they are writing. This could create a conflict of interest: how can reviewers report objectively on their own work [25] ? Some scientists may be overly enthusiastic about what they have published, and thus risk giving too much importance to their own findings in the review. However, bias could also occur in the other direction: some scientists may be unduly dismissive of their own achievements, so that they will tend to downplay their contribution (if any) to a field when reviewing it.

In general, a review of the literature should neither be a public relations brochure nor an exercise in competitive self-denial. If a reviewer is up to the job of producing a well-organized and methodical review, which flows well and provides a service to the readership, then it should be possible to be objective in reviewing one's own relevant findings. In reviews written by multiple authors, this may be achieved by assigning the review of the results of a coauthor to different coauthors.

Rule 10: Be Up-to-Date, but Do Not Forget Older Studies

Given the progressive acceleration in the publication of scientific papers, today's reviews of the literature need awareness not just of the overall direction and achievements of a field of inquiry, but also of the latest studies, so as not to become out-of-date before they have been published. Ideally, a literature review should not identify as a major research gap an issue that has just been addressed in a series of papers in press (the same applies, of course, to older, overlooked studies (“sleeping beauties” [26] )). This implies that literature reviewers would do well to keep an eye on electronic lists of papers in press, given that it can take months before these appear in scientific databases. Some reviews declare that they have scanned the literature up to a certain point in time, but given that peer review can be a rather lengthy process, a full search for newly appeared literature at the revision stage may be worthwhile. Assessing the contribution of papers that have just appeared is particularly challenging, because there is little perspective with which to gauge their significance and impact on further research and society.

Inevitably, new papers on the reviewed topic (including independently written literature reviews) will appear from all quarters after the review has been published, so that there may soon be the need for an updated review. But this is the nature of science [27] – [32] . I wish everybody good luck with writing a review of the literature.

Acknowledgments

Many thanks to M. Barbosa, K. Dehnen-Schmutz, T. Döring, D. Fontaneto, M. Garbelotto, O. Holdenrieder, M. Jeger, D. Lonsdale, A. MacLeod, P. Mills, M. Moslonka-Lefebvre, G. Stancanelli, P. Weisberg, and X. Xu for insights and discussions, and to P. Bourne, T. Matoni, and D. Smith for helpful comments on a previous draft.

Funding Statement

This work was funded by the French Foundation for Research on Biodiversity (FRB) through its Centre for Synthesis and Analysis of Biodiversity data (CESAB), as part of the NETSEED research project. The funders had no role in the preparation of the manuscript.

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  • Open access
  • Published: 22 February 2024

The impact of the cost-of-living crisis on population health in the UK: rapid evidence review

  • Jade Meadows 1 ,
  • Miranda Montano 2 ,
  • Abdelrahman J. K. Alfar 1 , 3 ,
  • Ömer Yetkin BaƟkan 1 ,
  • Caroline De BrĂșn 4 ,
  • Jennifer Hill 4 ,
  • Rachael McClatchey 5 , 6 ,
  • Nevila Kallfa 1 &
  • Gwen Sascha Fernandes 1 , 7  

BMC Public Health volume  24 , Article number:  561 ( 2024 ) Cite this article

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In the UK, unique and unforeseen factors, including COVID-19, Brexit, and Ukraine-Russia war, have resulted in an unprecedented cost of living crisis, creating a second health emergency. We present, one of the first rapid reviews with the aim of examining the impact of this current crisis, at a population level. We reviewed published literature, as well as grey literature, examining a broad range of physical and mental impacts on health in the short, mid, and long term, identifying those most at risk, impacts on system partners, including emergency services and the third sector, as well as mitigation strategies.

We conducted a rapid review by searching PubMed, Embase, MEDLINE, and HMIC (2020 to 2023). We searched for grey literature on Google and hand-searched the reports of relevant public health organisations. We included interventional and observational studies that reported outcomes of interventions aimed at mitigating against the impacts of cost of living at a population level.

We found that the strongest evidence was for the impact of cold and mouldy homes on respiratory-related infections and respiratory conditions. Those at an increased risk were young children (0–4 years), the elderly (aged 75 and over), as well as those already vulnerable, including those with long-term multimorbidity. Further short-term impacts include an increased risk of physical pain including musculoskeletal and chest pain, and increased risk of enteric infections and malnutrition. In the mid-term, we could see increases in hypertension, transient ischaemic attacks, and myocardial infarctions, and respiratory illnesses. In the long term we could see an increase in mortality and morbidity rates from respiratory and cardiovascular disease, as well as increase rates of suicide and self-harm and infectious disease outcomes. Changes in behaviour are likely particularly around changes in food buying patterns and the ability to heat a home. System partners are also impacted, with voluntary sectors seeing fewer volunteers, an increase in petty crime and theft, alternative heating appliances causing fires, and an increase in burns and burn-related admissions. To mitigate against these impacts, support should be provided, to the most vulnerable, to help increase disposable income, reduce energy bills, and encourage home improvements linked with energy efficiency. Stronger links to bridge voluntary, community, charity and faith groups are needed to help provide additional aid and support.

Although the CoL crisis affects the entire population, the impacts are exacerbated in those that are most vulnerable, particularly young children, single parents, multigenerational families. More can be done at a community and societal level to support the most vulnerable, and those living with long-term multimorbidity. This review consolidates the current evidence on the impacts of the cost of living crisis and may enable decision makers to target limited resources more effectively.

Peer Review reports

Introduction

In the UK, the COVID -19 pandemic and subsequent unforeseen geopolitical factors (e.g., Brexit & Ukraine-Russia War) resulted in a severe economic downturn with gross domestic product (GDP) decreasing by 11.0% in 2020, the sharpest drop since records began and unprecedented in modern times (Fig.  1 , panel a). Since March 2020, whilst GDP has increased , it has remained below 2020 pre-pandemic levels through to July 2022, accompanied by rising inflation rates due to endogenous and exogenous shocks (Fig.  1 , panel b) [ 1 ]. Internal shocks include supply chain challenges or labour shortages which affected the supply side, and pandemic-associated changes in consumer purchasing patterns which affected the demand side. These internal shocks have resulted in imbalances between the supply and demand of different markets including the goods and services market, the labour market, and the money market. Exogenous shocks occur due to non-economic interventions such as war (e.g., the Ukraine-Russia war) and the ongoing global pandemics (e.g., COVID-19). This combination of economic shocks is unprecedented, therefore the resulting impacts on inflation and the cost of living (CoL) are unique, both in terms of provenance and consequences for population health and wellbeing. This is further exacerbated by COVID-19 consequences and recovery from the pandemic which has been estimated to take 10–15 years [ 2 ]. The cost of living crisis is often regarded as the ‘second health emergency’ after the COVID-19 pandemic [ 3 ].

figure 1

Panel a : Annual % change in UK GDP since records began; Panel b : % change in GDP compared to Feb 2020 (pre-pandemic levels) [ 1 ].

Recent evidence from the World Health Organisation (WHO) shows that economic shocks and austerity exacerbate poverty, vulnerability, marginalisation, as well as socioeconomic and health inequalities [ 4 , 5 , 6 , 7 ], with serious implications for health [ 2 , 8 ],. In the UK, rising inflation has contributed to the rising CoL, which has made the population poorer and driven 1 in 5 into relative poverty [ 9 ].

