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• 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.

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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.

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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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How To Write An A-Grade Literature Review

3 straightforward steps (with examples) + free template.

By: Derek Jansen (MBA) | Expert Reviewed By: Dr. Eunice Rautenbach | October 2019

Quality research is about building onto the existing work of others , “standing on the shoulders of giants”, as Newton put it. The literature review chapter of your dissertation, thesis or research project is where you synthesise this prior work and lay the theoretical foundation for your own research.

Long story short, this chapter is a pretty big deal, which is why you want to make sure you get it right . In this post, I’ll show you exactly how to write a literature review in three straightforward steps, so you can conquer this vital chapter (the smart way).

Overview: The Literature Review Process

• Understanding the “ why “
• Finding the relevant literature
• Cataloguing and synthesising the information
• Outlining & writing up your literature review
• Example of a literature review

But first, the “why”…

Before we unpack how to write the literature review chapter, we’ve got to look at the why . To put it bluntly, if you don’t understand the function and purpose of the literature review process, there’s no way you can pull it off well. So, what exactly is the purpose of the literature review?

Well, there are (at least) four core functions:

• For you to gain an understanding (and demonstrate this understanding) of where the research is at currently, what the key arguments and disagreements are.
• For you to identify the gap(s) in the literature and then use this as justification for your own research topic.
• To help you build a conceptual framework for empirical testing (if applicable to your research topic).
• To inform your methodological choices and help you source tried and tested questionnaires (for interviews ) and measurement instruments (for surveys ).

Most students understand the first point but don’t give any thought to the rest. To get the most from the literature review process, you must keep all four points front of mind as you review the literature (more on this shortly), or you’ll land up with a wonky foundation.

Okay – with the why out the way, let’s move on to the how . As mentioned above, writing your literature review is a process, which I’ll break down into three steps:

• Finding the most suitable literature
• Understanding , distilling and organising the literature
• Planning and writing up your literature review chapter

Importantly, you must complete steps one and two before you start writing up your chapter. I know it’s very tempting, but don’t try to kill two birds with one stone and write as you read. You’ll invariably end up wasting huge amounts of time re-writing and re-shaping, or you’ll just land up with a disjointed, hard-to-digest mess . Instead, you need to read first and distil the information, then plan and execute the writing.

Step 1: Find the relevant literature

Naturally, the first step in the literature review journey is to hunt down the existing research that’s relevant to your topic. While you probably already have a decent base of this from your research proposal , you need to expand on this substantially in the dissertation or thesis itself.

Essentially, you need to be looking for any existing literature that potentially helps you answer your research question (or develop it, if that’s not yet pinned down). There are numerous ways to find relevant literature, but I’ll cover my top four tactics here. I’d suggest combining all four methods to ensure that nothing slips past you:

Method 1 – Google Scholar Scrubbing

Google’s academic search engine, Google Scholar , is a great starting point as it provides a good high-level view of the relevant journal articles for whatever keyword you throw at it. Most valuably, it tells you how many times each article has been cited, which gives you an idea of how credible (or at least, popular) it is. Some articles will be free to access, while others will require an account, which brings us to the next method.

Method 2 – University Database Scrounging

Generally, universities provide students with access to an online library, which provides access to many (but not all) of the major journals.

So, if you find an article using Google Scholar that requires paid access (which is quite likely), search for that article in your university’s database – if it’s listed there, you’ll have access. Note that, generally, the search engine capabilities of these databases are poor, so make sure you search for the exact article name, or you might not find it.

Method 3 – Journal Article Snowballing

At the end of every academic journal article, you’ll find a list of references. As with any academic writing, these references are the building blocks of the article, so if the article is relevant to your topic, there’s a good chance a portion of the referenced works will be too. Do a quick scan of the titles and see what seems relevant, then search for the relevant ones in your university’s database.

Method 4 – Dissertation Scavenging

Similar to Method 3 above, you can leverage other students’ dissertations. All you have to do is skim through literature review chapters of existing dissertations related to your topic and you’ll find a gold mine of potential literature. Usually, your university will provide you with access to previous students’ dissertations, but you can also find a much larger selection in the following databases:

• Open Access Theses & Dissertations
• Stanford SearchWorks

Keep in mind that dissertations and theses are not as academically sound as published, peer-reviewed journal articles (because they’re written by students, not professionals), so be sure to check the credibility of any sources you find using this method. You can do this by assessing the citation count of any given article in Google Scholar. If you need help with assessing the credibility of any article, or with finding relevant research in general, you can chat with one of our Research Specialists .

Alright – with a good base of literature firmly under your belt, it’s time to move onto the next step.

Need a helping hand?

Step 2: Log, catalogue and synthesise

Once you’ve built a little treasure trove of articles, it’s time to get reading and start digesting the information – what does it all mean?

While I present steps one and two (hunting and digesting) as sequential, in reality, it’s more of a back-and-forth tango – you’ll read a little , then have an idea, spot a new citation, or a new potential variable, and then go back to searching for articles. This is perfectly natural – through the reading process, your thoughts will develop , new avenues might crop up, and directional adjustments might arise. This is, after all, one of the main purposes of the literature review process (i.e. to familiarise yourself with the current state of research in your field).

As you’re working through your treasure chest, it’s essential that you simultaneously start organising the information. There are three aspects to this:

• Logging reference information
• Building an organised catalogue
• Distilling and synthesising the information

I’ll discuss each of these below:

2.1 – Log the reference information

As you read each article, you should add it to your reference management software. I usually recommend Mendeley for this purpose (see the Mendeley 101 video below), but you can use whichever software you’re comfortable with. Most importantly, make sure you load EVERY article you read into your reference manager, even if it doesn’t seem very relevant at the time.

2.2 – Build an organised catalogue

In the beginning, you might feel confident that you can remember who said what, where, and what their main arguments were. Trust me, you won’t. If you do a thorough review of the relevant literature (as you must!), you’re going to read many, many articles, and it’s simply impossible to remember who said what, when, and in what context . Also, without the bird’s eye view that a catalogue provides, you’ll miss connections between various articles, and have no view of how the research developed over time. Simply put, it’s essential to build your own catalogue of the literature.

I would suggest using Excel to build your catalogue, as it allows you to run filters, colour code and sort – all very useful when your list grows large (which it will). How you lay your spreadsheet out is up to you, but I’d suggest you have the following columns (at minimum):

• Author, date, title – Start with three columns containing this core information. This will make it easy for you to search for titles with certain words, order research by date, or group by author.
• Categories or keywords – You can either create multiple columns, one for each category/theme and then tick the relevant categories, or you can have one column with keywords.
• Key arguments/points – Use this column to succinctly convey the essence of the article, the key arguments and implications thereof for your research.
• Context – Note the socioeconomic context in which the research was undertaken. For example, US-based, respondents aged 25-35, lower- income, etc. This will be useful for making an argument about gaps in the research.
• Methodology – Note which methodology was used and why. Also, note any issues you feel arise due to the methodology. Again, you can use this to make an argument about gaps in the research.
• Quotations – Note down any quoteworthy lines you feel might be useful later.
• Notes – Make notes about anything not already covered. For example, linkages to or disagreements with other theories, questions raised but unanswered, shortcomings or limitations, and so forth.

If you’d like, you can try out our free catalog template here (see screenshot below).

2.3 – Digest and synthesise

Most importantly, as you work through the literature and build your catalogue, you need to synthesise all the information in your own mind – how does it all fit together? Look for links between the various articles and try to develop a bigger picture view of the state of the research. Some important questions to ask yourself are:

• What answers does the existing research provide to my own research questions ?
• Which points do the researchers agree (and disagree) on?
• How has the research developed over time?
• Where do the gaps in the current research lie?

To help you develop a big-picture view and synthesise all the information, you might find mind mapping software such as Freemind useful. Alternatively, if you’re a fan of physical note-taking, investing in a large whiteboard might work for you.

Step 3: Outline and write it up!

Once you’re satisfied that you have digested and distilled all the relevant literature in your mind, it’s time to put pen to paper (or rather, fingers to keyboard). There are two steps here – outlining and writing:

3.1 – Draw up your outline

Having spent so much time reading, it might be tempting to just start writing up without a clear structure in mind. However, it’s critically important to decide on your structure and develop a detailed outline before you write anything. Your literature review chapter needs to present a clear, logical and an easy to follow narrative – and that requires some planning. Don’t try to wing it!

Naturally, you won’t always follow the plan to the letter, but without a detailed outline, you’re more than likely going to end up with a disjointed pile of waffle , and then you’re going to spend a far greater amount of time re-writing, hacking and patching. The adage, “measure twice, cut once” is very suitable here.

In terms of structure, the first decision you’ll have to make is whether you’ll lay out your review thematically (into themes) or chronologically (by date/period). The right choice depends on your topic, research objectives and research questions, which we discuss in this article .

Once that’s decided, you need to draw up an outline of your entire chapter in bullet point format. Try to get as detailed as possible, so that you know exactly what you’ll cover where, how each section will connect to the next, and how your entire argument will develop throughout the chapter. Also, at this stage, it’s a good idea to allocate rough word count limits for each section, so that you can identify word count problems before you’ve spent weeks or months writing!

PS – check out our free literature review chapter template…

3.2 – Get writing

With a detailed outline at your side, it’s time to start writing up (finally!). At this stage, it’s common to feel a bit of writer’s block and find yourself procrastinating under the pressure of finally having to put something on paper. To help with this, remember that the objective of the first draft is not perfection – it’s simply to get your thoughts out of your head and onto paper, after which you can refine them. The structure might change a little, the word count allocations might shift and shuffle, and you might add or remove a section – that’s all okay. Don’t worry about all this on your first draft – just get your thoughts down on paper.

Once you’ve got a full first draft (however rough it may be), step away from it for a day or two (longer if you can) and then come back at it with fresh eyes. Pay particular attention to the flow and narrative – does it fall fit together and flow from one section to another smoothly? Now’s the time to try to improve the linkage from each section to the next, tighten up the writing to be more concise, trim down word count and sand it down into a more digestible read.

Once you’ve done that, give your writing to a friend or colleague who is not a subject matter expert and ask them if they understand the overall discussion. The best way to assess this is to ask them to explain the chapter back to you. This technique will give you a strong indication of which points were clearly communicated and which weren’t. If you’re working with Grad Coach, this is a good time to have your Research Specialist review your chapter.

Finally, tighten it up and send it off to your supervisor for comment. Some might argue that you should be sending your work to your supervisor sooner than this (indeed your university might formally require this), but in my experience, supervisors are extremely short on time (and often patience), so, the more refined your chapter is, the less time they’ll waste on addressing basic issues (which you know about already) and the more time they’ll spend on valuable feedback that will increase your mark-earning potential.

Literature Review Example

In the video below, we unpack an actual literature review so that you can see how all the core components come together in reality.

Let’s Recap

In this post, we’ve covered how to research and write up a high-quality literature review chapter. Let’s do a quick recap of the key takeaways:

• It is essential to understand the WHY of the literature review before you read or write anything. Make sure you understand the 4 core functions of the process.
• The first step is to hunt down the relevant literature . You can do this using Google Scholar, your university database, the snowballing technique and by reviewing other dissertations and theses.
• Next, you need to log all the articles in your reference manager , build your own catalogue of literature and synthesise all the research.
• Following that, you need to develop a detailed outline of your entire chapter – the more detail the better. Don’t start writing without a clear outline (on paper, not in your head!)
• Write up your first draft in rough form – don’t aim for perfection. Remember, done beats perfect.
• Refine your second draft and get a layman’s perspective on it . Then tighten it up and submit it to your supervisor.

Psst… there’s more!

This post is an extract from our bestselling Udemy Course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

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38 Comments

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You’re welcome, Yinka. Thank you for the kind words. All the best writing your literature review.

Thank you for a very useful literature review session. Although I am doing most of the steps…it being my first masters an Mphil is a self study and one not sure you are on the right track. I have an amazing supervisor but one also knows they are super busy. So not wanting to bother on the minutae. Thank you.

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Thank you so much Derek for such useful information on writing up a good literature review. I am at a stage where I need to start writing my one. My proposal was accepted late last year but I honestly did not know where to start

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Thank you. I requested to download the free literature review template, however, your website wouldn’t allow me to complete the request or complete a download. May I request that you email me the free template? Thank you.

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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
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• Reading Research Effectively
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A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• 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 sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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How to Make a Literature Review in Research (RRL Example)

What is an RRL in a research paper?

A relevant review of the literature (RRL) is an objective, concise, critical summary of published research literature relevant to a topic being researched in an article. In an RRL, you discuss knowledge and findings from existing literature relevant to your study topic. If there are conflicts or gaps in existing literature, you can also discuss these in your review, as well as how you will confront these missing elements or resolve these issues in your study.

To complete an RRL, you first need to collect relevant literature; this can include online and offline sources. Save all of your applicable resources as you will need to include them in your paper. When looking through these sources, take notes and identify concepts of each source to describe in the review of the literature.

A good RRL does NOT:

A literature review does not simply reference and list all of the material you have cited in your paper.

• Presenting material that is not directly relevant to your study will distract and frustrate the reader and make them lose sight of the purpose of your study.
• Starting a literature review with “A number of scholars have studied the relationship between X and Y” and simply listing who has studied the topic and what each scholar concluded is not going to strengthen your paper.

A good RRL DOES:

• Present a brief typology that orders articles and books into groups to help readers focus on unresolved debates, inconsistencies, tensions, and new questions about a research topic.
• Summarize the most relevant and important aspects of the scientific literature related to your area of research
• Synthesize what has been done in this area of research and by whom, highlight what previous research indicates about a topic, and identify potential gaps and areas of disagreement in the field
• Give the reader an understanding of the background of the field and show which studies are important—and highlight errors in previous studies

How long is a review of the literature for a research paper?

The length of a review of the literature depends on its purpose and target readership and can vary significantly in scope and depth. In a dissertation, thesis, or standalone review of literature, it is usually a full chapter of the text (at least 20 pages). Whereas, a standard research article or school assignment literature review section could only be a few paragraphs in the Introduction section .

Building Your Literature Review Bookshelf

One way to conceive of a literature review is to think about writing it as you would build a bookshelf. You don’t need to cut each piece by yourself from scratch. Rather, you can take the pieces that other researchers have cut out and put them together to build a framework on which to hang your own “books”—that is, your own study methods, results, and conclusions.