The UK Office for National Statistics (ONS) checks the prices of a whole range of items in a standard ‘basket’ of goods and services and the price of that basket determines the overall price level, otherwise known as the Consumer Prices Index (CPI). Inflation is a term used to describe rising prices and how quickly prices go up is called the rate of inflation. To calculate the inflation rate, the cost of the basket or level of CPI is compared with the previous year, and this change in price level over the year is the rate of inflation [ 10 , 11 ]. The inflation rate in the UK (February 2023) was 10.5% against a usual target of 2% [ 10 ]. The inflation rate is projected to worsen through 2023 and subsequently decrease by Q1 of 2024 as depicted in Fig.  2 [ 10 ], a trend confirmed in recent months with inflation now at 4.2% (Jan 2024).

figure 2

CPI inflation Q1 2008 to Q1 2028, including successive Bank of England and Office for Budget Responsibility forecasts. Source: Institute for Government

According to the official economic projections, the expected UK economic recovery is slower than the G7 countries, a full recovery and return to pre-pandemic peak is expected in the end of 2024. The average annual growth rate is less than 1% (per year), from the start of the pandemic till 2028. Prior to this period, the growth rate was 2.75%. In addition to this, the real disposable income per person is expected to fall by 5.7 cumulative percent by the end of the next March 2024 [ 12 ].

Meanwhile the consumer’s wages and benefit payments are not in tandem with rising living costs, and in particular, the cost of housing, food, energy, and fuel [ 13 ]. For example, evidence suggests that 14.4% of households in the UK (approximately 3.53 million) will be living in fuel poverty by January 2023 [ 14 ]. Those at risk include large families, lone parents, and pensioner couples [ 15 ], with the elderly and children being most vulnerable to an increased risk of physical illness such as respiratory infections [ 16 ]. In addition, studies have found that economic hardships increase the prevalence of mental illness, including feelings of anxiety and depression [ 17 ]. The modest economic growth, the decline in real disposable income, and the slow recovery expectations will put more pressure on hospital admission from respiratory and mental illnesses.

To better understand the current cost of living crisis, the associated triggers, drivers, consequences and potential solutions, a rapid evidence review was undertaken between November 2022 and March 2023. This was a cross-organisation, multidisciplinary endeavour that brought together academics, researchers, clinicians, public health practitioners, and policymakers to develop a review that would be informative, useful and of value to the wider health and care system and their stakeholders.

Aims and objectives

The review aimed to provide a first narrative review of evidence relevant to the current CoL crisis and impact on our population health, wellbeing and related services.

The objectives of this evidence review were:

To explain the provenance of the current CoL crisis from a UK perspective including the causes, triggers, drivers, and consequences.

To map the short (1 – 2 months), mid- (3 – 6 months) and long- term (6 months plus) implications of the current CoL crisis on population health and wellbeing. These would be themed by physical health, mental health, wellbeing, education, environment, workforce, and wider health and care system pressures. It would also involve the identification of those most vulnerable to the cost-of-living crisis.

To describe how people change their behaviour or cope/respond to the current CoL crisis, how it impacts on their self-care (e.g., attending regular health checks or screening visits) and the longer-term implications of this behaviour change.

To describe some of the mitigation strategies or interventions that have been deployed to counter the negative impacts of the current CoL/economic crisis and their effects in the UK and key European counterparts, where available.

To describe the breadth of impacts on health and care system partners of the current CoL crisis.

Methodology

Search strategy.

The search strategy was based on the objectives of this review and cross-referenced with the search strategy adopted by UKHSA’s Library Services on CoL and poverty evidence reviews, conducted since November 2022. Studies published from 2020, which was the start of the coronavirus pandemic and unique set of circumstances culminating in the cost of living crisis, and up to and including the 2023 were reviewed.

Key themes were discussed with experts, such as respiratory consultants, to finalise the search strategy to ensure the search included key phrases.

The definition of the CoL crisis has been taken from the WHO which describes CoL as the decrease in real disposable income that people have been experiencing since late 2021. The key causes are high inflation overriding income and benefit increases, and, have been worsened by the COVID-19 pandemic, the war in Ukraine, disruption to global supply chains and the food and energy crises [ 2 ].

The keywords included: cost of living, population impacts, living cost, fuel poverty, poverty, mental health, physical health, wellbeing, education, work environment, ability to work, and ability to care. Full details of search strategy are included in Appendix 1 .

Selection methodology

Evidence identification, screening and extraction.

The selection criteria were structured around PICOS structure [ 18 , 19 ]:

All age groups impacted by the CoL crisis in the UK.

Intervention

Any strategies or interventions that have been used to mitigate the impacts of a CoL crisis to be presented by theme/topic, individual level e.g., reducing energy bills at home or changing food preparation patterns; community level e.g., provision of warm drinks at community centres for the elderly, economic/societal level e.g., energy payments for all households, etc. Could also present these at local/sub-regional, national levels.

All age groups that are used to compare with and against those most impacted by CoL (those most protected or least vulnerable to a financial crisis).

The primary outcomes includes a comprehensive tally of physical health (e.g., admissions, morbidity, mortality), Mental Health (e.g., anxiety, depression, injuries, suicide and self-harm), Wellbeing (e.g., social and economic insecurity, working additional jobs, reduced leisure time), educational attainment/school absenteeism, Environmental (e.g., pollution, housing conditions, infrastructure disruptions), workforce (inability to work due to sickness inability to care for family members) and Service pressures or impacts (e.g., lack of staff, lack of community based care or service provision).

Study design

Due to the specific nature of this CoL crisis and time restrictions, we reviewed all review study designs.

Inclusion criteria

UK-based studies only, due to the unique set of circumstances political policies and populations pertaining to the UK; review studies from the 1st of January 2020 up to include the 24th of February 2023. Including grey literature, such as reports from think tanks and charities, such as The Kings Fund [ 3 ] and the Joseph Rowntree Foundation [ 9 , 20 ].

Exclusion criteria

Non-UK based studies, specific study formats including letters to Editors.

Article review

From the search, excluding grey literature, 1,256 records were identified. The team extracted these titles/abstracts into Rayyan, an online software programme used for systematic literature reviews. The study team were then given individual access, with the ‘blind’ feature activated, allowing for independent assessments to be made of each article and corresponding eligibility for inclusion into this evidence review. The initial abstract review was undertaken by two members of the study team, with 50% of articles assessed by at least two members of the team – any discrepancies were discussed and a mutual decision made. Following abstract review, the full text screen was divided into topic areas where two team members reviewed each paper for suitability. As previously, any discrepancies were discussed and a mutual decision made. Each extracted article, regardless of relevance or quality, underwent initial screening to determine relevance to the review topic. Figure  3 details the process for inclusion of studies.

figure 3

PRISMA flowchart showing inclusion of studies into the study review process through Rayyan including identification, screening and final, included articles

Quality assessment methodology

Forty-one studies were included in the full text review. Suitable studies (with interventions) were appraised for quality by a primary reviewer and, to ensure robustness, 50% of these were appraised by a second reviewer. Study quality (cross-sectional, case–control, cohort or qualitative) was assessed using the Newcastle Ottawa Scale (NOS) adapted to consider key areas: selection (representativeness of the sample, sample size, non-responders and exposure details); comparability (is confounding considered) and outcome (blinding, recording and statistical test used). Whilst there are a myriad range of assessment tools available, the NOS has been endorsed by the Cochrane Collaboration to assess quality of research studies [ 18 ].

Three studies were eligible for scoring, the results are detailed in Table  1 . Eligibility for scoring was based on whether an intervention was evaluated as part of the study – those that described an intervention were considered for scoring.

The results are presented by the five objectives outlined in the methodology. Table 2 summarises the 26 papers identified as part of our review process and Table  3 describes the grey literature used.

Current CoL crisis

We have addressed objective 1 of the evidence review (describe the current CoL, including the causes, triggers, and drivers of economic instability by internal and external shock factors) as part of the introduction of this report and cited findings from the World Health Organisation [ 2 ], the Bank of England [ 11 ] and the Institute for Health Equity [ 14 ]. Six (out of twenty-six) peer-reviewed papers from the evidence review were also used to gather evidence and establish a baseline understanding of the current CoL crisis.

Short, mid and long term implications

The review mapped health and wellbeing outcomes using evidence published from six (out of twenty-six) peer-reviewed papers from the evidence review and findings from the World Health Organisation [ 2 ], the King’s Fund [ 3 ], the Joseph Rowntree Foundation [ 9 , 20 ] and Public Health Wales [ 13 ]. A summary of the findings from our reading across papers and grey literature, as well as discussions with our expert advisory panel, on relatable health outcomes is shown in Table  4 and are themed by type of impact (environmental impacts, mental health, physical health and service pressures/impact areas), by time (immediate 1–2 months, intermediate 3–6 months and longer-term 6 months and over) and populations at risk.

The review found that the strongest evidence for the impact of a CoL crisis, particularly from living in cold homes, was on acute hospital admissions due to respiratory distress or illnesses and in particular, affected the very young (children aged 0–4 years) or the elderly (75 + years) [ 13 , 16 , 29 , 33 ]. It is also anticipated that in 2023, a further 500,000 children across England will fall below the UK poverty line [ 33 ] with families struggling to buy essential items like food and clothing [ 34 ]. Increases in the cost of energy and food would result in families choosing between energy dense foods vs. more costly healthier food options [ 30 ]. The CoL crisis could widen socioeconomic inequalities in obesity by affecting disadvantaged families and communities at an existing risk of obesity [ 30 ]. Specifically concerning in younger children are issues related to living in a cold home – including unsafe sleep practices for children, reduced ventilation to keep ‘the heat in’, and living in areas where it is unsafe to open windows [ 35 ].

Behaviour change

Objective 3 of the evidence review was on the impact of the CoL crisis on health behaviours, how people cope or respond to a CoL crisis, and how it impacts on their self-care e.g., attending regular health checks or screening visits. Evidence from 3 (out of 26) peer-reviewed papers [ 32 , 36 , 37 ] from the evidence review and findings from Public Health Wales [ 13 ] informed our results. These were:

Reducing transport related costs associated with attending screening services and appointments may be effective as cost was a barrier for people accessing health and care services. Missing or delaying medical appointments will exacerbate physical and mental health illnesses and delay treatment.

Economic crisis was associated with a lower probability of drinking alcohol frequently and lower probability of being physically inactive.

Economic austerity was associated with increasing child poverty and poorer access and quality of services provided, particularly to children with physical disabilities.

Screening could be offered in acute care and community-based settings to address the social needs of vulnerable patients and families.

The Food Foundation has tracked food insecurity [ 38 ] and found that:

17.7% of households experienced food insecurity (moderate or severe) in January 2023, with 24.4% of households with children experiencing food insecurity.

3.2 million adults (6.1% of households) reported not eating for a whole day because they couldn’t afford food.

Key workers are more likely to be experiencing food insecurity.

Half of households on Universal Credit experienced food insecurity

Disability exacerbates food insecurity.

Non – white people more likely to experience food insecurity.

Mitigation strategies

Objective 4 of the evidence review was on potential interventions to address the CoL crisis at a population level. Nine (out of 26) peer-reviewed papers [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ] were included alongside evidence from the grey literature sources including the King’s Fund [ 3 ], Joseph Rowntree Foundation [ 9 ] and Public Health Wales [ 13 ].

Where possible, scoring of studies with an intervention were undertaken. Three studies were scored using the Newcastle Ottawa Scale (NOS) as detailed in Table  1 :

A summary of interventions that could be deployed to mitigate the effects of the CoL crisis is presented in Appendix 2 with most peer-reviewed publications focussing on mitigating the negative impacts on mental health. By theme and strength of evidence (where grading was possible), the key findings are:

Mental health

Strong evidence (based on systematic review and meta-analysis of results) to support the use of short-stay crisis units for people experiencing mental health crises.

Evidence showed that suicide risk assessment tools are deployed variably across 85 NHS mental health organisations with limited staff training. Study outcomes recommend standardisation of assessment tools and bespoke staff training in use and implementation, to help improve service and care provision for people attempting suicide or serious self-harm.

Despite strong study design, there was a lack of evidence for the effectiveness of specialist mental health day units compared to crisis teams which support people in crisis at home.

Similarly, there was weak evidence for the use of mental health units which act independently of emergency departments with some units experiencing lengthy stays in a setting which was designed for short stays.

Public Health Wales 2023 [ 13 ] related commissioned review recommends focussing on mental health and wellbeing support including suicide prevention campaigns (short term) and linking people with community support including voluntary and community sector (long term).

Physical health

Providing financial help and home improvements to those at risk of living in a cold home (increasing the warmth and/or energy efficiency of a home)

Preventing falls through exercise (strength training) and home safety assessments

Preventing the spread of respiratory viral infections maximising vaccination uptakes e.g., influenza vaccines, employers encouraging sick employees to stay at home, and providing handwashing advice.

Helping vulnerable individuals keep warm, particularly those experiencing homelessness.

Environmental (income support, energy relief, housing, food)

Public Health Wales recommend providing targeted support on energy bills and extending the Winter Fuel Support Scheme for all households and focusing on the elderly, the very young and people with disabilities or long-term health conditions.

Advising on modifying home energy use in the community e.g., best time of day to use appliances or monitoring use with a smart meter.

Extension of the council tax reduction scheme for tenants and households experiencing hardship

Provision of meal allowances and free school meals to all primary school children.

Supporting emergency schemes such as food banks and community groups which provide essentials of daily living (extend to community/faith groups).

Voluntary & community sector

Weak evidence for the use of individualised/bespoke advice on facilitating energy tariff switching, particularly in vulnerable communities (BAME, elderly over 75 years, and families with young children). Young families most likely to switch, elderly least likely due to apathy, lack of knowledge and scepticism.

Impact on system partners

The last objective of the evidence review aimed to summarise the impact of the CoL crisis on other partners in the health and care systems, such as the voluntary and community sector, fire and rescue service, military, police, and ambulance service. The results of the review (predominantly grey literature as well as discussions with our expert advisory panel) found the following impacts by different sectors as presented here:

Voluntary and community sector

There has been a reduction in voluntary services and community groups, particularly in deprived areas where the level of need is higher. This is largely driven by an increase in energy prices, consumable such as food, and an increase in fuel prices, and more expensive labour [ 48 ].

Reductions in charitable donations and volunteer time have been seen in charity settings with charities now responding more to crisis planning, including welfare and wellbeing support for people.

A decrease in the volume of food donated to food banks has resulted in limited supplies of food provisions against rising demand in the community [ 49 ].