What Makes a Good Literature Review?

The contents of a literature review (RRL) are determined by many factors, including its precise purpose in the article, the degree of consensus with a given theory or tension between competing theories, the length of the article, the number of previous studies existing in the given field, etc. The following are some of the most important elements that a literature review provides.

Historical background for your research

Analyze what has been written about your field of research to highlight what is new and significant in your study—or how the analysis itself contributes to the understanding of this field, even in a small way. Providing a historical background also demonstrates to other researchers and journal editors your competency in discussing theoretical concepts. You should also make sure to understand how to paraphrase scientific literature to avoid plagiarism in your work.

The current context of your research

Discuss central (or peripheral) questions, issues, and debates in the field. Because a field is constantly being updated by new work, you can show where your research fits into this context and explain developments and trends in research.

A discussion of relevant theories and concepts

Theories and concepts should provide the foundation for your research. For example, if you are researching the relationship between ecological environments and human populations, provide models and theories that focus on specific aspects of this connection to contextualize your study. If your study asks a question concerning sustainability, mention a theory or model that underpins this concept. If it concerns invasive species, choose material that is focused in this direction.

Definitions of relevant terminology

In the natural sciences, the meaning of terms is relatively straightforward and consistent. But if you present a term that is obscure or context-specific, you should define the meaning of the term in the Introduction section (if you are introducing a study) or in the summary of the literature being reviewed.

Description of related relevant research

Include a description of related research that shows how your work expands or challenges earlier studies or fills in gaps in previous work. You can use your literature review as evidence of what works, what doesn’t, and what is missing in the field.

Supporting evidence for a practical problem or issue your research is addressing that demonstrates its importance: Referencing related research establishes your area of research as reputable and shows you are building upon previous work that other researchers have deemed significant.

Types of Literature Reviews

Literature reviews can differ in structure, length, amount, and breadth of content included. They can range from selective (a very narrow area of research or only a single work) to comprehensive (a larger amount or range of works). They can also be part of a larger work or stand on their own.

• A course assignment is an example of a selective, stand-alone work. It focuses on a small segment of the literature on a topic and makes up an entire work on its own.
• The literature review in a dissertation or thesis is both comprehensive and helps make up a larger work.
• A majority of journal articles start with a selective literature review to provide context for the research reported in the study; such a literature review is usually included in the Introduction section (but it can also follow the presentation of the results in the Discussion section ).
• Some literature reviews are both comprehensive and stand as a separate work—in this case, the entire article analyzes the literature on a given topic.

Literature Reviews Found in Academic Journals

The two types of literature reviews commonly found in journals are those introducing research articles (studies and surveys) and stand-alone literature analyses. They can differ in their scope, length, and specific purpose.

Literature reviews introducing research articles

The literature review found at the beginning of a journal article is used to introduce research related to the specific study and is found in the Introduction section, usually near the end. It is shorter than a stand-alone review because it must be limited to very specific studies and theories that are directly relevant to the current study. Its purpose is to set research precedence and provide support for the study’s theory, methods, results, and/or conclusions. Not all research articles contain an explicit review of the literature, but most do, whether it is a discrete section or indistinguishable from the rest of the Introduction.

How to structure a literature review for an article

When writing a literature review as part of an introduction to a study, simply follow the structure of the Introduction and move from the general to the specific—presenting the broadest background information about a topic first and then moving to specific studies that support your rationale , finally leading to your hypothesis statement. Such a literature review is often indistinguishable from the Introduction itself—the literature is INTRODUCING the background and defining the gaps your study aims to fill.

The stand-alone literature review

The literature review published as a stand-alone article presents and analyzes as many of the important publications in an area of study as possible to provide background information and context for a current area of research or a study. Stand-alone reviews are an excellent resource for researchers when they are first searching for the most relevant information on an area of study.

Such literature reviews are generally a bit broader in scope and can extend further back in time. This means that sometimes a scientific literature review can be highly theoretical, in addition to focusing on specific methods and outcomes of previous studies. In addition, all sections of such a “review article” refer to existing literature rather than describing the results of the authors’ own study.

In addition, this type of literature review is usually much longer than the literature review introducing a study. At the end of the review follows a conclusion that once again explicitly ties all of the cited works together to show how this analysis is itself a contribution to the literature. While not absolutely necessary, such articles often include the terms “Literature Review” or “Review of the Literature” in the title. Whether or not that is necessary or appropriate can also depend on the specific author instructions of the target journal. Have a look at this article for more input on how to compile a stand-alone review article that is insightful and helpful for other researchers in your field.

How to Write a Literature Review in 6 Steps

So how do authors turn a network of articles into a coherent review of relevant literature?

Writing a literature review is not usually a linear process—authors often go back and check the literature while reformulating their ideas or making adjustments to their study. Sometimes new findings are published before a study is completed and need to be incorporated into the current work. This also means you will not be writing the literature review at any one time, but constantly working on it before, during, and after your study is complete.

Here are some steps that will help you begin and follow through on your literature review.

Step 1: Choose a topic to write about—focus on and explore this topic.

Choose a topic that you are familiar with and highly interested in analyzing; a topic your intended readers and researchers will find interesting and useful; and a topic that is current, well-established in the field, and about which there has been sufficient research conducted for a review. This will help you find the “sweet spot” for what to focus on.

Step 2: Research and collect all the scholarly information on the topic that might be pertinent to your study.

This includes scholarly articles, books, conventions, conferences, dissertations, and theses—these and any other academic work related to your area of study is called “the literature.”

Step 3: Analyze the network of information that extends or responds to the major works in your area; select the material that is most useful.

Use thought maps and charts to identify intersections in the research and to outline important categories; select the material that will be most useful to your review.

Step 4: Describe and summarize each article—provide the essential information of the article that pertains to your study.

Determine 2-3 important concepts (depending on the length of your article) that are discussed in the literature; take notes about all of the important aspects of this study relevant to the topic being reviewed.

For example, in a given study, perhaps some of the main concepts are X, Y, and Z. Note these concepts and then write a brief summary about how the article incorporates them. In reviews that introduce a study, these can be relatively short. In stand-alone reviews, there may be significantly more texts and more concepts.

Step 5: Demonstrate how these concepts in the literature relate to what you discovered in your study or how the literature connects the concepts or topics being discussed.

In a literature review intro for an article, this information might include a summary of the results or methods of previous studies that correspond to and/or confirm those sections in your own study. For a stand-alone literature review, this may mean highlighting the concepts in each article and showing how they strengthen a hypothesis or show a pattern.

Discuss unaddressed issues in previous studies. These studies that are missing something you address are important to include in your literature review. In addition, those works whose theories and conclusions directly support your findings will be valuable to review here.

Step 6: Identify relationships in the literature and develop and connect your own ideas to them.

This is essentially the same as step 5 but focused on the connections between the literature and the current study or guiding concepts or arguments of the paper, not only on the connections between the works themselves.

Your hypothesis, argument, or guiding concept is the “golden thread” that will ultimately tie the works together and provide readers with specific insights they didn’t have before reading your literature review. Make sure you know where to put the research question , hypothesis, or statement of the problem in your research paper so that you guide your readers logically and naturally from your introduction of earlier work and evidence to the conclusions you want them to draw from the bigger picture.

Your literature review will not only cover publications on your topics but will include your own ideas and contributions. By following these steps you will be telling the specific story that sets the background and shows the significance of your research and you can turn a network of related works into a focused review of the literature.

Literature Review (RRL) Examples

Because creating sample literature reviews would take too long and not properly capture the nuances and detailed information needed for a good review, we have included some links to different types of literature reviews below. You can find links to more literature reviews in these categories by visiting the TUS Library’s website . Sample literature reviews as part of an article, dissertation, or thesis:

• Critical Thinking and Transferability: A Review of the Literature (Gwendolyn Reece)
• Building Customer Loyalty: A Customer Experience Based Approach in a Tourism Context (Martina Donnelly)

Sample stand-alone literature reviews

• Literature Review on Attitudes towards Disability (National Disability Authority)
• The Effects of Communication Styles on Marital Satisfaction (Hannah Yager)

Additional Literature Review Format Guidelines

In addition to the content guidelines above, authors also need to check which style guidelines to use ( APA , Chicago, MLA, etc.) and what specific rules the target journal might have for how to structure such articles or how many studies to include—such information can usually be found on the journals’ “Guide for Authors” pages. Additionally, use one of the four Wordvice citation generators below, choosing the citation style needed for your paper:

Wordvice Writing and Academic Editing Resources

Finally, after you have finished drafting your literature review, be sure to receive professional proofreading services , including paper editing for your academic work. A competent proofreader who understands academic writing conventions and the specific style guides used by academic journals will ensure that your paper is ready for publication in your target journal.

See our academic resources for further advice on references in your paper , how to write an abstract , how to write a research paper title, how to impress the editor of your target journal with a perfect cover letter , and dozens of other research writing and publication topics.

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

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.

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 summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write 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, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

When you write a dissertation or thesis, you will 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 scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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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 objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. 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 if 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 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 use boolean operators to help narrow down your search:

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.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

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?
• How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
• 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 find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

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’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference 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.

You can use our free APA Reference Generator for quick, correct, consistent citations.

To begin organising your literature review’s argument and structure, you need to 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 organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

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 summarising sources in order.

Try to analyse 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 organise 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.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, 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 transitions and topic sentences to draw connections, comparisons and contrasts.

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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 dissertation , thesis, research paper , or proposal .

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

• To familiarise 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  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

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1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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Literature Reviews

What this handout is about.

This handout will explain what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.

Introduction

OK. You’ve got to write a literature review. You dust off a novel and a book of poetry, settle down in your chair, and get ready to issue a “thumbs up” or “thumbs down” as you leaf through the pages. “Literature review” done. Right?

Wrong! The “literature” of a literature review refers to any collection of materials on a topic, not necessarily the great literary texts of the world. “Literature” could be anything from a set of government pamphlets on British colonial methods in Africa to scholarly articles on the treatment of a torn ACL. And a review does not necessarily mean that your reader wants you to give your personal opinion on whether or not you liked these sources.

What is a literature review, then?

A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period.

A literature review can be just a simple summary of the sources, but it usually has an organizational pattern and combines both summary and synthesis. A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information. It might give a new interpretation of old material or combine new with old interpretations. Or it might trace the intellectual progression of the field, including major debates. And depending on the situation, the literature review may evaluate the sources and advise the reader on the most pertinent or relevant.

But how is a literature review different from an academic research paper?

The main focus of an academic research paper is to develop a new argument, and a research paper is likely to contain a literature review as one of its parts. In a research paper, you use the literature as a foundation and as support for a new insight that you contribute. The focus of a literature review, however, is to summarize and synthesize the arguments and ideas of others without adding new contributions.

Why do we write literature reviews?

Literature reviews provide you with a handy guide to a particular topic. If you have limited time to conduct research, literature reviews can give you an overview or act as a stepping stone. For professionals, they are useful reports that keep them up to date with what is current in the field. For scholars, the depth and breadth of the literature review emphasizes the credibility of the writer in his or her field. Literature reviews also provide a solid background for a research paper’s investigation. Comprehensive knowledge of the literature of the field is essential to most research papers.

Who writes these things, anyway?

Literature reviews are written occasionally in the humanities, but mostly in the sciences and social sciences; in experiment and lab reports, they constitute a section of the paper. Sometimes a literature review is written as a paper in itself.

Let’s get to it! What should I do before writing the literature review?

If your assignment is not very specific, seek clarification from your instructor:

• Roughly how many sources should you include?
• What types of sources (books, journal articles, websites)?
• Should you summarize, synthesize, or critique your sources by discussing a common theme or issue?
• Should you evaluate your sources?
• Should you provide subheadings and other background information, such as definitions and/or a history?

Find models

Look for other literature reviews in your area of interest or in the discipline and read them to get a sense of the types of themes you might want to look for in your own research or ways to organize your final review. You can simply put the word “review” in your search engine along with your other topic terms to find articles of this type on the Internet or in an electronic database. The bibliography or reference section of sources you’ve already read are also excellent entry points into your own research.

Narrow your topic

There are hundreds or even thousands of articles and books on most areas of study. The narrower your topic, the easier it will be to limit the number of sources you need to read in order to get a good survey of the material. Your instructor will probably not expect you to read everything that’s out there on the topic, but you’ll make your job easier if you first limit your scope.

Keep in mind that UNC Libraries have research guides and to databases relevant to many fields of study. You can reach out to the subject librarian for a consultation: https://library.unc.edu/support/consultations/ .

And don’t forget to tap into your professor’s (or other professors’) knowledge in the field. Ask your professor questions such as: “If you had to read only one book from the 90’s on topic X, what would it be?” Questions such as this help you to find and determine quickly the most seminal pieces in the field.

Consider whether your sources are current

Some disciplines require that you use information that is as current as possible. In the sciences, for instance, treatments for medical problems are constantly changing according to the latest studies. Information even two years old could be obsolete. However, if you are writing a review in the humanities, history, or social sciences, a survey of the history of the literature may be what is needed, because what is important is how perspectives have changed through the years or within a certain time period. Try sorting through some other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to consider what is currently of interest to scholars in this field and what is not.

Strategies for writing the literature review

Find a focus.

A literature review, like a term paper, is usually organized around ideas, not the sources themselves as an annotated bibliography would be organized. This means that you will not just simply list your sources and go into detail about each one of them, one at a time. No. As you read widely but selectively in your topic area, consider instead what themes or issues connect your sources together. Do they present one or different solutions? Is there an aspect of the field that is missing? How well do they present the material and do they portray it according to an appropriate theory? Do they reveal a trend in the field? A raging debate? Pick one of these themes to focus the organization of your review.

Convey it to your reader

A literature review may not have a traditional thesis statement (one that makes an argument), but you do need to tell readers what to expect. Try writing a simple statement that lets the reader know what is your main organizing principle. Here are a couple of examples:

The current trend in treatment for congestive heart failure combines surgery and medicine. More and more cultural studies scholars are accepting popular media as a subject worthy of academic consideration.