The rate of closures and number of closures of charities was significantly higher in 2022 than in 2021, and simultaneous reduction in the resilience of the voluntary and charity sector in April 2023 compared with previous years [ 50 ]. This includes operating losses for large front-line charities.

There has been a reduction in number of volunteers as part time jobs [ 50 ].

Successes were seen, with services being continued, in charities providing hot meals to elderly residents and a scheme for free school meals provision during school holidays.

Providing safe, warm spaces by making use of local amenities have been successfully deployed in some areas (Wiltshire Community Foundation).

Increases in fuel theft and shoplifting (crime/policing) were noted, however, the Office for National Statistics reports that this increase could be due to improved recording processes and practices by police staff and expansion of recorded crime figures to include new offences [ 51 ].

Fire & rescue

Increased risk of fires as people try to heat their homes or find alternative and cheaper ways to light or heat their homes, for example, wood burner fires linked to chimneys not being swept [ 52 ].

Increased emergency admissions in A & E from burns as a result of alternative heating mechanisms used or unsafe practices, for example, plugging in an electric heater too close to flammable materials.

Data from the House of Commons [ 53 ] shows that a series of measures have been introduced to mitigate against the CoL increase for defence people, veterans and service families including subsidised accommodation charges at 1%, freezing food charges, increasing travel allowance, and providing additional wraparound childcare services.

This is one of the first narrative reviews of the published and grey literature from 2020–2023 to describe the breadth of impact of the current and unique CoL crisis on population health in the UK. The main findings of this report refer to the immediate impacts on population health and well-being, including physical, mental, and financial health. This paper sequentially assesses the literature to present mapped population impacts, individual and population behavioural responses to the cost of living crisis, and the system wide implications of these impacts. Since conducting our review Broadbent et al. [ 54 ] and Richardson et al. [ 55 ], have published work which also investigates the impact of the cost-of-living crisis on population health, which corroborate our findings. Our review was produced to help stakeholders and partners in the health and care sector to rapidly assimilate key information, knowledge, and evidence on the impacts of the cost of living and use it to inform, challenge, change, and drive local policies and practices on tackling this crisis.

The unique provenance of the cost of living

The COVID-19 pandemic, Brexit, and the Ukraine-Russia war have resulted in unique economic shocks in the UK with steep declines in GDP, reduction in disposable incomes, and increases in inflation from 2020 to 2023. The situation has been further compounded by public sector strikes, political instability, changing fiscal and energy policies, climbing interest rates, findings further corroborated by Broadbent and colleagues [ 54 ]. At a population level, the evidence reflects a reduction in spending power due to the rising costs of essentials such as food and medication, and basic utilities such as heating, electricity, and council tax [ 56 ]. Evidence from the grey literature, the Office of National Statistics, reports that from 17 to 29 May 2023, 7 in 10 adults reported an increase in their cost of living compared to the previous year, largely driven by food bills (95%), gas or electricity bills (73%) and fuel prices (39%) [ 31 ]. A reduction in a household’s spending power or income, is likely to have marked effects on health, as other longitudinal analyses and reports have purported [ 55 ].Our review highlights the unique provenance of the current cost of living crisis, and why it is markedly different and more serious compared to previous economic crises, both at a UK and global level.

The short, mid- and long-term impacts

Our review captures a breadth of physical and mental health conditions which can be affected by the CoL crisis in the short, mid and long term. In the short term, the strongest evidence was for the impact of CoL on housing, resulting in cold, damp, or mouldy homes, and the subsequent effect on the rate of respiratory conditions. These impacts are also more likely to affect those already vulnerable, such as those with chronic conditions, lone parents, multigeneration families, and children [ 13 , 16 , 29 , 33 , 57 ]. Another group vulnerable to the CoL impacts include key workers, those on universal credit, disabled and people from non-white ethnicities [ 16 , 21 , 31 ]. The July 2023 labour market figures form the ONS show that over 410,000 people were not actively seeking employment due to long-term sick leave [ 58 ]. In the longer term, increased morbidity rates and mortality rates from all-causes and cause-specific, such as respiratory and cardiovascular diseases, are expected with recent publications citing an increase in premature mortality by up to 6.4% and life expectancy to decrease by 0.9% [ 55 ].This has been demonstrated with official mortality rates in March 2023, which were 4.8% above the expected rate [ 59 ].

Behaviour changes because of the CoL crisis are likely to confound the issues that are affecting physical and mental health. Changes in food buying patterns, changes in the frequency and temperature to which homes are heated, and reduced physical activity levels can contribute to poor physical and mental health and impact wellbeing. Other impacts include the inability to afford travels costs to attend screening or hospital services or the reduction in community services such as community pharmacies [ 13 ]. This CoL crisis has had a negative impact on voluntary services and community groups. Charity and food donations have decreased, whilst the need for charity and food banks have exponentially increased. The Trussell Trust report that from March 2022-March 2023, they provided almost 3 million emergency food parcels, higher than during the pandemic and more than double the number in the same period 5 years prior [ 60 ], a finding further highlighted by Broadbent and colleagues [ 54 ].

What can be done to mitigate the impacts?

Our evidence suggests that financial help should be provided to those most at risk of living in a cold home because of the CoL crisis, such as lone parents, multigenerational families, and those living alone via targeted support for energy bills with a focus on those at risk from the CoL crisis [ 13 ]. In addition to these groups, Broadbent [ 54 ]and Richardson [ 55 ] also suggest focus on women, unemployed people and those who are living with a disability, as being most vulnerable to the cost of living crisis. Financial support could also be provided in terms of reduction of council tax, provision of universal free school meals [ 61 ], and bespoke advice on how to save energy when using appliances at home [ 13 ]. To mitigate against the effects of the CoL crisis on physical health, particularly from respiratory illness, evidence was suggestive of investing in-home improvements for those living in cold homes, strength training to reduce the risk of falls, and that flu vaccination uptake should be maximised to reduce the spread of influenza alongside good hand washing guidance [ 13 ]. Campaigns aimed at suicide prevention and linking people with community support may also benefit those with mental health illnesses and those who live alone. Our evidence also found that linking system partners across the health and social care arena and including community-based partners such as the voluntary, charity and faith sectors may collectively have better outreach and impact.

What are the strengths and limitations of this review?

The key strength of this review is the immediate availability of a succinct report which considers the volume of evidence, both published and grey, on the current cost of living crisis. The authors also expanded the original search to include mitigating actions, behaviours, and strategies, so that colleagues may benefit from evidence-based solutions that may work at a population level. We have attempted to synthesis the most recent evidence, to build a picture of why the current economic crisis is unique, and what that means for the population. As with all original reviews, there are several limitations to this work. Firstly, the review period covers 2020–2023, rather than considering the impacts of historic CoL crises on population health. Whilst more evidence on population health outcomes may be needed, the provenance of the current CoL crisis remains unique and warranted specific focus and attention, hence our selection of the time window for review. Secondly, we were not able to ascertain peer-reviewed literature on the impacts on system partners including Fire & Rescue colleagues as these data remain unpublished, anecdotal, and discussed in privileged meetings. However, as more evidence gets published through this crisis, we may consider updating our review in due course to reflect the published evidence. Another limitation is the lack of consideration for any positive impacts of a cost of living crisis, for example a reduced consumption of alcohol due to reduced affordability, reduced usage of public transport due to costs, and a reduction in air quality in major cities. Lastly, due to the time, resources and need for this review, it was conducted in a 3-month timeframe to be of immediate use, value, and impact for current system partners but may have introduced bias to our findings such as a publication bias due to the shorter timeframe [ 62 ]. However, to mitigate this, we have provided a detailed description of methods used including search strategies and discussed the implications of the chosen method in terms of bias. Should more time and resources be made available, future iterations of this review should consider the wider impacts of the CoL crisis at a personalised and individual level, and family and community level but also include different types of study designs rather than the focus on reviews alone in this rapid synthesis which may not fully capture data on the cost of living impacts.