Consider organization

You’ve got a focus, and you’ve stated it clearly and directly. Now what is the most effective way of presenting the information? What are the most important topics, subtopics, etc., that your review needs to include? And in what order should you present them? Develop an organization for your review at both a global and local level:

First, cover the basic categories

Just like most academic papers, literature reviews also must contain at least three basic elements: an introduction or background information section; the body of the review containing the discussion of sources; and, finally, a conclusion and/or recommendations section to end the paper. The following provides a brief description of the content of each:

• Introduction: Gives a quick idea of the topic of the literature review, such as the central theme or organizational pattern.
• Body: Contains your discussion of sources and is organized either chronologically, thematically, or methodologically (see below for more information on each).
• Conclusions/Recommendations: Discuss what you have drawn from reviewing literature so far. Where might the discussion proceed?

Organizing the body

Once you have the basic categories in place, then you must consider how you will present the sources themselves within the body of your paper. Create an organizational method to focus this section even further.

To help you come up with an overall organizational framework for your review, consider the following scenario:

You’ve decided to focus your literature review on materials dealing with sperm whales. This is because you’ve just finished reading Moby Dick, and you wonder if that whale’s portrayal is really real. You start with some articles about the physiology of sperm whales in biology journals written in the 1980’s. But these articles refer to some British biological studies performed on whales in the early 18th century. So you check those out. Then you look up a book written in 1968 with information on how sperm whales have been portrayed in other forms of art, such as in Alaskan poetry, in French painting, or on whale bone, as the whale hunters in the late 19th century used to do. This makes you wonder about American whaling methods during the time portrayed in Moby Dick, so you find some academic articles published in the last five years on how accurately Herman Melville portrayed the whaling scene in his novel.

Now consider some typical ways of organizing the sources into a review:

• Chronological: If your review follows the chronological method, you could write about the materials above according to when they were published. For instance, first you would talk about the British biological studies of the 18th century, then about Moby Dick, published in 1851, then the book on sperm whales in other art (1968), and finally the biology articles (1980s) and the recent articles on American whaling of the 19th century. But there is relatively no continuity among subjects here. And notice that even though the sources on sperm whales in other art and on American whaling are written recently, they are about other subjects/objects that were created much earlier. Thus, the review loses its chronological focus.
• By publication: Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on biological studies of sperm whales if the progression revealed a change in dissection practices of the researchers who wrote and/or conducted the studies.
• By trend: A better way to organize the above sources chronologically is to examine the sources under another trend, such as the history of whaling. Then your review would have subsections according to eras within this period. For instance, the review might examine whaling from pre-1600-1699, 1700-1799, and 1800-1899. Under this method, you would combine the recent studies on American whaling in the 19th century with Moby Dick itself in the 1800-1899 category, even though the authors wrote a century apart.
• Thematic: Thematic reviews of literature are organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in a thematic review. For instance, the sperm whale review could focus on the development of the harpoon for whale hunting. While the study focuses on one topic, harpoon technology, it will still be organized chronologically. The only difference here between a “chronological” and a “thematic” approach is what is emphasized the most: the development of the harpoon or the harpoon technology.But more authentic thematic reviews tend to break away from chronological order. For instance, a thematic review of material on sperm whales might examine how they are portrayed as “evil” in cultural documents. The subsections might include how they are personified, how their proportions are exaggerated, and their behaviors misunderstood. A review organized in this manner would shift between time periods within each section according to the point made.
• Methodological: A methodological approach differs from the two above in that the focusing factor usually does not have to do with the content of the material. Instead, it focuses on the “methods” of the researcher or writer. For the sperm whale project, one methodological approach would be to look at cultural differences between the portrayal of whales in American, British, and French art work. Or the review might focus on the economic impact of whaling on a community. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed. Once you’ve decided on the organizational method for the body of the review, the sections you need to include in the paper should be easy to figure out. They should arise out of your organizational strategy. In other words, a chronological review would have subsections for each vital time period. A thematic review would have subtopics based upon factors that relate to the theme or issue.

Sometimes, though, you might need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. Put in only what is necessary. Here are a few other sections you might want to consider:

• Current Situation: Information necessary to understand the topic or focus of the literature review.
• History: The chronological progression of the field, the literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Methods and/or Standards: The criteria you used to select the sources in your literature review or the way in which you present your information. For instance, you might explain that your review includes only peer-reviewed articles and journals.

Questions for Further Research: What questions about the field has the review sparked? How will you further your research as a result of the review?

Begin composing

Once you’ve settled on a general pattern of organization, you’re ready to write each section. There are a few guidelines you should follow during the writing stage as well. Here is a sample paragraph from a literature review about sexism and language to illuminate the following discussion:

However, other studies have shown that even gender-neutral antecedents are more likely to produce masculine images than feminine ones (Gastil, 1990). Hamilton (1988) asked students to complete sentences that required them to fill in pronouns that agreed with gender-neutral antecedents such as “writer,” “pedestrian,” and “persons.” The students were asked to describe any image they had when writing the sentence. Hamilton found that people imagined 3.3 men to each woman in the masculine “generic” condition and 1.5 men per woman in the unbiased condition. Thus, while ambient sexism accounted for some of the masculine bias, sexist language amplified the effect. (Source: Erika Falk and Jordan Mills, “Why Sexist Language Affects Persuasion: The Role of Homophily, Intended Audience, and Offense,” Women and Language19:2).

Use evidence

In the example above, the writers refer to several other sources when making their point. A literature review in this sense is just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence to show that what you are saying is valid.

Be selective

Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the review’s focus, whether it is thematic, methodological, or chronological.

Use quotes sparingly

Falk and Mills do not use any direct quotes. That is because the survey nature of the literature review does not allow for in-depth discussion or detailed quotes from the text. Some short quotes here and there are okay, though, if you want to emphasize a point, or if what the author said just cannot be rewritten in your own words. Notice that Falk and Mills do quote certain terms that were coined by the author, not common knowledge, or taken directly from the study. But if you find yourself wanting to put in more quotes, check with your instructor.

Summarize and synthesize

Remember to summarize and synthesize your sources within each paragraph as well as throughout the review. The authors here recapitulate important features of Hamilton’s study, but then synthesize it by rephrasing the study’s significance and relating it to their own work.

Keep your own voice

While the literature review presents others’ ideas, your voice (the writer’s) should remain front and center. Notice that Falk and Mills weave references to other sources into their own text, but they still maintain their own voice by starting and ending the paragraph with their own ideas and their own words. The sources support what Falk and Mills are saying.

Use caution when paraphrasing

When paraphrasing a source that is not your own, be sure to represent the author’s information or opinions accurately and in your own words. In the preceding example, Falk and Mills either directly refer in the text to the author of their source, such as Hamilton, or they provide ample notation in the text when the ideas they are mentioning are not their own, for example, Gastil’s. For more information, please see our handout on plagiarism .

Revise, revise, revise

Draft in hand? Now you’re ready to revise. Spending a lot of time revising is a wise idea, because your main objective is to present the material, not the argument. So check over your review again to make sure it follows the assignment and/or your outline. Then, just as you would for most other academic forms of writing, rewrite or rework the language of your review so that you’ve presented your information in the most concise manner possible. Be sure to use terminology familiar to your audience; get rid of unnecessary jargon or slang. Finally, double check that you’ve documented your sources and formatted the review appropriately for your discipline. For tips on the revising and editing process, see our handout on revising drafts .

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Anson, Chris M., and Robert A. Schwegler. 2010. The Longman Handbook for Writers and Readers , 6th ed. New York: Longman.

Jones, Robert, Patrick Bizzaro, and Cynthia Selfe. 1997. The Harcourt Brace Guide to Writing in the Disciplines . New York: Harcourt Brace.

Lamb, Sandra E. 1998. How to Write It: A Complete Guide to Everything You’ll Ever Write . Berkeley: Ten Speed Press.

Rosen, Leonard J., and Laurence Behrens. 2003. The Allyn & Bacon Handbook , 5th ed. New York: Longman.

Troyka, Lynn Quittman, and Doug Hesse. 2016. Simon and Schuster Handbook for Writers , 11th ed. London: Pearson.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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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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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).

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

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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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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 
• How to write a good literature review 
• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

• Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 
• Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 
• Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 
• Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 
• Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 
• Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

How to write a good literature review

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. 

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

Paperpal is an AI writing assistant that help academics write better, faster with real-time suggestions for in-depth language and grammar correction. Trained on millions of research manuscripts enhanced by professional academic editors, Paperpal delivers human precision at machine speed.  

Try it for free or upgrade to  Paperpal Prime , which unlocks unlimited access to premium features like academic translation, paraphrasing, contextual synonyms, consistency checks and more. It’s like always having a professional academic editor by your side! Go beyond limitations and experience the future of academic writing.  Get Paperpal Prime now at just US$19 a month!

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• Empirical Research: A Comprehensive Guide for Academics 
• How to Write a Scientific Paper in 10 Steps 
• Life Sciences Papers: 9 Tips for Authors Writing in Biological Sciences
• What is an Argumentative Essay? How to Write It (With Examples)

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Literature Reviews

• What is a literature review?
• Steps in the Literature Review Process
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support

What is a Literature Review?

A literature or narrative review is a comprehensive review and analysis of the published literature on a specific topic or research question. The literature that is reviewed contains: books, articles, academic articles, conference proceedings, association papers, and dissertations. It contains the most pertinent studies and points to important past and current research and practices. It provides background and context, and shows how your research will contribute to the field. 

A literature review should: 

• Provide a comprehensive and updated review of the literature;
• Explain why this review has taken place;
• Articulate a position or hypothesis;
• Acknowledge and account for conflicting and corroborating points of view

From  S age Research Methods

Purpose of a Literature Review

A literature review can be written as an introduction to a study to:

• Demonstrate how a study fills a gap in research
• Compare a study with other research that's been done

Or it can be a separate work (a research article on its own) which:

• Organizes or describes a topic
• Describes variables within a particular issue/problem

Limitations of a Literature Review

Some of the limitations of a literature review are:

• It's a snapshot in time. Unlike other reviews, this one has beginning, a middle and an end. There may be future developments that could make your work less relevant.
• It may be too focused. Some niche studies may miss the bigger picture.
• It can be difficult to be comprehensive. There is no way to make sure all the literature on a topic was considered.
• It is easy to be biased if you stick to top tier journals. There may be other places where people are publishing exemplary research. Look to open access publications and conferences to reflect a more inclusive collection. Also, make sure to include opposing views (and not just supporting evidence).

Source: Grant, Maria J., and Andrew Booth. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal, vol. 26, no. 2, June 2009, pp. 91–108. Wiley Online Library, doi:10.1111/j.1471-1842.2009.00848.x.

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Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

For help in other subject areas, please see the guide to library specialists by subject .

Periodically, UT Libraries runs a workshop covering the basics and library support for literature reviews. While we try to offer these once per academic year, we find providing the recording to be helpful to community members who have missed the session. Following is the most recent recording of the workshop, Conducting a Literature Review. To view the recording, a UT login is required.

• October 26, 2022 recording
• Last Updated: Oct 26, 2022 2:49 PM
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Review of Relevant Literature