At a population level, the current CoL affects everyone, but particularly exacerbates poorer physical and mental health outcomes in those already vulnerable in our society. Our review found that while the most vulnerable are people living alone, single parents and those living in multigenerational households, more can be done at a community and societal level to support and improve health outcomes. This review brings together the evidence to enable decision makers to act at the right time whilst targeting their resources at the right groups.

Availability of data and materials

All data used or analysed during this study are included in this published article and its supplementary information files.

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This work was undertaken and supported by the South West Critical Thinking Unit (NHS England) with collaboration and partner contributions from across the health and care sector including colleagues from NHS England, the Office for Health Improvement and Disparities, and the UK Health Security Agency. NK, GF, and JM were involved in the initial concept, design, and development of the protocol. CDB and JH devised the search strategy and RC helped with theme development. GF, JM, and MM completed the abstract review, and GF, JM, MM, OB, and AA conducted the full text screening. JM and GF wrote the main manuscript text. NK, GF, JM, AA, OB, MM, JH, CDB and RC contributed to the manuscript development and multiple draft versions before finalising. No further funding or commissions to declare.

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Appendix 1. Search Strategy. Appendix 2. Interventions to mitigating the impacts of the CoL crisis.

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Strategies for engaging older adults and informal caregivers in health policy development: A scoping review

  • Opeyemi Rashidat Kolade 1 , 2 ,
  • Joshua Porat-Dahlerbruch 1 , 3 ,
  • Rustem Makhmutov 1 , 4 ,
  • Theo van Achterberg 2 &
  • Moriah Esther Ellen   ORCID: orcid.org/0000-0001-7127-7283 1 , 5  

Health Research Policy and Systems volume  22 , Article number:  26 ( 2024 ) Cite this article

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Care for older adults is high on the global policy agenda. Active involvement of older adults and their informal caregivers in policy-making can lead to cost–effective health and long-term care interventions. Yet, approaches for their involvement in health policy development have yet to be extensively explored. This review maps the literature on strategies for older adults (65+ years) and informal caregivers’ involvement in health policy development.

As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute’s methodology. Published and grey literature was searched, and eligible studies were screened. Data were extracted from included studies and analysed using the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare.

A total of 13 engagement strategies were identified from 11 publications meeting the inclusion criteria. They were categorized as “traditional”, “deliberative” and “others”, adopting the World Bank’s categorization of engagement methods. Older adults and informal caregivers are often consulted to elicit opinions and identify priorities. However, their involvement in policy formulation, implementation and evaluation is unclear from the available literature. Findings indicate that older adults and their informal caregivers do not often have equal influence and shared leadership in policy-making.

Although approaches for involving older adults and their informal caregivers’ involvement were synthesized from literature, we found next to no information about their involvement in policy formulation, implementation and evaluation. Findings will guide future research in addressing identified gaps and guide policy-makers in identifying and incorporating engagement strategies to support evidence-informed policy-making processes that can improve health outcomes for older adults/informal caregivers.

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Introduction

One in six people worldwide will be over 65 years in 2050 [ 1 ]. Ageing is correlated with increased multimorbidity and chronic health needs. This is burdensome to older adults and their informal caregivers and significantly increases health and social care service utilization [ 2 , 3 ], and the complexity of health and long-term care needs. Informal caregiving and care for older adults have become critical issues of public policy. Informal caregivers of older adults are the mainstay of support for older adults with chronic health conditions [ 4 ]. Furthermore, they are potentially at risk for adverse effects on their health and well-being, quality of life and economic security [ 5 ]. Therefore, health policy decisions are relevant to older adults and their informal caregivers and impact the healthcare system, highlighting the need to develop responsive health policies [ 6 , 7 , 8 ]. One approach to efficacious health policy development is citizen engagement [ 9 ].

When citizens are engaged in policy development, policy-makers are better aware of needs and outcomes affecting the target population [ 8 ]. Citizen engagement in policy-making can improve instrumental (designed to improve the quality of decision-making), developmental (intended to improve knowledge and capacity of the participants) and democratic (intended to meet transparency, accountability, trust and confidence goals) outcomes [ 10 , 11 , 12 ]. As such, involving older adults and their informal caregivers in health policy development improves the legitimacy and transparency of the health policy-making process and can also lead to carefully crafted, relevant policies that improve cost–effective healthcare and long-term care interventions [ 8 , 13 , 14 ]. However, informal caregiver and older adult input in health policy development is limited, and little is known about strategies to engage them in developing policies affecting their lives [ 15 , 16 ]. Most previous research on engagement at the policy level focuses on the general population, which does not often reflect older adults’ unique and complex social and healthcare needs [ 17 ]. Policy-making would benefit from older adult and informal caregiver perspectives, as their involvement has been shown to improve policy sustainability and outcomes [ 6 ]. Finally, tangible public health outcomes emerge when active citizen participation in decision-making is promoted [ 18 ].

Engaging older adults in health policy development holds substantial public health implications, affecting diverse aspects of healthcare. This impact spans from individual older adults and informal caregivers to the broader societal level, influencing healthcare systems, policies, emerging technologies, healthcare innovation and the overall quality of care. Participation in shaping solutions and emerging health technologies enables the creation of practical and effective solutions alongside those experiencing the issues. For instance, employing collaborative methods such as creative workshops and dilemma games fosters active involvement in co-developing health technologies [ 19 ]. Similarly, involvement methods such as patient journey mapping, surveys, workshops, expert panels, user boards, public and patient involvement (PPI) conferences, Delphi methods, living laboratories for technology innovation, stakeholder activities and patient interviews have been employed in the co-development of health services [ 20 ].

Most existing research focuses on citizens’ engagement in research. For example, engaging older adults as partners in transitional care research, engaging patients in health research and engaging older adults in healthcare research and planning [ 21 , 22 , 23 , 24 , 25 ]. Previous research has also focused on involvement of older adults/informal caregivers in healthcare decision-making [ 26 , 27 ] as opposed to older adult/informal caregiver engagement in health policy development. There are a few examples of older adult and informal caregiver engagement in health policy development [ 17 , 28 , 29 ]. However, these works include no overview nor synthesis of methods for engaging older adults and informal caregivers in health policy development. More information on strategies for their engagement is necessary to promote older adult and informal caregiver engagement in health policy development and improve outcomes linked to health policy. This review aims to provide a foundation for older adult and informal caregiver engagement in health policy development by providing an overview of available research evidence on strategies for their engagement in health and well-being policy development. The scope of this study is thus focused specifically on exploring older adult and informal caregiver involvement in government policy development rather than involvement in individual care/healthcare decision-making, and organizational governance/policy-making.