Chapter 6 Review of Relevant Literature   http://evolve.elsevier.com/Grove/practice/ You have been asked to present a lecture about home health care for undergraduate nursing students. Maybe you are concerned about the families of the patients in your critical care unit and want to devise a program to address their unique needs. Maybe you are a graduate nursing student and your teacher said your paper needed to include a review of the literature. Maybe you are in a Magnet hospital and the nurses on your unit are developing a proposal for a study. In each situation, you need to understand how to review the literature and to present the information you find in a logical, synthesized manner. By building on previous knowledge, nurse researchers can add to the evidence upon which we base our practice. The rate of new knowledge being generated each year continues to grow. Early studies in the 1960s indicated that knowledge doubled every 13 to 15 years ( Larsen & von Ins, 2010 ). The vast amount of information available within seconds implies that knowledge is doubling much more rapidly in the digital age. Bachrach (2001) noted that each new discipline launches new journals to develop its disciplinary knowledge. Computerized bibliographical databases have made the process of searching for relevant empirical or theoretical literature easier in some ways, but you are faced with the dilemma of selecting the most relevant sources from a much larger number of articles. The task of reading, critically appraising, analyzing, and synthesizing has expanded and can consume any time gained by more efficient searching. This chapter provides basic skills and knowledge to identify evidence for changing nursing practice, developing a research proposal, preparing a lecture, or writing a manuscript. What Is “The Literature”? “The literature” consists of all written sources relevant to the topic you have selected. The literature consists of newspapers, monographs, encyclopedias, conference papers, scientific journals, textbooks, other books, theses, dissertations, and clinical journals. Websites and reports developed by government agencies and professional organizations are also included. For example, to support the significance of diabetes mellitus as a topic for a research study, you could find statistics about the prevalence and cost of the disease from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Not every source that you find, however, will be valid and legitimate for scholarly use. The website of a company that sells insulin may not be an appropriate source for diabetes statistics. Online encyclopedias to which anyone can contribute, such as Wikipedia, are not considered scholarly sources. These websites might point you toward professional sources but should not be cited in a professional or academic paper. You should use primary, peer-reviewed, professional literature. New knowledge develops when researchers and scholars produce manuscripts for journals and books that are reviewed by peers to determine whether the manuscripts should be published. What Is a Literature Review? The literature review is an organized written presentation of what you find when you review the literature. The literature review is “central to scholarly work and disciplined inquiry” ( Holbrook, Bourke, Fairbairn, & Lovat, 2007 , p. 337); it summarizes what has been published on a topic by scholars and presents relevant research findings. Developing the ability to write coherently about what you have found in the literature requires time and guidance. The review should be organized into sections that present themes, identify trends, or examine variables. The purpose is not to list all the material published but, rather, to synthesize and evaluate it on the basis of the phenomenon of interest. The focus of the review depends on the reason you are reviewing the literature. This overview describes common purposes for conducting literature reviews; however, the goal of this chapter is to provide specific guidance and practical suggestions related to reviewing research relevant to a proposed study. The three major stages of literature reviews are discussed: (1) searching the literature, (2) processing the literature, and (3) writing the literature review. Purposes of Reviewing the Literature Writing a Course Paper For most course papers, your instructor will expect you to review published sources on the topic of your paper. Reviews of the literature for a course assignment will vary depending on the level of educational program, the purpose of the assignment, and the expectations of the instructor. The literature review for a graduate course is expected to have greater depth, scope, and breadth than a review for an undergraduate course ( Hart, 2009 ). A paper in a nurse practitioner course might require that you review pharmacology and pathology reference books in addition to journal articles. In a nursing education course, you may review neurological development, cognitive science, and general education publications to write a paper on a teaching strategy. For a doctor of nursing practice course on clinical information systems, your review might need to extend into computer science and hospital management literature. For a theory course in a doctor of philosophy in nursing program, your review may need to include all the publications of a specific theorist or all the studies based on the theory. For each of these papers, your professor may specify the publication years and the type of literature to be included. Also, you must note the acceptable length of the written review of the literature to be submitted. Reviews of the literature for course assignments tend to focus on what is known, the strength of the evidence, the implications of the knowledge, and what is not known for the purpose of developing new studies. Examining the Strength of the Evidence Evidence-based practice guidelines are developed through the synthesis of the literature on the clinical problem. The purpose of the literature review designed to examine the strength of the evidence is to identify all studies that provide evidence of a particular intervention, to critically appraise the quality of each study, and to synthesize all of the studies providing evidence of the effectiveness of a particular intervention. It is also important to locate and include previous evidence-based papers that have examined the evidence of a particular intervention, because the conclusions of the authors of such papers are highly relevant. Literature syntheses related to promoting evidence-based nursing practice are described in Chapter 19 . Developing a Qualitative Research Proposal In qualitative research, the purpose and timing of the literature review depend on the type of study to be conducted (see Chapter 12 ). Some phenomenologists believe that the literature should not be reviewed until after the data have been collected and analyzed, so that the literature does not interfere with the researcher’s ability to suspend what is known and to approach the topic with openness ( Munhall, 2012 ). In the development of a grounded theory study, a minimal review of relevant studies provides the beginning point of the inquiry, but this review is only a means of making the researcher aware of what studies have been conducted. This information, however, is not used to direct the collection of data or interpretation of the findings in a grounded theory study. During the data analysis stage, a core variable is identified and the researcher theoretically samples the literature for extant theories that may assist in explaining and extending the emerging theory ( Munhall, 2012 ). In historical research, the initial review of the literature helps the researcher define the study questions and make decisions about relevant sources. The data collection is actually an intense review of published and unpublished documents that the researcher has found. The purposes of reviewing the literature for ethnographic studies and for exploratory descriptive qualitative research are more similar to that for quantitative research. The researcher develops a general understanding of the concepts to be examined in relation to the selected culture or topic. The literature review also provides a background for conducting the study and interpreting the findings. Chapter 12 describes in more detail the role of the literature review in qualitative research. Developing a Quantitative Study The review of literature in quantitative research directs the development and implementation of a study. The focus of the major literature review at the beginning of the research process is to identify a gap in what is known. The study is designed to add knowledge in the area of the identified gap. For example, an intervention to prevent hospital-acquired infections related to intravenous infusions has been shown to reduce the incidence of these infections among postoperative patients who have no history of diabetes mellitus. After a thorough review of the literature, the researcher identifies a specific gap in knowledge. What is not known is whether this intervention will be equally effective for postoperative patients who have diabetes. After the data have been analyzed and the findings described, the researcher will return to the literature in the generalization phase of the research report to integrate knowledge from the literature with new knowledge obtained from the study. The purposes of the literature review are similar for the different types of quantitative studies (descriptive, correlational, quasi-experimental, and experimental). Table 6-1 describes the role of the literature throughout the development and implementation of the study. The types of sources needed and how you will search the literature will vary throughout the study. The introduction section uses relevant sources to summarize the background and significance of the research problem. The review of the literature section includes both theoretical and empirical sources that document the current knowledge of the problem. The researcher develops the framework section from the theoretical literature and sometimes from empirical literature. If little theoretical literature is found, the researcher may need to develop a tentative theory to guide the study from the findings of previous research studies (see Chapter 7 for more information). The methods section describes the design, sample, measurement methods, treatment, and data collection process of the planned study and is based on previous research. Thus, previous studies may be cited in the methods section. In the results section, sources are included to document the different types of statistical analyses conducted and the computer software to conduct these analyses. The discussion section of the research report begins with what the results mean in light of the results of previous studies. Conclusions are drawn that are a synthesis of the cited findings from previous research and those from the present study. TABLE 6-1 The Role of the Literature Review in Developing a Quantitative Research Proposal Phase of the Research Process How Literature Is Used and Its Role Research topic Broad searches using keywords to understand the extent of what is known and what is not known; what concepts are related to the topic Statement of the research purpose From your synthesis of the literature, the specific gap in knowledge that this study will address Background and significance Searches of books and articles to provide an overview of the topic Identification of the size, cost, and consequences of the research problem Research framework Find and read relevant theories Facilitate development of the framework Develop conceptual definitions of concepts Purpose of the study On the basis of your knowledge of the literature, state the purpose of the study Research objectives, questions, or hypotheses On the basis of the knowledge gained from and examples found in the literature, write the objectives or questions of the study If sufficient literature allows a prediction, state the hypotheses of the study Review of the literature Find sources as evidence for logical argument for why this study and methodology are needed Summarize current empirical knowledge that is related to the topic Methodology Compare research designs of reviewed studies to select the most appropriate design for the proposed study Identify possible instruments or measures of variables Provide operational definitions of concepts Describe performance of measures in previous studies Develop sampling strategies based on what you have learned from the studies in the literature Findings Refer to statistical textbooks to explain the results of the data analysis Discussion Compare your findings with those of studies you have previously reviewed Return to the literature to find new references to interpret unexpected findings Identify limitations of the study Refer to theory sources to relate the findings to the research framework Conclusions On basis of your knowledge of the literature and your study’s findings, draw conclusions Discuss implications for nursing clinical practice, administration, and education Propose future studies Practical Considerations What Types of Literature Can I Expect to Find? Two broad types of literature are cited in the review of literature for research: theoretical and empirical. Theoretical literature consists of concept analyses, models, theories, and conceptual frameworks that support a selected research problem and purpose. Empirical literature comprises knowledge derived from research. The empirical literature reviewed depends on the study problem and the type of research conducted. Research problems that have been frequently studied or are currently being investigated have more extensive empirical literature than new or unique problems. If searching the empirical literature, you need to identify seminal and landmark studies. Seminal studies are the first studies that prompted the initiation of the field of research. Nurse researchers studying hearing loss in infants would need to review the seminal work of Fred H. Bess, an early researcher on this topic who advocated for effective screening tools ( Gravel, 2009 ). Critical care nurses comparing correction formulas for QT intervals on electrocardiograms would want to refer to Bazet’s correction formula. The development of the formula can be traced to his seminal paper, published in 1920, on time-relations in electrocardiograms ( Roguin, 2011 ). Landmark studies are the studies that led to an important development or a turning point in the field of research. For example, researchers conducting studies related to glycemic control must be knowledgeable of the implications of the Diabetes Control and Complications Trial, a longitudinal study whose findings changed diabetic care beginning in the mid-1990s ( Everett, Bowes, & Kerr, 2010 ). Literature is disseminated in several different formats. Serials are published over time or may be in multiple volumes but do not necessarily have predictable publication dates. Periodicals are subsets of serials with predictable publication dates, such as journals, which are published over time and are numbered sequentially for the years published. This sequential numbering is seen in the year, volume, issue, and page numbering of a journal. Monographs , such as books, hard-copy conference proceedings, and pamphlets, are usually written once and may be updated with a new edition as needed. Conference proceedings can help you identify major researchers in your research area who have presented findings that may not yet be published. Periodicals and monographs are available in a variety of media, such as print, online, CD-ROM, and downloadable formats. Textbooks are monographs written to be used in formal education programs. Entire volumes of books available in a digital or electronic format are called eBooks ( Tensen, 2010 ). You may be familiar with digital books in the mass publication literature that are available to download to read on a special reading device, such as a Kindle or Nook. eBooks are also available for scholarly volumes and articles that can be downloaded to a reading device, cell phone, laptop, or other computer. Books that in the past would have been difficult to obtain through interlibrary loan are now available 24 hours a day, 7 days a week as eBooks. To develop the significance and background section of a proposal, you may also need to search for government reports for the United States (U.S.) and other countries, if appropriate for your study. A researcher developing a proposal on task shifting in HIV care settings in low-resource countries would search the Ministry of Health websites for those countries to find official guidelines for this type of practice. Researchers developing a proposal in Wisconsin on the smoking cessation in adolescents would consult the Healthy People 2020 website for the national goals related to this topic ( http://www.healthypeople.gov/2020/default.aspx/ ). They may also explore health-related agencies in Wisconsin to determine information specific to their state. Position papers are disseminated by professional organizations and government agencies to promote a particular viewpoint on a debatable issue. Position papers, along with descriptions of clinical situations, may be included in the discussion of the background and significance of the research problem. A researcher developing a proposal on race-related differences in HIV treatment outcomes would want to review the Association of Nurses in AIDS Care position paper, “Health Disparities,” which the organization’s board approved in 2009. Master’s theses and doctoral dissertations are valuable literature as well but may not be published. A thesis is a research project completed as part of the requirements for a master’s degree. A dissertation is an extensive, usually original research project that is completed as the final requirement for a doctoral degree. Theses and dissertations can be found by searching special databases that are available for these publications, such as ProQuest Dissertations and Theses ( http://www.proquest.com/en-US/default.shtml/ ). The published literature contains primary and secondary sources. A primary source is written by the person who originated, or is responsible for generating, the ideas published. A research publication published by the person or people who conducted the research is a primary source. A theoretical book or paper written by the theorist who developed the theory or conceptual content is a primary source. A secondary source summarizes or quotes content from primary sources. Thus, authors of secondary sources paraphrase the works of researchers and theorists. The problem with a secondary source is that its author has interpreted the works of someone else, and this interpretation is influenced by that author’s perception and bias. Authors have sometimes spread errors and misinterpretations by using secondary sources rather than primary sources. You should use mostly primary sources to write literature reviews. Secondary sources are used only if primary sources cannot be located or if a secondary source contains creative ideas or a unique organization of information not found in a primary source. Citation is the act of quoting or paraphrasing a source, using it as an example, or presenting it as support for a position taken. How Long Will the Review of the Literature Take? The time required to review the literature is influenced by the problem studied, sources available, and goals of the reviewer. The literature review for a topic that is focused and somewhat narrow may require less time than one for a topic that is broad. The difficulty you experience identifying and locating sources and the number of sources to be located also influence the time involved, as does the intensity of effort. Only through experience does one become knowledgeable about the time needed for a literature review. The novice reviewer requires more time to find the relevant literature than an experienced searcher, and the novice frequently underestimates the time needed for the review. An experienced librarian who works closely with nursing graduate students on a variety of course assignments recommends that the reviewer estimate the time required on the basis of the number of sources required and the reviewer’s familiarity with the library’s databases. The reviewer knows he or she needs at least 30 sources and that finding these sources may require 10 hours of searching. The reviewer estimates that it will take another 20 hours to read and synthesize the sources. The reviewer estimates that the review will require 30 hours. The reviewer should then multiply that number by four, making the estimated time required for the review 120 hours. This longer estimate is often more realistic. As searching skills are refined, the need to use this expanded estimate reduces. Often, the literature review is limited by the time that the reviewer can commit to the assignment. The conclusion related to the time issue is to start as early as possible and stay focused on the purpose of the review. How Many Sources Do I Need to Review? Students repeatedly ask, “How many articles should I have? How far back in years should I look to find relevant information?” The answer to both those questions is an emphatic “It depends.” Course faculty for masters courses commonly require that you obtain full-text articles of all studies relevant to the variables in the proposed study that were published in the previous 10 years. The instructors often indicate, however, that the length of time may vary depending on the topic and the presence of classic studies. Doctoral students are expected to conduct a more extensive review for course papers. If you are writing a research proposal for a thesis or dissertation, the literature required will be extensive. You need to locate the key papers in the field of interest. After doing some initial searches, discuss what you find with your instructor, thesis chair, or dissertation chair, who will be able to help you determine a reasonable publication period for you to use in your review. Am I Expected to Read Every Word of the Available Sources? The answer is “No.” If researchers attempted to read every word of every source that is somewhat related to a selected problem, they would be well read but would probably never complete their searches or move on to developing study proposals. Some individuals, even after a thorough literature review, continue to believe that they do not know enough about their area of interest, so they persist in their review; however, this activity ultimately becomes an excuse for not progressing with their work. The opposite of this situation is the individual who wants to move rapidly through the review of literature to reach the conclusion or get to the part of the work that is more enjoyable or important. With the availability of full-text online articles, the researcher can easily get “lost in the literature” and forget the focus of the review. Becoming a skilled reviewer of the literature involves finding a balance and learning to identify the most pertinent and relevant sources. On the other hand, you cannot critically appraise and synthesize what you have not read. Avoid being distracted by nonrelevant information provided by the author. Learn to read with a purpose and involve multiple senses in your reading. Try reading aloud a section that you have difficulty understanding. Are you having difficulty following an author’s presentation? Try writing an outline. Draw a diagram of key points. Audio record your thoughts on the content of an article. Listen to soothing music if you are tense or anxious. Listen to music with an upbeat tempo if you are tired and having trouble staying awake. Try reading in a quiet place outside or standing up with the copy of the article or your laptop on a counter or high table. Involving multiple senses while reading may help you stay awake and focused. Stages of a Literature Review The stages of a literature review reflect a systems model. Systems have input, throughput, and output. The input consists of the sources that you find through searching the literature. The throughput is the processes you use to read, critically appraise, analyze, and synthesize the literature you find. The written literature review is the output of these processes (see Figure 6-1 ). The quality of the input and throughput will determine the quality of the output. As a result, each stage of the literature review is critical to producing a high-quality literature review. Although these stages are presented here as sequential, you may go back to a previous stage. For example, during the analysis and synthesis of your sources, you identify that the studies you are citing were conducted only in Europe. You might go back and search the literature again using the United States or another search term to ascertain that no studies have been done in that country. As you are writing your literature review, you may identify a problem with the logic of your presentation. To resolve it, you may return to the processing stage to clarify the presentation. Figure 6-1 Systems model of the review of the literature. Searching the Literature Before writing a literature review, you must first perform literature searches to identify sources relevant to your topic of interest. The literature review will help you narrow your topic and develop a feasible study ( Hart, 2009 ). Whether you are a student, practicing nurse, or nurse researcher, your goal is to develop a search strategy designed to retrieve as much of the relevant literature as possible given the time and financial constraints of your project. Libraries have become gateways to information or information resource centers, rather than storehouses of knowledge ( Hart, 2009 ). High-quality libraries provide access to a large number of electronic databases that supply a broad scope of the literature available internationally, enabling library users not only to identify relevant sources quickly but also to read full-text versions of most of these sources immediately. When your library does not have the hard copy of a book or electronic access to a specific journal, the librarian can usually provide the book or an electronic copy of the article through interlibrary loan. All libraries, public, private, college, and university, have interlibrary loan capabilities. You may especially need to use interlibrary loan when sources relevant to your topic were published prior to the advent of electronic databases. Consider consulting with an information professional, such as a subject specialist librarian, to develop a literature search approach ( Booth, Colomb, & Williams, 2008 ; Tensen, 2010 ). Often these consultations can be performed via email or a web-based meeting, so that communication occurs at the convenience of both the researcher and the information professional. Many university libraries provide this consultation service whether or not the library user is affiliated with the university. Develop a Search Plan Before you begin searching the literature, you must consider exactly what information you are seeking. Expending time and effort in the early stage of a review to develop a search strategy is likely to save time and effort later ( Hart, 2009 ). A written plan helps you to avoid duplication of effort, to return to a previously searched area with a different set of search terms or a different range of publication years. Your initial search should be based on the widest possible interpretation of your topic. This strategy enables you to envision the extent of the relevant literature. As you see the results of the initial searches and begin reading the material, you will refine your topic, and then you can narrow the focus of your searches. As you search, add your selected search terms to your written search plan. As you search, add other terms that you discover from the references you locate. For each search, record (1) the name of the database, (2) the date, (3) search terms and searching strategy, (4) the number and types of articles found, and (5) an estimate of the proportion of the citations you retrieved that were relevant articles. Table 6-2 is an example of search history that you can use to record what and how you have searched the literature. Save the results of each search on your computer or external device. Some databases allow you to create an account and save your search history online (i.e., the record of what and how you searched). TABLE 6-2 Plan and Record for Searching the Literature Database Searched Date of Search Search Strategy and Limiters Number and Type of Articles Found Estimate of Relevant Articles Cumulative Index to Nursing and Allied Health Literature (CINAHL)         MEDLINE         Academic Search Premier         Cochrane Library         Select Databases to Search A database is computer data that have been collected and arranged to be searchable and automatically retrievable ( Tensen, 2010 ). A bibliographical database is an “an electronic version of a bibliographic index” (p. 57) or compilation of citations. The database may consist of citations relevant to a specific discipline or may be a broad collection of citations from a variety of disciplines. Databases of periodical citations include the authors, title, journal, keywords, and usually an abstract of the article. Library databases contain titles and authors of hard copy books and documents, government reports, and reference books. Library databases also include a searchable list of the journals to which the library has a paper or electronic subscription. For example, your library may have received paper copies of a monthly journal in the mail until 2006. The hard copies of the issues were bound to create annual volumes of the journal. Since 2006, the library has subscribed to the electronic journal or a journal database that provides access to specific issues. Bibliographical databases provided by the same vendor, such as those databases affiliated with EBSCO Publishing, allow you to search multiple databases simultaneously to save time. Usually the search engine will automatically delete duplicates of the same study. You can also change the order in which the results of the search are shown. For example, with the EBSCO Publishing databases, you can sort the citations by relevance, date descending (most current first), or date ascending (oldest to more recent). Older sources of reference indexes are useful for sources published prior to the electronic databases. Card catalogs, abstract reviews, and indexes were the only ways to search for nursing references until 1955, when the Cumulative Index to Nursing and Allied Health Literature (CINAHL) began being published. Because the printed editions had red covers, you still may hear more experienced scholars fondly refer to “the Red Books.” The print version of CINAHL is still available in libraries, and you may find it useful when searching for citations published before 1982 or when bibliographic databases are not available ( Tensen, 2010 ). In medicine, the Index Medicus (IM) was first published in 1879 and is the oldest health-related index. The Index Medicus includes some citations of nursing publications, with the number of nursing journals cited growing. CINAHL contains, however, a more extensive listing of nursing publications and uses more nursing terminology as subject headings. With the greater focus on interdisciplinary research, nurse researchers must also be consumers of the literature in the National Library of Medicine (MEDLINE), other government agencies, and professional organizations. Table 6-3 provides descriptions of commonly used bibliographical databases. TABLE 6-3 Bibliographical Databases Name of Database Description of the Database by the Publisher * Cumulative Index of Nursing and Allied Health Literature (CINAHL) “Comprehensive source of full text for nursing & allied health journals, providing full text for more than 770 journals” MEDLINE “Information on medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences, and much more” Created and provided by the National Library of Medicine Uses Medical Subject Headings (MeSH terms) for indexing and searching of “citations from over 4,800 current biomedical journals” PubMed Free access to Medline that provides links to full-text articles when available PsychARTICLES 15,000 “full-text, peer-reviewed scholarly and scientific articles in psychology” Limited to journals published by the American Psychological Association (APA) and affiliated organizations PsychINFO “Scholarly journal articles, book chapters, books, and dissertations, is the largest resource devoted to peer-reviewed literature in behavioral science and mental health” Supported by APA Covers over 3 million records Academic Search Complete “Comprehensive scholarly, multi-disciplinary full-text database, with more than 8,500 full-text periodicals, including more than 7,300 peer-reviewed journals” Health Source Nursing/ Academic Edition “Provides nearly 550 scholarly full text journals focusing on many medical disciplines” Also includes 1,300 patient education sheets for generic drugs Psychological and Behavioral Sciences Collection “Comprehensive database covering information concerning topics in emotional and behavioral characteristics, psychiatry & psychology, mental processes, anthropology, and observational & experimental methods” 400 journals indexed * Direct quotations from EBSCO Publishing descriptions of the databases, available at http://www.ebscohost.com/academic/ .