Using the Joanna Briggs Institute (JBI) methodology, we gathered evidence on engagement strategies for older adults and informal caregivers in health policy development, and identified and analysed knowledge gaps [ 30 ]. A scoping review protocol was developed to guide the study [ 31 ]. Data analysis was guided by the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare by Carman et al. [ 32 ] (Additional file 1 : Appendix S1), which was influenced by Arnstein’s ladder of participation [ 33 ]. The multidimensional framework describes a continuum of engagement (consultation, involvement and partnership/shared leadership) across three levels of the healthcare system (individual care, organizational governance and government policy) and describes factors influencing engagement. This study derives the basis for analysis from the following elements adapted from the framework: the engagement continuum (consultation, involvement, partnership/shared leadership), the level/stage of government policy (agenda setting, policy formulation, policy implementation, policy evaluation) and factors influencing policy-makers to create involvement opportunities, all described in data charting section below. Finally, we were interested in synthesizing data on reported outcomes of engagement.

There are a plethora of potentially relevant frameworks, theories and conceptualizations related to citizen engagement, such as Arnstein’s ladder of citizen participation and the International Association for Public Participation (Iap2) models, among others [ 33 , 34 , 35 , 36 , 37 , 38 ]. However, for this study, we opted for the Multidimensional framework by Carman and colleagues. This choice was based on its ability to illustrate different levels of the healthcare system where patients and families can be engaged, a fundamental aspect of our study.

Search strategy and selection criteria

An initial search of two online databases (PubMed and Embase) was conducted. We analysed the keywords in the title and abstract of retrieved papers and the index terms used to describe the articles. A second search used all identified keywords and index terms across all relevant databases: Health Systems Evidence, Health Evidence, CINAHL, PubMed, and Embase. Thirdly, the reference lists of identified reports and articles were scanned for additional sources. We worked with three librarians for search terms and search strategy refinement. We searched grey literature (Participedia.net and Google) using a combination of indexing (Mesh) terms and the following search key words: (older adult OR aged OR senior) AND (patient participation OR empowerment OR deliberation OR activation) AND (health policy OR Advisory committee OR policy formulation; Additional file 2 : Appendix S2). We refined search results from Participedia.net by using filters relating to health and well-being.

Search results were imported into EndNote 20 for de-duplication, then into an online systematic review software, Covidence ( www.covidence.org ). Titles and abstracts were screened to determine eligibility for full-text review. Results from the grey literature were screened by reading the titles and summaries. All five research team members screened a sample together for eligibility and discussed any doubts and differences. Then all titles and abstracts were screened independently by at least two team members. Disagreements were discussed and resolved through discussion or involving a third team member, and a consensus was reached.

Titles and abstracts of empirical studies, reviews and grey literature reports were included for full-text review if they reported on policy development in the areas of health and well-being, addressed the use or evaluation of a method for engaging older adults and/or informal caregivers in health and well-being policy development, focused on older adults (defined as persons with a minimum age of 65 years; a majority of participants were aged 65 years and above) and/or their informal caregivers, or used proxy words (such as chronically ill, dementia and frail elderly), and addressed policy development at regional, national or international level. In the screening of titles and abstracts, we specifically sought studies that identified participants as either older adults aged 65 years and above, informal caregivers or a combination of both. For full-text screening, we checked for the actual ages and percentage of participants aged 65 years and above. Studies that only included participants younger than 65 years were excluded. Articles with a majority of 65 years and older were included. Corresponding authors of full-text articles were contacted for clarity when the sample population was unclear. Articles were not included in this review when there was no response.

Empirical studies, reviews and grey literature reported in all languages and from the databases’ inception were included. Titles and abstracts of included studies in languages other than English were first screened by a colleague able to read the applicable language to decide on its relevance for extraction. Studies describing older adult and informal caregiver engagement in research or in healthcare decision-making were excluded. We excluded articles describing engagement for organizational governance/policy development. Studies that involved heterogeneous population groups (for example, older adults/informal caregivers and health workers, or government representatives) were excluded. Finally, studies whereby we could not access the full texts were excluded.

Data charting

Based on the elements of the multidimensional framework for patient and family engagement in health and healthcare [ 32 ], a preliminary data charting table (Additional file 3 : Appendix S3) was developed and piloted by two team members who also extracted the data. In case of discrepancies, a third team member reviewed for extraction agreement. Data charting followed the following elements – continuum of engagement, stages of government policy development and factors influencing policy-makers to create engagement opportunities. Additionally, data were extracted on outcomes of engagement which we defined as the result of engaging older adults in health policy development.

The engagement continuum is categorized based on how much information flows between parties (policy-maker and citizens), and the level of influence citizens have over decision-making ranging from limited participation, or degrees of tokenism, to a state of collaborative partnership in which citizens share leadership or control decisions. The engagement continuum, according to Carman et al., includes consultation (eliciting opinions about health issues), involvement (when research recommendations influence policy) and partnership/shared leadership (when citizens and policy-makers share equal power and responsibility in decision-making) [ 32 ].

Levels of engagement in the framework was modified to “levels/stages of policy development” since we were particularly focused on engagement in policy development. We focused on these stages of the policy cycle: agenda setting (identifying priorities, recognition of issues as a problem demanding public attention), policy formulation (developing and refining policy options for government), policy implementation (activities taken to achieve goals stated in policy statement) and policy evaluation (examination of the effects ongoing policies and public programs have on their targets in terms of the goals they are meant to achieve) [ 39 ]. Factors influencing engagement were modified to factors influencing policy-makers to create opportunities for engagement, as this was a gap in the framework this review set out to fill to build on the framework.

Study selection

The published and grey literature search yielded 10 921 publications. After removing duplicates, 7486 articles were included for the title and abstract screening. We excluded 7385 articles for irrelevance. Altogether, 101 articles were assessed for full-text eligibility, 90 articles were excluded and data were extracted from 11 publications (Fig.  1 ). We identified the engagement methods in the relevant articles and described how they were used to engage participants in health policy development. Then, we interpreted these findings on the basis of the elements in the framework.

figure 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram showing article selection process

Study characteristics

The studies included were conducted in countries in North America [ 40 , 41 , 42 ] ( n  = 3), Europe [ 17 , 43 , 44 , 45 ] ( n  = 4), Australia [ 46 , 47 , 48 ] ( n  = 3) and Asia [ 29 ] ( n  = 1). Publication dates of included studies ranged from 1997 to 2021. The design of the studies included a multi-method design [ 45 ] ( n  = 1), qualitative designs [ 17 , 29 , 40 , 41 , 42 , 43 , 46 , 47 ] ( n  = 8), a quantitative design [ 48 ]) ( n  = 1) and a case study design [ 44 ] ( n  = 1; Table  1 ). About half of the studies [ 17 , 41 , 44 , 45 , 47 , 48 ] ( n  = 6) involved both older adults and their informal caregivers. Four studies [ 40 , 42 , 43 , 46 ] involved only older adults, and one study [ 29 ] involved only informal caregivers in health policy development. A wide range of older adults (people with chronic illnesses, dementia, complex health and social needs, and home-bound older adults) and their informal caregivers were included in the studies. Finally, some engagement strategies were implemented as a one-time event, while others were ongoing or continued for a longer period of time.

Engagement strategies

A total of 13 unique engagement strategies were reported across the 11 included articles. We adopted the World Bank Groups’ categorization of citizen engagement being traditional consultation and feedback mechanisms, participatory mechanisms and citizen-led mechanisms [ 49 ]. For this review, we slightly adjusted these categories to traditional strategies, deliberative strategies, and other strategies (see Additional file 4 : Appendix S4 for definition of terms). Traditional engagement strategies (interviews, surveys, focus groups, workshops, telephone conferencing) were categorized as such, as they are commonly used strategies not unique for engagement (for example, also used for research purposes) and generally designed to measure the prevalence and range of opinions and not their stability or depth [ 50 , 51 ]. Deliberative strategies (citizen juries, citizen panels, community juries, policy cafĂ© and carers assembly) were thus categorized, as they highlight participants’ prior education on the topic of discussion (for example, using citizen briefs and expert witnesses), thus eliciting informed views and perspectives on complex topics [ 50 ]. The “other strategies” category under which we classified a discrete choice experiment and two visual engagement strategies (photo elicitation and photovoice and audio recording) were so categorized under a general heading “other engagement strategies”, as they did not fit into the traditional or deliberative categories.

Traditional engagement strategies only ( n  = 5) were reported in four articles [ 42 , 44 , 45 , 47 ], deliberative strategies only ( n  = 4) were reported in three articles [ 17 , 41 , 46 ], one article reported using one deliberative method and two traditional methods [ 29 ], and the remaining three articles [ 40 , 43 , 48 ] reported “other” engagement strategies. The strategies engaged participants in a wide range of health policy issues, most of which related to older adults. One article used carers assembly to engage caregivers of people with dementia to discuss issues of concern to them and to identify priorities to bring to policy-makers about to make important legislative decisions on the future provision of home care in Ireland [ 17 ]. Traditional engagement strategies were used to engage participants on recommendations for improving care for people with chronic illnesses (semi-structured interviews), priorities for older adults with multiple long-term conditions (survey, interview, workshop), quality of life and care in nursing homes, medication reimbursement (focus group, telephone interview), eldercare and informal caregiver policy (policy cafĂ© and carers assembly) and health-related concerns of homebound people (survey, interview, group discussion, telephone conferencing). Deliberative methods were used to engage participants on government-funded mammography screening (community jury), long-term care provision (citizen jury with interview and focus group), post-diagnosis support/home care legislation (policy cafĂ© and carers assembly) and hospital-to-home care transitions (citizen panels). Finally, other methods engaged participants in consumer-directed care (discrete choice experiment), age-friendliness of a rural community (photo-elicitation) and improving neighbourhood food and physical environment (photovoice and audio recording). Table 2 presents a summary of the engagement strategies, their descriptions and examples of health policy issues addressed.

Synthesis of result according to Carman et al. ’s framework

Continuum of engagement.

Identified engagement strategies varied in the level of influence (engagement continuum) participants had, with no clear relationship between engagement approach and continuum of involvement. In all, 4 of the 11 included articles reported engagement approaches on the lower end of the engagement continuum (that is, views on and experiences with a health issue were elicited [ 45 , 46 , 47 , 48 ]. Six articles [ 17 , 29 , 40 , 41 , 42 , 43 ] reported engagement approaches best situated in between the consultation and involvement continuum (that is, in addition to simply eliciting views and experiences, participants’ opinions were used for advocacy, development and presentation of research evidence and policy recommendations to policy-makers). This is a newly added component to the Framework. Finally, one article [ 44 ] reported engagement strategies with characteristics fitting the involvement continuum (that is, older adults’ inputs to contributed to changes in service provisions). No article reported engagement strategies reflecting participants’ involvement on the highest end of the continuum (partnership/shared leadership; Fig.  2 ). The level of power and decision-making authority that older adults and informal caregivers had was not a function of the engagement approach/category. Thus, it was impossible to establish a clear relationship between individual engagement approaches/the category they belong to, and the engagement continuum. For example, three unique traditional engagement strategies (interviews, surveys, and workshops) belonged to the consultation continuum, thus indicating that older adults/caregivers involved using those approaches had a lower level of power in decision-making. Contrastingly, another article described similar traditional engagement strategies (survey, interviews, group discussions and telephone conferencing), but older adult and informal caregivers involved had a higher level of influence in decision-making (involvement continuum) as shown in Table  3 .

figure 2

Distribution of studies ( n  = 11) over the continuum of engagement

Stages of policy development

Regarding the stages of policy development, none of the 11 studies described older adults and their informal caregivers’ involvement beyond the agenda/priority-setting stage of policy development. Their role in the process of policy formulation, implementation and evaluation was not clear. Most of the studies reported participant involvement in identifying health priority issues or care needs and examining how citizen involvement can be actualized. Also, no studies reported on factors influencing policy-makers to create engagement opportunities.

Outcomes of engagement

Of the 11 studies, 8 reported on outcomes of older adult/informal caregiver engagement in policy development. Outcomes reported in the studies included but were not limited to developmental outcomes (civic education of citizens, citizens’ developed capacity to participate in public policy issues) [ 29 , 45 , 46 ] and instrumental outcomes (promotion of active citizenship and awareness of lived experiences of other older adults) [ 17 , 29 ]. Other outcomes included increased health and information access, quality of life and self-esteem of participants [ 44 ]; provision of reform solutions [ 47 ]; and priorities for policy-makers [ 17 ]. Finally, some engagement strategies were reportedly used in isolation [ 41 , 43 , 46 , 47 , 48 ], while others were combined with one [ 17 , 40 , 42 , 45 ] or more than one [ 29 , 44 ] engagement method.

This review synthesized existing literature on strategies for engaging older adults and informal caregivers in health and well-being policy development. Findings suggest that, although older adults and informal caregivers were consulted for identifying priorities and to elicit their opinions on health issues, they were rarely engaged in the actual processes of policy formulation, implementation and evaluation. They also rarely had shared leadership and decision-making authority. None of the included studies provided data on factors influencing policy-makers to create engagement opportunities and data on comparisons of alternative engagement strategies for variation, content, breadth and depth of participants’ input.

Our categorization of engagement methods into “traditional”, “deliberative” and “others” is in line with previous research suggesting the same. For example, the World Bank categorized engagement mechanisms as traditional and consultative feedback mechanisms (including surveys and focus groups), participatory mechanisms and citizen-led mechanisms. Similarly, approaches such as citizen juries, community juries, citizen panels and policy cafĂ©s have been described as deliberative engagement methods in previous literature, usually characterized by the presenting research evidence or using expert witnesses to educate lay citizens to make reasoned and informed judgement on complex issues [ 17 , 50 , 52 , 53 ]. Finally, photovoice and audio-recording and photo elicitation, categorized under the other category with the discrete choice experiment, have been described in previous research as visual research methodologies [ 54 , 55 ].

Furthermore, findings from this review indicate that the engagement of older adults in policy-making often relies solely on consultation approaches [ 15 ] and takes place at the beginning stages of the policy cycle through older adult and informal caregiver consultation and priority identification. However, meaningful participation involves stakeholders in all stages of the policy cycle. This includes research, data collection, priority setting, policy formulation, budgeting, implementation and review and evaluation [ 15 , 56 ]. Thus, future research can be conducted to increase our understanding of older adult and informal caregiver involvement in the higher end of engagement continuum as well as how or when in the policy cycle/process they are involved.