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• http://orcid.org/0000-0003-0157-5319 Ahtisham Younas 1 , 2 ,
• http://orcid.org/0000-0002-7839-8130 Parveen Ali 3 , 4
• 1 Memorial University of Newfoundland , St John's , Newfoundland , Canada
• 2 Swat College of Nursing , Pakistan
• 3 School of Nursing and Midwifery , University of Sheffield , Sheffield , South Yorkshire , UK
• 4 Sheffield University Interpersonal Violence Research Group , Sheffield University , Sheffield , UK
• Correspondence to Ahtisham Younas, Memorial University of Newfoundland, St John's, NL A1C 5C4, Canada; ay6133{at}mun.ca

https://doi.org/10.1136/ebnurs-2021-103417

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Introduction

Literature reviews offer a critical synthesis of empirical and theoretical literature to assess the strength of evidence, develop guidelines for practice and policymaking, and identify areas for future research. 1 It is often essential and usually the first task in any research endeavour, particularly in masters or doctoral level education. For effective data extraction and rigorous synthesis in reviews, the use of literature summary tables is of utmost importance. A literature summary table provides a synopsis of an included article. It succinctly presents its purpose, methods, findings and other relevant information pertinent to the review. The aim of developing these literature summary tables is to provide the reader with the information at one glance. Since there are multiple types of reviews (eg, systematic, integrative, scoping, critical and mixed methods) with distinct purposes and techniques, 2 there could be various approaches for developing literature summary tables making it a complex task specialty for the novice researchers or reviewers. Here, we offer five tips for authors of the review articles, relevant to all types of reviews, for creating useful and relevant literature summary tables. We also provide examples from our published reviews to illustrate how useful literature summary tables can be developed and what sort of information should be provided.

Tip 1: provide detailed information about frameworks and methods

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Tabular literature summaries from a scoping review. Source: Rasheed et al . 3

The provision of information about conceptual and theoretical frameworks and methods is useful for several reasons. First, in quantitative (reviews synthesising the results of quantitative studies) and mixed reviews (reviews synthesising the results of both qualitative and quantitative studies to address a mixed review question), it allows the readers to assess the congruence of the core findings and methods with the adapted framework and tested assumptions. In qualitative reviews (reviews synthesising results of qualitative studies), this information is beneficial for readers to recognise the underlying philosophical and paradigmatic stance of the authors of the included articles. For example, imagine the authors of an article, included in a review, used phenomenological inquiry for their research. In that case, the review authors and the readers of the review need to know what kind of (transcendental or hermeneutic) philosophical stance guided the inquiry. Review authors should, therefore, include the philosophical stance in their literature summary for the particular article. Second, information about frameworks and methods enables review authors and readers to judge the quality of the research, which allows for discerning the strengths and limitations of the article. For example, if authors of an included article intended to develop a new scale and test its psychometric properties. To achieve this aim, they used a convenience sample of 150 participants and performed exploratory (EFA) and confirmatory factor analysis (CFA) on the same sample. Such an approach would indicate a flawed methodology because EFA and CFA should not be conducted on the same sample. The review authors must include this information in their summary table. Omitting this information from a summary could lead to the inclusion of a flawed article in the review, thereby jeopardising the review’s rigour.

Tip 2: include strengths and limitations for each article

Critical appraisal of individual articles included in a review is crucial for increasing the rigour of the review. Despite using various templates for critical appraisal, authors often do not provide detailed information about each reviewed article’s strengths and limitations. Merely noting the quality score based on standardised critical appraisal templates is not adequate because the readers should be able to identify the reasons for assigning a weak or moderate rating. Many recent critical appraisal checklists (eg, Mixed Methods Appraisal Tool) discourage review authors from assigning a quality score and recommend noting the main strengths and limitations of included studies. It is also vital that methodological and conceptual limitations and strengths of the articles included in the review are provided because not all review articles include empirical research papers. Rather some review synthesises the theoretical aspects of articles. Providing information about conceptual limitations is also important for readers to judge the quality of foundations of the research. For example, if you included a mixed-methods study in the review, reporting the methodological and conceptual limitations about ‘integration’ is critical for evaluating the study’s strength. Suppose the authors only collected qualitative and quantitative data and did not state the intent and timing of integration. In that case, the strength of the study is weak. Integration only occurred at the levels of data collection. However, integration may not have occurred at the analysis, interpretation and reporting levels.

Tip 3: write conceptual contribution of each reviewed article

While reading and evaluating review papers, we have observed that many review authors only provide core results of the article included in a review and do not explain the conceptual contribution offered by the included article. We refer to conceptual contribution as a description of how the article’s key results contribute towards the development of potential codes, themes or subthemes, or emerging patterns that are reported as the review findings. For example, the authors of a review article noted that one of the research articles included in their review demonstrated the usefulness of case studies and reflective logs as strategies for fostering compassion in nursing students. The conceptual contribution of this research article could be that experiential learning is one way to teach compassion to nursing students, as supported by case studies and reflective logs. This conceptual contribution of the article should be mentioned in the literature summary table. Delineating each reviewed article’s conceptual contribution is particularly beneficial in qualitative reviews, mixed-methods reviews, and critical reviews that often focus on developing models and describing or explaining various phenomena. Figure 2 offers an example of a literature summary table. 4

Tabular literature summaries from a critical review. Source: Younas and Maddigan. 4

Tip 4: compose potential themes from each article during summary writing

While developing literature summary tables, many authors use themes or subthemes reported in the given articles as the key results of their own review. Such an approach prevents the review authors from understanding the article’s conceptual contribution, developing rigorous synthesis and drawing reasonable interpretations of results from an individual article. Ultimately, it affects the generation of novel review findings. For example, one of the articles about women’s healthcare-seeking behaviours in developing countries reported a theme ‘social-cultural determinants of health as precursors of delays’. Instead of using this theme as one of the review findings, the reviewers should read and interpret beyond the given description in an article, compare and contrast themes, findings from one article with findings and themes from another article to find similarities and differences and to understand and explain bigger picture for their readers. Therefore, while developing literature summary tables, think twice before using the predeveloped themes. Including your themes in the summary tables (see figure 1 ) demonstrates to the readers that a robust method of data extraction and synthesis has been followed.

Tip 5: create your personalised template for literature summaries

Often templates are available for data extraction and development of literature summary tables. The available templates may be in the form of a table, chart or a structured framework that extracts some essential information about every article. The commonly used information may include authors, purpose, methods, key results and quality scores. While extracting all relevant information is important, such templates should be tailored to meet the needs of the individuals’ review. For example, for a review about the effectiveness of healthcare interventions, a literature summary table must include information about the intervention, its type, content timing, duration, setting, effectiveness, negative consequences, and receivers and implementers’ experiences of its usage. Similarly, literature summary tables for articles included in a meta-synthesis must include information about the participants’ characteristics, research context and conceptual contribution of each reviewed article so as to help the reader make an informed decision about the usefulness or lack of usefulness of the individual article in the review and the whole review.

In conclusion, narrative or systematic reviews are almost always conducted as a part of any educational project (thesis or dissertation) or academic or clinical research. Literature reviews are the foundation of research on a given topic. Robust and high-quality reviews play an instrumental role in guiding research, practice and policymaking. However, the quality of reviews is also contingent on rigorous data extraction and synthesis, which require developing literature summaries. We have outlined five tips that could enhance the quality of the data extraction and synthesis process by developing useful literature summaries.

• Aromataris E ,
• Rasheed SP ,

Twitter @Ahtisham04, @parveenazamali

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

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• Methodology
• Open access
• Published: 06 April 2024

Consolidated guidance for behavioral intervention pilot and feasibility studies

• Christopher D. Pfledderer   ORCID: orcid.org/0000-0001-7503-8554 1 , 2 ,
• Lauren von Klinggraeff 3 ,
• Sarah Burkart 3 ,
• Alexsandra da Silva Bandeira 3 ,
• David R. Lubans 4 ,
• Russell Jago 5 ,
• Anthony D. Okely 6 ,
• Esther M. F. van Sluijs 7 ,
• John P. A. Ioannidis 11 , 12 , 8 , 9 , 10 ,
• James F. Thrasher 3 ,
• Xiaoming Li 3 &
• Michael W. Beets 3  

Pilot and Feasibility Studies volume  10 , Article number:  57 ( 2024 ) Cite this article

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In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that provides essential information used to inform the design, conduct, and implementation of a larger-scale trial. There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All of these publications offer some form of guidance on PFS, but many focus on one or a few topics. This makes it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions conducted in the behavioral sciences.