Most of the engagement strategies reported in this review involved participants directly and not through advisory bodies or organizations of older persons, although some collaborations and partnerships with other stakeholders were necessary in some cases to reach the older adults and their informal caregivers [ 17 , 40 , 43 , 44 ]. Also worthy of note is the fact that leveraging on partnerships, institutionalizing engagement and community-based partnerships is critical to enabling desired engagement outcomes [ 12 , 40 , 43 , 44 ]. Finally, the literature on engagement strategies for other populations can be useful to inform future empirical work on engagement strategies for older adults aged 65 years and above. These strategies include the participatory theatre approach [ 57 ], concept maps [ 58 ], deliberative polling and citizen dialogues [ 59 ].

Although our research focuses solely on identifying literature that describes the use and evaluation of older adults and informal caregivers involvement approaches, we recognize that older persons or informal caregivers’ participation in policy-making can take place both in individual and collective settings [ 60 ]. Thus, there may be other engagement approaches that accommodate older adults and informal caregivers in group settings with other stakeholders and not as the sole participants, for example, public consultations on the living conditions of seniors which involved older adults, representatives of health and social services, and elected members of city councils [ 61 ]. The choice of engagement approach may be dependent on existing policy processes within a particular setting, for example, senior councils in Europe for supporting local political decision-making. Also, Keogh and colleagues [ 17 ] designed innovative methods for involving people with dementia in policy development, using a world cafĂ© methodology and citizen assembly model commonly implemented in Ireland [ 17 , 62 ].

The evaluation of engagement methods has been minimal. Understanding the effectiveness of engagement strategies is fundamental to informing the design of successful engagement and reaching the full potential of engagement [ 16 , 63 , 64 , 65 ]. This review discusses existing engagement strategies, but it does not address which may be most effective for older adults and informal caregivers based on the context/health system. One of the excluded studies (on the basis of the age criterion) reported on the evaluation of engagement strategies. Two deliberative methods of public participation – the citizens’ workshop and the citizens’ jury – were evaluated. The evaluation of the methods was based on process and outcome evaluation measures [ 66 ], and found that both methods were not rated significantly differently by the participants on most criteria, thus, signalling an overlap in the impact and utility of the two methods of deliberation. There is need for more studies on the evaluation of engagement strategies for involving older adults 65 years and older and their informal caregivers in health policy development.

Having established that research is needed around the evaluation of engagement methods, we also need to provide the older adults and informal caregivers with the necessary skills needed to educate themselves about the process of policy-making as well as advocacy training. Engaging them in advocacy has the potential to achieve better local policy outcomes [ 40 ]. For example, one excluded study (on the basis of the age criterion) reported the evaluation of a senior civic academy (SCA) methodology: a self-advocacy course that simultaneously educates older residents about policy-making processes and engages them in advocacy training to incorporate their voices in local policy and planning. A pre- and post-program evaluation, as well as follow-up interviews, were conducted [ 67 ]. The study reported the efficaciousness of the methodology in engaging older adults. Advocacy training can be provided for older adults and informal caregivers on advocating for policy changes. Training components may include building a case for change, identifying potential allies and resources, and role-playing scenarios targeting local policy-makers [ 40 ]. Finally, civil society organizations and older adult organizations also play a role in building the skills of older persons to engage in advocacy with governments, thus creating a space for them to tell their own stories from their perspectives to inform policy-making [ 56 ].

Strengths and limitations

This is the first attempt we can identify to synthesize evidence on strategies for engaging older adults and informal caregivers in health policy development. We used the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare to guide data extraction and analysis, thus providing a theoretical contribution to the literature.

Some limitations were, however, identified. First, although the review was not sufficient to provide information to build on the framework (for example, it was not clear how or whether older adults and their informal caregivers are involved in all the stages/cycle of policy development; also no factors influencing policy-makers to create opportunities for involvement were identified), gaps in the literature were identified, providing direction for future studies. Secondly, due to the ambiguity and heterogeneity of terminology for engagement, the search string for this review, although built with the help of librarians, may not have identified all relevant published and grey literature. Quality appraisal, which is an evaluation of the quality of the included publications, was not performed, since our objective was to identify and describe the range of literature available on the topic without excluding studies on the basis of methodological quality. Furthermore, our intention was to provide a comprehensive overview of the field rather than to evaluate the quality of individual studies. Also, quality appraisal is not required in scoping review methods. Finally, our research focused solely on engagement approaches that were used exclusively for older adults and informal caregivers; thus, we may have missed out on publications reporting approaches that include other citizens and stakeholders alongside older adults and informal caregivers.

Implications for future research and policy

An examination of the existing literature points to a dearth of literature on the use and evaluation of engagement strategies for older adults aged 65 years and above and their informal caregivers. Implications for future research include understanding different healthcare systems and contexts in which these methods were used, understanding factors influencing policy-makers to create engagement opportunities for them and researching methods for evaluating and assessing engagement strategies for variation, content, breadth and depth of participants’ input.

Policy-makers can learn from the findings of this review by understanding how older adults and informal caregivers can be involved in policy process using the identified approaches. Engaging older adults and their informal caregivers in health policy formulation, implementation and evaluation beyond just consultations and tokenism [ 33 ] but also, in the continuum of involvement and partnership/shared leadership, requires a concerted effort of all stakeholders, including researchers, policy-makers, older adults’ representative organizations and older adults and their informal caregivers.

The analysis shows a dearth in literature on the use and evaluation of strategies for engaging older adults and informal caregivers in health policy development. The small number of studies reviewed could indicate a need to further explore older adult and informal caregiver involvement in collective settings including other stakeholders. Finally, this review highlights gaps in strategies for involving older adults and informal caregiver, and provides relevant information to enable policy-makers to make evidence-informed and responsive policy decisions, thus improving health outcomes.

Availability of data and materials

All data are publicly available and included within the article and its supplementary information files.

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Acknowledgements

The authors wish to acknowledge Thomas Vandendriessche and Chayenne Van Meel, librarians at KU Leuven and Ruth Suhami, a librarian at Tel-Aviv University.

This work was supported by the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No. 812656. The sponsors had no role in the project.

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Opeyemi Rashidat Kolade, Joshua Porat-Dahlerbruch, Rustem Makhmutov & Moriah Esther Ellen

Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium

Opeyemi Rashidat Kolade & Theo van Achterberg

Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA

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Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany

Rustem Makhmutov

Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

Moriah Esther Ellen

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Contributions

The authors confirm that study conception and design was by ME and TvA. OK prepared the initial draft of the manuscript with substantial contributions from JP-D. RM performed a secondary review of full-text articles. OK developed the data extraction instrument. OK and RM performed the piloting of the data extraction instrument. All authors contributed to the title and abstract article screening and data analysis, reviewed the results and approved the final version of the manuscript.

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Correspondence to Moriah Esther Ellen .

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Ethical review is not required, as the scoping review is a form of secondary data analysis that synthesizes data from publicly available sources.

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Supplementary Information

Additional file 1: appendix s1..

A Multidimensional Framework for Patient and Family Engagement in Health and Healthcare by Carman et al. [ 25 ].

Additional file 2: Appendix S2.

Search strategy.

Additional file 3: Appendix S3.

Data charting table.

Additional file 4: Appendix S4.

Definition of terms.

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Kolade, O.R., Porat-Dahlerbruch, J., Makhmutov, R. et al. Strategies for engaging older adults and informal caregivers in health policy development: A scoping review. Health Res Policy Sys 22 , 26 (2024). https://doi.org/10.1186/s12961-024-01107-9

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Received : 25 April 2023

Accepted : 12 January 2024

Published : 19 February 2024

DOI : https://doi.org/10.1186/s12961-024-01107-9

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