To develop this consolidation, we undertook a review of the published guidance on PFS in combination with expert consensus (via a Delphi study) from the authors who wrote such guidance to inform the identified considerations. A total of 161 PFS-related guidelines, checklists, frameworks, and recommendations were identified via a review of recently published behavioral intervention PFS and backward/forward citation tracking of a well-known PFS literature (e.g., CONSORT Ext. for PFS). Authors of all 161 PFS publications were invited to complete a three-round Delphi survey, which was used to guide the creation of a consolidated list of considerations to guide the design, conduct, and reporting of PFS conducted by researchers in the behavioral sciences.

A total of 496 authors were invited to take part in the three-round Delphi survey (round 1, N  = 46; round 2, N  = 24; round 3, N  = 22). A set of twenty considerations, broadly categorized into six themes (intervention design, study design, conduct of trial, implementation of intervention, statistical analysis, and reporting) were generated from a review of the 161 PFS-related publications as well as a synthesis of feedback from the three-round Delphi process. These 20 considerations are presented alongside a supporting narrative for each consideration as well as a crosswalk of all 161 publications aligned with each consideration for further reading.

We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. Researchers may use these considerations alongside the previously published literature to guide decisions about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.

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Key messages regarding feasibility

• There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All these publications offer some form of guidance on PFS, but many focus on one or a few topics, making it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS.

• We present a set of consolidated considerations for behavioral intervention pilot and/or feasibility studies based on a review of the literature and a Delphi study with the authors who wrote this literature.

• We believe this consolidated set of considerations can be a “go-to” resource for any behavioral interventionist wanting to design, conduct, and report on their pilot and/or feasibility study.

In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that occurs early in the translational science continuum. PFS provide essential information to inform the design, conduct, and implementation of larger-scale trials, although not all studies follow the traditional roadmap to scale-up [ 1 ]. PFS are designed to answer questions surrounding uncertainty (feasibility) and potential impact (preliminary efficacy) and to inform gaps in knowledge about the various aspects of the intervention or conduct of the study. In turn, this information is used to make decisions regarding scale-up and future plans for a larger-scale trial.

There are more than 160 published guidelines, checklists, frameworks, and recommendations related to the design, conduct, and reporting of PFS. These publications offer some form of guidance on PFS, but many focus on a specific aspect of design, conduct, and reporting considerations. This makes it difficult for researchers who want to gain a broader understanding of all the relevant and important aspects of PFS and forces them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. Because of this, we believe a consolidated list of considerations, drawing on the breadth and depth of knowledge that has already been published on the topic, would have high utility for researchers and assist them in understanding important considerations and nuances when conducting a PFS.

Throughout this paper, we refer to PFS as early-stage studies designed to inform larger-scale, well-powered trials. We recognize that there are numerous labels for such studies (e.g., “proof-of-concept”, “evidentiary”, “vanguard”). We also realize that the terms “pilot” and “feasibility” evoke different meanings [ 2 , 3 ] and are used interchangeably and, in some instances, simultaneously. We address this issue in this consolidation of considerations. We also recognize that not all PFS will include or need to consider all the identified considerations. In many instances, however, a single PFS is designed to cover all of the data needed to inform a larger-scale trial [ 4 ]. This includes everything from estimating recruitment/retention rates, participant satisfaction and engagement, fidelity, and a host of other feasibility indicators, as well as providing some preliminary indications of change in one or more outcomes of interest. Researchers often deliberately design a PFS to collect information across these multiple dimensions, though their decision making is often largely driven by such issues as available resources and abbreviated timelines.

The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions in the fields of behavioral sciences. The considerations presented herein were developed through any extensive review of the literature and a Delphi study of experts who wrote the existing literature on PFS. The consolidated set of considerations was developed for universal application across interventions in the behavioral sciences and across the study designs one may choose. We expect this consolidation will serve as a valuable resource for all behavioral science interventionists who design and conduct PFS, regardless of the intervention mechanism, target population, or study design.

To ensure rigor and methodological quality throughout the consolidation of previously published guidelines, checklists, frameworks, and recommendations, we relied on guidance from Moher et al., [ 5 , 6 ] which details the main steps in the development of evidence-based consensus in health fields. These steps included developing a strong rationale for the consolidation, necessary preparatory work conducted by the study team, consensus activities, and development of the final consolidation. These steps are detailed below. When relevant, we also drew on similar consensus studies conducted in the behavioral sciences [ 2 , 3 , 7 , 8 ].

Review of previously published guidelines, checklists, frameworks, and recommendations for PFS

A scoping bibliometric review of published PFS-related guidelines, checklists, frameworks, and recommendations was conducted prior to developing the Delphi survey, which has been reported elsewhere [ 9 ]. Briefly, we identified 4143 PFS from which we then identified 90 guidelines, checklists, frameworks, and recommendations cited in that literature. We then continued searching for relevant literature via backward citation tracking of known publications, including the CONSORT Extension for Pilot and Feasibility Studies [ 7 ], Medical Research Council guidance [ 10 ], and publications such as Bowen et al. [ 11 ] and Pearson et al. [ 12 ] A total of 161 publications were identified that encompassed nine thematic domains: adaptations , definitions of pilot and feasibility studies , design and interpretation , feasibility , implementation , intervention development , progression criteria , sample size , and scale-up . The 161 publications guided our inclusion of the sample of respondents for the Delphi survey, which is detailed in the next section. It is worth noting that after this review, we identified an additional relevant publication published after the completion of the study, which is included in our final sample (bringing the total number of studies to 162) but was not used to inform the Delphi study.

Participant selection and recruitment for the Delphi survey

Lead, second, corresponding, and senior authors of the 161 published guidelines, checklists, frameworks, and recommendations for PFS were invited via email to complete a three-round Delphi study. Contact information was retrieved from published article meta-data and when not found in the published articles, emails were retrieved from another publicly available source, such as faculty pages or university websites. This resulted in 496 potential participants, who were sent an individualized invitation email via Qualtrics for round 1 of the Delphi study. For round 2, only participants who completed round 1 were invited to take part in the survey. We then sent the round 3 survey back to the original pool of 496 potential participants, regardless of whether they completed round 1. This process is summarized in Fig.  1 and took place between May 2022 and January 2023. Ethical approval was granted by the University of South Carolina’s Institutional Review Board (IRB # Pro00120890) prior to the start of the study.

Participant flow through each round of the Delphi survey process

Delphi survey

Each round of the Delphi survey process was guided by established protocols [ 13 , 14 ] and is detailed below.

Round 1—Delphi survey

In round 1 of the Delphi process, participants were asked to provide the most important considerations regarding the design, conduct, analysis, or reporting of behavioral pilot and/or feasibility intervention studies in separate free-text fields via Qualtrics. Before beginning the survey, participants were provided with operational definitions of both “behavioral interventions” and “preliminary studies” for context. No other prompts were provided. In round 1 of the Delphi study, we referred to PFS as “preliminary” studies, but after receiving comments about the use of this term, this was changed to “pilot and/or feasibility” studies in round 2. Survey distribution for round 1 took place in May and June 2022.

Preparation for round 2

Participants’ responses from round 1 were exported from Qualtrics to a.csv file in Microsoft Excel, collated into individual Microsoft Word documents for each participant, converted to PDFs, and imported into NVivo for thematic coding. Prior to coding responses in NVivo, we simplified and revised our original nine thematic domains from the scoping bibliometric review into six overarching themes: intervention design , study design , conduct of trial , implementation of intervention , statistical analysis , and reporting . This revision was conducted after an initial review of responses from round 1 of the Delphi survey in an effort to simplify themes and to allow for maximum parsimony across expert perspectives. Specifically, we identified overlap in several of the original nine themes and made a decision to include them as subthemes in the revision to six overarching themes. The titles of the original nine thematic domains were largely retained and can be found embedded as subthemes in the six revised overarching themes. A two-step thematic coding process followed. First, individual participant responses were coded into a corresponding theme based on the content of their response. This was completed by two members of the research team (CDP and MWB). Disagreements were brought to the larger research team (LV, SB, and AB) during weekly meetings and were resolved at that time. Once participant responses were coded into one of the six overarching themes, our research team coded responses into one of 20 subthemes based on qualitative analysis of participants’ responses by theme. These 20 subthemes served as the coding framework for the second step of the thematic coding process, and responses were coded as such by two members of the research team (CDP and MWB).

Round 2—Delphi survey

In round 2 of the Delphi study, participants were re-oriented to the study with a brief narrative and were presented with the six overarching themes and 20 subthemes generated via qualitative analysis of the results from round 1. To give participants context, we provided select, representative quotes for each subtheme from round 1 of the survey. After being presented with the theme, subtheme, and select quotes, participants were asked to provide a recommendation for each subtheme for inclusion in a consolidated framework for behavioral intervention PFS. Participants were also given the chance to indicate if they felt a subtheme should not be included in a consolidated framework. The survey was organized such that each theme (along with the corresponding subthemes) was presented as a randomized block, meaning individual participants were presented with a unique order of themes and asked to provide their considerations. Block randomization of themes was performed to prevent the possibility of homogenous burnout across participants as they reached the last theme of the survey. The last question of the survey was a free-text field in which participants could indicate if there were any additional considerations that were not mentioned in the survey that should be added to a consolidated framework for pilot and/or feasibility behavioral intervention studies. Survey distribution for round 2 took place in September and October 2022.

Preparation for round 3

Participant responses from round 2 were exported from Qualtrics to a.csv file in Microsoft Excel and collated into individual Microsoft Word documents for each of the 20 subthemes. A collection of considerations for each subtheme was written based on participant responses from rounds 1 and 2 and from information provided throughout the previously identified 161 pilot and/or feasibility-related guidelines, checklists, frameworks, and recommendations. Weekly research group meetings were used to further refine the considerations.

Round 3—Delphi survey

In the final round of the Delphi study, participants were first asked to provide basic demographic information including age, sex, race/ethnicity, and the year in which they received their terminal degree. Demographic information was not collected from participants in round 1 or 2 of the Delphi survey to limit participant burden in the initial rounds of the survey. We then provided participants with an outline of the six themes and 20 subthemes that emerged from rounds 1 and 2 of the study, a description of the final recommendation for the study, and instructions for the final survey. For each of the 20 subthemes, participants were given an operational definition of the subtheme and a list of considerations, which were generated based on the comments from rounds 1 and 2. They were then asked to rate their level of agreement with the considerations (0–10 Likert scale from Strongly Disagree to Strongly Agree). An optional free-text field was provided for additional information about what we should add to/change about the considerations. Participants were presented with each subtheme in block-randomized order just as in round 2. Survey distribution for round 3 took place in December 2022 and January 2023.

Final consolidation of considerations

The final set of considerations was written in a similar manner to round 2. Responses were collated into separate working documents for each of the 20 subthemes, which also included the list of previously written considerations drafted for round 2. The previously written considerations were altered based on participant feedback from round 3 and from further supporting information from the 161 pilot and/or feasibility-related guidelines, checklists, frameworks, and recommendations. Primary changes to the considerations were made by two members of the research team (CDP and MWB) and further refined by members of our larger research team (LV, SB, and AB).

Analysis of quantitative data

There were two forms of quantitative data gathered from participants during round 3 of the Delphi survey process. The first was demographic information, which was summarized descriptively as means, standard deviations, and ranges where appropriate. The second were the participant’s Likert-scale ratings of each set of considerations for each of the 20 subthemes. These data were summarized visually with boxplots and descriptively with means, standard deviations, medians, ranges, and interquartile ranges. All quantitative analysis was performed in STATA v17.0 statistical software package (College Station, TX, USA).

Participant characteristics and survey completion

A total of 46 of the 496 (9.3%) invited authors representing 51 of the 161 (31.7%) identified publications completed round 1 of the Delphi study. In round 1, where respondents were asked to provide up to 20 considerations regarding the design, conduct, analysis, or reporting of behavioral pilot and/or feasibility intervention studies, participants gave a mean of 8 ± 4 (range = 1–20, median = 7, IQR = 5–10) considerations. Of the 46 participants who completed round 1, 24 (52.2%) completed round 2. A total of 50 (10.1%) of the original pool of 496 participants representing 60 (37.3%) publications completed round 3. For the 161 publications that were represented by authors in the Delphi study, the median year of publication was 2015 (range = 1998–2022, IQR = 2013–2018). Comparatively, across all possible 161 identified publications, the median year of publication was 2013 (range = 1989–2022, IQR = 2009–2017). A visual summary of participant flow through each of the three rounds of the Delphi survey process is provided in Fig.  1 . Demographic information for participants who completed round 3 is presented in Table  1 .

Likert ratings of the considerations

Likert scale ratings (0–10 scale) of each of the considerations for the 20 subthemes were provided by 50 out of 50 (100%) participants during round 3 of the Delphi survey. These are summarized in Table  2 . Average ratings for considerations across all 20 subthemes ranged from 7.6 to 8.8, with medians ranging from 8 to 10.

Consolidated considerations for PFS

For each subtheme, we provide an operational definition of the subtheme, a consolidated list of considerations based on the review of pilot and/or feasibility literature and the three-round Delphi study, and a narrative summary of the subtheme. We also provide a crosswalk of 161 guidelines, checklists, frameworks, and recommendations, mapped on to the subthemes identified and an additional publication that was published after the Delphi process, but was relevant to include in the list [ 15 ]. The crosswalk is found in Additional file 1 and can be used to identify supporting literature for each of the subthemes and considerations we have consolidated. Of the 161 publications, 15 are reporting guidelines/checklists, 44 are guidelines/recommendations, 18 are reviews that offer recommendations, 37 are frameworks/models, and 47 are commentaries/editorials that offer recommendations or guidance for preliminary studies. For the narrative summary, wherever possible, we have identified relevant examples across widely used study designs for PFS which range from “N of 1” studies, micro-randomized trials, single and multiple group designs, and those involving traditional randomization, to highlight the universality of the consolidated considerations.

Intervention design

Adaptations and tailoring.

Adaptations and tailoring refer to any deliberate changes to the design or delivery of an intervention, with the goal of improving fit or effectiveness in a given context [ 16 ].

Considerations

Where components of the intervention are adapted/tailored, details of who was involved (e.g., investigative team, key stakeholders, participants) in the decisions (see 1.3. Stakeholder Engagement and Co-Production ), when the adaptations/tailoring occurred, and how and why the modification(s) were made need to be clearly reported.

How the proposed adaptations/tailoring address the issues/challenges observed in the intervention need to be clearly reported along with justification for why these changes should result in an improved design.

Whether the adaptations/tailoring occurred a priori or during the conduct of the study should be clearly described.

The intervention component of PFS can be conducted in a rigorous fashion yet be flexible enough to allow for minor adaptations or tailoring (in composition, format, design, etc.) when justified and in response to emerging feasibility indicators.

If substantial adaptations are made to the intervention, such that the adaptations may influence feasibility indicators or behavioral outcomes, re-testing of the PFS prior to progression is justifiable (see 2.1. Iteration and Intervention Refinement ). Adaptations/tailoring occurring under these circumstances should refer to any a priori progression criteria specifications (see 2.2. Progression Criteria ).

Often, existing evidence-based interventions are modified (i.e., adapted/tailored) for delivery to a new sample or in a new setting that is different from where the intervention was originally implemented and evaluated. In these situations, a PFS may be conducted to establish whether the modifications are appropriate in the new sample/setting [ 17 , 18 ]. Adaptations are often made to increase relevance and participant engagement, with the assumption the adaptations would lead to better outcomes in the target populations and settings of eventual interest [ 19 , 20 ].

Adaptations can consist of changes to intervention materials to make them culturally relevant to the target population (race/ethnicity, country/setting, norms/values) [ 19 , 21 ]. Adaptations may also include changes to the intervention itself, such as how it is delivered (e.g., combining sessions, online vs. face-to-face), delivery location, who it is delivered by, or the length of the sessions/intervention [ 22 , 23 ]. Adaptations may occur at any point in the design, implementation, and evaluation/interpretation of a PFS. These include a priori adaptations of existing interventions, those that occur as a result of the evaluation of an intervention, or adaptations made on an ongoing basis throughout a PFS [ 19 , 21 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].

Where adaptations/tailoring occur, reasons for the adaptations and who participated in the decision-making process should be reported. Often, the adaptation process includes coproduction/codesign methods that can involve focus groups, feedback sessions, and key patient, participant, and public involvement [ 17 ] to justify and inform the relevancy of the adaptations [ 19 , 34 , 35 , 36 ] (see 1.3. Stakeholder Engagement and Co-Production). If coproduction/codesign methods are used, these should be clearly reported.

Site selection and context

Site selection refers to the location in which a PFS will be conducted. Context refers to the factors that form the setting of the intervention, including location, culture, environment, and situation [ 12 , 37 ].

Whenever feasible, researchers should choose sites for PFS that are representative of those anticipated in the future larger-scale trial.

Purposeful selection of sites can be used to ensure an intervention is tested in an appropriate range of contexts.

A rationale for the sites selected should be clearly stated along with how the sites and context reflect what is anticipated in the future larger-scale trial.

Key characteristics of the sites and context should be reported.

The context of intervention delivery and any information that suggests contextual elements may impact the feasibility or future efficacy of the intervention should be clearly reported.

Where context is known or hypothesized to influence the implementation and/or feasibility of an intervention, including more than one site may be necessary.

Setting and contextual characteristics are known factors that can influence intervention outcomes. For PFS testing interventions that rely on a setting as part of the delivery process or are embedded naturally within existing settings, site selection and context become key factors to understand at the early stages of the design and evaluation of an intervention. Setting and context may represent static (e.g., hospital serving low-resource area) or dynamic (e.g., weather, day-to-day variability) characteristics [ 38 ]. Reasons why sites are selected in a PFS can include a range of pragmatic considerations. These include the need for representation of a diverse range of characteristics (e.g., geography, populations served), facilities/infrastructure required for the project (e.g., cell phone connectivity, low-resource settings), and proximity to the investigative team [ 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. These decisions may also be based on the ability to refer sufficient numbers of participants at a given site [ 43 , 46 , 47 ]. Descriptions of the context and setting and how these might influence intervention outcomes should be clearly reported [ 38 , 48 , 49 ].

In some PFS, understanding setting complexity and how an intervention fits within a broader system may be the primary research questions that need to be answered prior to conducting a larger-scale trial. Studies investigating setting or context are useful for the identification of whether an intervention is appropriate or feasible to deliver for a given setting [ 50 , 51 , 52 , 53 ]. This allows for understanding uncertainties about the setting and how differences across settings may influence implementation [ 54 , 55 , 56 , 57 ]. In some situations, where an existing intervention is adapted to be delivered in a different setting, understanding how the intervention interacts with the new context becomes a key feasibility outcome to evaluate.

Stakeholder engagement and co-production

Stakeholder engagement and co-production refers to the use of partnerships with individuals, communities, and service providers to aid in the development and implementation of an intervention [ 58 ].

PFS should be, whenever possible, co-designed/co-created or informed by key stakeholder (e.g., community and professional) perspectives throughout all stages of design and implementation.

Whenever possible, pro-equity approaches that ensure the unique considerations and perspectives around an intervention’s acceptability, safety, etc., and participation in and ownership of research from minority and vulnerable populations, should be used.

The processes by which the PFS was co-designed, including who was consulted, why, when they were consulted, and how their input was obtained, should be clearly described.

Stakeholder engagement and co-production methods are commonly used in PFS to ensure the relevance of a number of intervention-related facets. These include the relevance of intervention materials, how an intervention is delivered, whether the content is appropriate, and if any important components are missing [ 59 , 60 , 61 ]. Employing stakeholder engagement and co-production methods can be useful to ensure ownership of the developed intervention by recipients and end-users [ 62 ]. Where these methods are employed, it is important to report who is involved in co-production (participants, interventionists, members of the public, other key stakeholders) and a rationale for their involvement in the process [ 63 , 64 , 65 ]. The process of engaging stakeholders in co-production can take many forms, including “think aloud”—commonly used for useability testing, questionnaires, and/or interviews [ 66 , 67 , 68 , 69 , 70 ]. What participants did during the co-production process, such as reviewing qualitative interviews or initial testing of intervention materials, should be reported. Details of how participants were engaged in the co-production (e.g., time dedicated, number of rounds of review/workshops, the total number of individuals involved) should also be included [ 71 , 72 ]. In some instances, it may be appropriate to describe details of the training required to facilitate a co-production process [ 61 ].

Theory usage

Theory usage refers to the utilization of any conceptual or theoretical model to inform aspects of the PFS that are mechanisms of change [ 8 ].

Researchers, where relevant, should include details about one or more behavior change theories (e.g., intervention activities, mechanisms) which informed aspects of the PFS, including whether components of the intervention are theoretically or practically informed.

The theoretical foundation of an intervention should be clearly stated. The components of an intervention may directly map on to one or more theories of change. These could be specific theories, mechanisms, or conceptual frameworks informed by practice. Theories of change should refer to intervention resources, activities, mechanisms, and intermediate and final outcomes. This information can be presented in the form of a logic model of change or conceptual frameworks depicting the theory of change or program theory [ 50 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ]. Details of the theory of change and how this informed intervention development can be presented alongside pilot and/or feasibility outcomes, but could also be published separately, such as in a protocol overview [ 81 , 82 ].

Well-defined problem and aims

Well-defined problems and aims refers to the focused research questions/objectives used to guide the design, conduct, and analyses of PFS [ 8 ].

PFS should be guided by clear and focused research questions related primarily to the feasibility of the intervention and prospects of subsequent scale-up to a larger-scale trial. These well-formulated research questions should be answered by an appropriate and transparent methodology that uses both quantitative and qualitative data.

Where appropriate, the PFS proposal and report should define a clinically important public health problem for which researchers are designing, refining, or adapting an intervention.

PFS are designed primarily to answer key aspects regarding the feasibility of an intervention. These include addressing uncertainties about the intervention and the implications of the findings for larger-scale trials [ 83 ]. Questions of uncertainty are the basis for well-defined problems and aims of PFS. These can include understanding researchers’ access to the population of interest (recruitment); acceptability of randomization (for certain study designs); developing, refining, and finalizing intervention protocols; acceptability of the intervention for the target population; intervention deliverers and other key personnel; and other feasibility-related outcomes including fidelity, cost, equity, and cultural appropriateness [ 70 , 84 , 85 , 86 , 87 ].

In certain situations, the aims of a PFS can be more exploratory in nature. But this does not preclude the study from having a set of well-defined problems and aims. Examples may include learning about the assets, values, and/or history of the community in which an intervention could potentially be delivered and learning about the processes in which co-design and collaboration with community members could naturally take place prior to delivering an intervention.

Study design

Iteration and intervention refinement.

Iteration and intervention refinement refers to the re-testing of an intervention in PFS to further refine intervention components before scaling to a larger trial [ 88 ].

If the conclusion of the PFS is to make significant adjustments to either the study design or the intervention, then it should be acknowledged that the results do not justify proceeding further and a second PFS is necessary to establish feasibility before testing the intervention in a larger-scale, well-powered trial. Any potential changes (adaptations/tailoring) should be clearly documented along with information about how and why the changes are to be made (see 1.1. Adaptations and Tailoring ).

The decision to conduct multiple iterations of a PFS can be pragmatic or theoretical and based on factors including the perceived confidence the redesign will sufficiently address the identified problems.

Conclusions from a PFS should include whether the intervention, in its current form, is ready for a future trial or if modifications are needed (and if so, details of them), and whether they are substantial enough to warrant another PFS.

Iterations refer to the re-testing of an intervention in another PFS [ 89 , 90 , 91 , 92 ]. This can be done based upon findings from a previous PFS trial where minor and/or major adjustments to the intervention, its delivery, or other aspects of the study were found. Initial evaluations of an intervention may even pre-plan for multiple iterations. The iterations create a sequence of trialing and modifying prior to any well-powered trials. At the conclusion of a PFS, investigators can make the decision, based upon progression criteria and other findings, whether additional testing of the intervention needs to ensue prior to scale-up. This decision should be left to the interventionists and co-developers and be based on the evidence collected from the PFS, available resources, and time. Decisions can be pragmatic but also important are theoretical considerations that can inform whether or why alterations to the intervention may or may not result in anticipated or unanticipated changes.

Progression criteria

Progression criteria are a set of a priori benchmarks or thresholds regarding key feasibility markers that inform decisions about whether to proceed, to proceed with changes, or not to proceed from the PFS to a future study, either a main trial or another PFS [ 15 ].

PFS should include a set of progression criteria which are used to inform decisions about whether to proceed, proceed with changes, or not to proceed to a larger-scale study.

Progression criteria should be determined a priori and be based on either evidence from previously published/conducted research or a sound rationale provided.

Decisions on whether to proceed should also be informed by contextual, temporal, and partnership factors that evolve over the course of the pilot and/or feasibility.

Progression criteria should be made for feasibility metrics such as recruitment rate, retention/drop-out rate, acceptability, implementation/fidelity, and other appropriate feasibility indicators where appropriate.

Progression decisions can also include evidence of potential impact (see 5.2. Preliminary Impact ).

Progression criteria decisions can be in the form of a “Go/No Go” system or a “Stop Light” (red/amber/green) system, indicating no progression, progression with changes, or progression with no changes.

Deviations from the application of progression criteria may be justified if researchers are confident that a proposed solution will address the problem at a larger scale and can provide strong theoretical and/or empirical evidence to support their assertion (see 1.1. Adaptations/Tailoring ).

Across all feasibility metrics, some form of progression criteria thresholds and classification systems should be pre-defined [ 74 , 80 , 93 , 94 , 95 , 96 , 97 , 98 ]. The thresholds are commonly study- and intervention-specific, and these thresholds can be designated by investigators and any co-designers. Common classification schemes include red/amber/green and go/no-go. Often, these criteria are pre-registered and/or appear in protocol documents. Progression criteria can be used to gauge whether certain aspects of the intervention and its delivery along with other aspects of the study need to be modified. This information can be used to inform decisions about whether a subsequent test of the intervention should be conducted in another PFS (see 2.1. Iteration and Intervention Refinement ).

Randomization and control groups

Randomization refers to the process of using random chance to allocate units (individuals or settings/clusters) to one or more intervention conditions. Randomization can be used to separate units into distinct groups or randomization within a unit for when and what intervention(s) they may receive (order and timing). A control/comparator condition serves as the counterfactual. A control/comparator group is a group of participants (and/or settings/clusters) allocated to receive differing amounts, orders, or types of intervention(s) being tested [ 99 , 100 , 101 ]. A baseline period can serve as a control/comparator condition for studies employing single-arm or individual-level interventions (e.g., N-of-1) [ 102 ].

Not every PFS needs to include two or more groups or employ random allocation.

The presence of a control/comparator group or randomization can be included if it reflects the aims and objectives of the study.

Control groups can take numerous forms and should be reflective of the objectives of the study, the context within which the intervention is tested, and acceptability by the target population.

When randomization is employed, methods of randomization should be clearly described to ensure reproducibility.

If a control/comparator group is present, feasibility indicators collected on the intervention group should also be collected on the control group where appropriate (e.g., feasibility of data collection, acceptability of randomization, retention).

PFS can employ a range of designs. These include N-of-1 [ 103 ], micro-randomized trials [ 104 ], single-group [ 105 ], quasi-experimental [ 106 ], and multi-group/multi-setting designs [ 107 ]. Despite these design options, not every PFS needs to employ randomization or include more than one group. The use of randomization and multi-group design features should be based on the objectives of the PFS. Randomization in PFS can take the form of allocating groups to different interventions or varying levels of the same intervention (doses). Randomization can also take the form of within-person or group allocation of the timing and/or varying interventions participants may receive. Where multiple groups are included, “what” they receive (i.e., allocated to) should be based on the nature of the intervention and be consistent with conventions within the field of study. This can range from a purely no-treatment comparator to standard practice to alternate active interventions. Where some form of a comparator group is used, researchers should evaluate feasibility metrics to understand such things as the ability to retain those not receiving the intervention and acceptability of randomization. Incorporating either randomization or multiple groups can increase the scientific rigor of the PFS but is not necessary to evaluate most feasibility metrics of an intervention.

Scale-up refers to the process of delivering and evaluating an intervention in progressively larger studies, beginning with testing an intervention within one or more PFS and moving towards larger studies of the same, or similar, interventions. It is a “deliberate effort to increase the impact of successfully tested health intervention so as to benefit more people and foster policy and program development on a lasting basis” [ 108 , 109 ].

PFS should be designed with the intent for future testing of an intervention in large-scale trials and beyond.

Researchers should consider plans for later-phase research on the intervention and explain how information gathered from the PFS will be used to answer key questions surrounding the uncertainty of the intervention or the design or conduct of a progressively larger future study.

Issues regarding the adoption, implementation, and maintenance of the intervention over progressively larger studies can be considered at both the design and conduct phases of the PFS.

Efforts should be made to ensure key features of the PFS be similar to those in the future large-scale trial. These include the amount of support to implement the intervention, characteristics of who delivers the intervention, the target population, the duration under which the intervention is tested, and the measures employed.

Where differences are anticipated between pilot and/or feasibility testing and the larger-scale trial, a description of these differences should be provided along with a clear justification of how the changes may or may not impact the intervention.

PFS should be designed and conducted with the idea the information collected will be used to inform the testing of an intervention in progressively larger sample sizes and/or settings [ 85 , 110 , 111 , 112 , 113 , 114 , 115 , 116 ]. This implies researchers who conduct PFS intend to continue to refine and optimize an intervention for maximal impact along a translational science continuum [ 117 , 118 , 119 ]. With this in mind, understanding early on how an intervention could be delivered to progressively larger numbers of individuals and/or settings should be incorporated into the early stages of the design and conduct of PFS. Considerations for scaling can include characteristics of those who deliver an intervention, the resources required to train and deliver an intervention, and to whom an intervention is delivered. How these aspects can change as one progresses from commonly smaller-sized PFS to evaluating an intervention for broader population-level impact should inform what transpires in a PFS. Researchers should, therefore, consider whether what they can accomplish on a smaller scale can similarly be accomplished on a larger scale [ 120 , 121 ].

Conduct of trial

Measurement and data collection

Measurement and data collection refer to any tools, devices, instruments, personnel, and time required to assess feasibility or outcomes related to an intervention.

PFS can assess the feasibility and appropriateness of measurement and data collection procedures including the following:

How or if the data can be collected

The acceptability of the measurements and data collection procedures (e.g., burden)

If the measures are valid for the population/outcomes in question

Where applicable, measurements and data collection procedures should closely resemble those anticipated for the well-powered trial.

The reporting of measurement and data collection procedures should be sufficiently detailed to permit standardized data collection, including information about why the measurements were selected and how they were administered, scored, and interpreted.

Information about the feasibility and appropriateness of measurement and data collection procedures can consist of both quantitative and qualitative data sources.

The process of collecting outcome data in a PFS serves to demonstrate the feasibility of data collection methods—whether explicitly stated or not [ 122 ]. However, some PFS may be designed to answer whether outcome measures proposed for the larger-scale trial can be collected. This can include the ability to collect data using more invasive/burdensome methods (e.g., urine/hair samples, blood draws) [ 123 , 124 ]. Additional metrics associated with the feasibility of measurement and data collection may include determining rates of missing data, participant response rates, and any time/resource costs associated with data collection [ 125 , 126 , 127 ]. This information can be used to reduce participant burden and costs associated with data collection as well as refine protocols in the larger-scale trial [ 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ].

Recruitment

Recruitment refers to the procedures used to identify and select potential participants (individuals and/or settings/clusters) and enroll them into a PFS. The recruitment rate is the proportion of eligible participants or settings/clusters who are enrolled at the baseline of an intervention trial compared to the invited/eligible target population [ 137 ].

Recruitment procedures should be clearly described, with any strategies designed to maximize recruitment fully detailed.

Information should include details of procedures used to recruit at the individual and setting/cluster levels, where appropriate.

Recruitment information should include the following, where appropriate:

Proportion of eligible units (e.g., individuals, settings) recruited

The start and end dates of the recruitment periods

Number of participants recruited per setting/cluster, overall, and number of settings/clusters

Number of potential participants screened, eligible, consented, and enrolled in the study

Reasons for non-recruitment/non-consent

Acceptability of recruitment strategies

Details should be provided about the recruitment strategies used, measures of their success, what worked, and what may need to be altered for future studies.

Participant recruitment is a key marker of intervention feasibility. Identifying optimal recruitment strategies in a PFS plays a critical role in determining whether the specified sample size can be achieved in the well-powered trial. Recruitment strategies may include opt-out methods (passive consent), telephone reminders, open designs (participants know what arm of the trial they are in), referrals, modalities of communication with potential participants (e.g., phone calls, emailing, text, mailings), convenient study location, and partnering with community members/settings [ 138 , 139 , 140 , 141 ]. The specific recruitment strategies used can influence the demographic makeup of participants. Different recruitment strategies can also yield varying amounts of eligible participants. In addition, each recruitment strategy has an associated cost. It may also be important to identify reasons why participants refused to participate in the study and record these reasons quantitatively and/or qualitatively. This information should be collected at the individual and/or setting level where appropriate. These can be important to establish during a PFS to optimize recruitment procedures in the larger-scale trial, especially in situations where there are uncertainties around recruiting the target population. At times, it may even be appropriate to formally test recruitment strategies, particularly when there is uncertainty about the best approach. For example, by embedding a “Study Within A Trial” (SWAT), researchers may gain answers to uncertainties around methodological decisions regarding a number of feasibility outcomes, including recruitment [ 142 , 143 ].

Retention (attrition/drop-out) is the proportion of enrolled participants who are present throughout the full length of the intervention [ 137 ].

Researchers conducting PFS should ensure retention rates are measured.

Where possible, assessments can be made to identify differences in retention across groups or intervention conditions.

Reasons why individuals leave a study can be collected and analyzed to investigate whether particular factors are associated with retention.

Procedures should clearly describe strategies used to assist with retaining participants during the delivery of the intervention and any post-intervention follow-up time periods, where appropriate.

Retention-related information can include both quantitative and qualitative data sources.

Retention is a commonly assessed marker of intervention feasibility. Retaining participants throughout an intervention is important to ensure participants receive the full dose of intervention components as designed and whether selective attrition is present. Retention-related information also helps to understand issues regarding missing data and low statistical power in future studies. Ultimately, retention is a marker of intervention viability. In other words, if participants do not want to receive an intervention it is unlikely to be impactful.

For a given intervention, a clear definition of retention should be reported. This can include participants staying for the duration of study-related procedures/measures (e.g., data collection), completing intervention components, and/or attendance at intervention sessions [ 22 , 92 , 128 , 144 ]. Depending on the nature of the intervention and the outcomes targeted, PFS may be designed specifically to address issues regarding retention in samples that have been historically challenging to engage/retain in interventions [ 145 , 146 ].

Retention strategies, such as flexible scheduling, reminders, compensation, consistency in study staff (continuity of relationships), gathering multiple contacts, thank you and birthday cards, and follow-up phone calls within a given period, can reduce the rate of participant drop-out [ 139 , 147 , 148 , 149 ]. Where dropouts occur, reasons for withdrawal from the study can be collected [ 128 , 150 ]. Factors influencing retention, both positively and negatively, including participant motivation/aspirations, expectations, the perceived need for an intervention, and accessibility of intervention (location delivered), can be collected from both participants and intervention deliverers [ 151 , 152 , 153 , 154 , 155 ].

Implementation of intervention

Acceptability.

Acceptability is a perception/notion that an intervention or various aspects of an intervention are favorable, agreeable, palatable, enjoyable, satisfactory, valued, appropriate from the perspectives of participants or communities receiving the intervention, and/or have a wider fit within a system. It relates to how users “feel” about an intervention [ 156 ].

Researchers should clearly define what is meant by “acceptability” for a given study, at what levels (e.g., individual, deliverer, setting) it will be assessed, and by what methods (e.g., surveys, interviews). This should be based on the nature of the intervention and its constituent components, target population, setting level characteristics, and key stakeholders.

Measures of acceptability can be pre-defined and included in both the PFS and large-scale trial stages.

Acceptability should be captured, at minimum, from the end user (intervention participants). Acceptability can also be captured from those involved with delivering the intervention, along with anyone else involved in the implementation process.

Acceptability, as defined for a given study, can be assessed for participants in control conditions where appropriate (e.g., acceptability of randomization to active comparator, acceptability of data collection procedures).

Researchers can use both quantitative (e.g., surveys) and qualitative (e.g., interviews) methods to assess acceptability.

In most behavioral interventions, it is important to understand whether those receiving an intervention, those delivering an intervention, and any other key individual(s) find the intervention, either in its entirely or in relevant parts, to be “acceptable” to inform whether the intervention would be used or tolerated. Acceptability encompasses a range of aspects related to impressions of an intervention. These can be gathered anytime along the intervention development continuum. At the earliest stages of conceptualization, prior to packaging and preliminary testing of an intervention, assessments of acceptability (preferences) can include participants’ views of whether the proposed intervention could be appropriate for addressing a given outcome, whether they (the participants) would be willing to adhere to an intervention, the suitability of intervention materials, or whether they perceive the intervention to be useful. During intervention delivery, ongoing assessment of likeability, satisfaction, metrics of engagement with an intervention, and utility can be collected periodically [ 45 , 157 , 158 , 159 ]. Once an intervention is completed, post-assessment markers of acceptability can include perceptions of the length or overall burden of the intervention, what strategies/components of an intervention were liked best, referral of the intervention to others, or whether the intervention met their (the recipients, deliverers, others) preferences/expectations. Where an intervention is delivered by individuals outside the intervention-development team, assessing their perspectives on the acceptability of an intervention may be necessary.

Assessments of acceptability can include both qualitative and quantitative measures. User-centered design [ 160 ] and “think aloud” protocols [ 161 ] can be used in the early stages of intervention conceptualization/formulization. Exit interviews, upon intervention completion, from recipients, deliverers, and other key individuals involved in the intervention, are often employed to evaluate markers of acceptability. Quantitative measures typically include items developed specifically for a given study. Alternatively, existing scales assessing acceptability can be used or modified accordingly for a given application [ 162 , 163 , 164 ]. Acceptability can also cover other aspects of the evaluation process of an intervention. This includes such areas as whether completing the proposed measures is feasible, acceptability of being randomized, or whether recipients were satisfied with the location where an intervention was delivered.

Fidelity is the degree to which an intervention is delivered as intended and the quality of that delivery [ 165 , 166 ].

Researchers should clearly define what is meant by “fidelity” for a given study, at what levels (e.g., individual, deliverer, setting) it will be assessed, and by what methods (e.g., surveys, interviews).

Measures of fidelity should be pre-defined with all intervention components listed.

Fidelity can consist of information about how an intervention will be delivered, for whom, what the intervention consists of, and when and where (context) the intervention will be delivered.

If strategies are used to encourage fidelity (e.g., a manualized intervention, feedback to those delivering the intervention), these should be reported.

Factors influencing fidelity can be assessed and, where appropriate, linked to feasibility outcomes.

Fidelity is often a primary marker of implementation. Assessment of an intervention’s fidelity provides key information regarding whether an intervention, either the testing of individual components or in their entirety, can be delivered as intended. In PFS where initial evaluations of an intervention are conducted, fidelity plays an important role in identifying whether the intervention can be delivered as intended. Evaluation of fidelity implies a working understanding of the intervention and some pre-planned, a priori expected delivery [ 167 , 168 ]. Measuring fidelity can be useful where adaptations (or changes) to the materials may take place (either planned or unplanned). Systematically documenting deviations from the original intervention can yield important insights into whether adaptations were beneficial or detrimental to the outcomes [ 169 ].

Fidelity can include many aspects of an intervention. These include adherence to intervention materials (what was done), quality of delivery (how it was done), and the dose of what was received [ 166 , 170 ]. Assessing fidelity can take many forms. This includes the creation of study-specific fidelity checklists which capture the presence of key components that should be delivered during an intervention (e.g., key material to be delivered in session one or a multi-session intervention) and how they were delivered [ 134 , 171 ]. Response ranges vary from present/absent, yes/no, to Likert-scaled items. Fidelity checklists can be completed either in real-time or reviewed later through the use of recorded video or audio of completed sessions [ 172 , 173 , 174 ]. Checklists can be completed by either someone external to the delivery agent via structured observations/recordings or completed by the delivery agent (e.g., self-report, logbooks) immediately following the delivery [ 175 , 176 , 177 ].

Qualitative interviews of delivery agents can also be conducted to gauge views regarding aspects of an intervention such as the training received to deliver, confidence in delivering, and any perceived barriers to delivering an intervention as planned [ 172 ]. Factors affecting fidelity can be collected to understand what, if anything, may influence departures from delivering an intervention as designed [ 22 , 132 , 173 , 178 ]. Common ways to encourage fidelity are through the use of a manualized package of procedures, training materials, and ongoing review of sessions accompanied by feedback.

Cost and resources

Costs and resources refer to the investments and assets required to develop, implement, and sustain an intervention [ 12 , 179 ].

PFS can include assessments of the costs and required resources of conducting an intervention.

In PFS costs and resources mIn PFS costs and resources may include the following:ay include the following:

Monetary costs associated with training, supervision, and recruitment of both stakeholders and participants, incentivization, facilities, materials, and intervention component development and delivery.

Opportunity costs/time demands associated with completing the intervention by participants and delivering the intervention by providers.

Researchers can collect information to determine the feasibility of measuring the costs associated with the intervention, with this information used to inform a more well-defined cost analysis/economic evaluation in a larger-scale trial.

Researchers should keep in mind that some costs associated with the intervention will be fixed (one-time costs) and some will be recurring during the successful scale-up and sustainment of the intervention.

For some PFS, collecting the costs associated with delivering an intervention may be necessary to inform a larger-scale trial. In PFS, this is often referred to as conducting an economic evaluation, costing, or cost analysis [ 125 , 180 , 181 , 182 , 183 ]. Studies may collect cost data to “rehearse” cost-effectiveness evaluations (economic evaluations) or evaluate the feasibility of collecting cost-related data [ 169 , 184 ]. Where cost data are collected, micro-costing approaches that inventory all associated costs with an intervention are often conducted and used to generate a total cost per unit estimate, often expressed as a cost per participant. Costs can be fixed, variable, or projected future estimates, and they may vary according to the desired fidelity and rigor of the implementation of the interventions. Common resources inventoried for cost include the costs of consumables, staff time, services received, transportation, room hires, and refreshments. Costs can be separated into the costs associated with the initial design/development, set up of the intervention, training of staff to deliver, and the costs associated with intervention delivery. The inclusion of cost data is not study-design specific and spans a wide range of designs from N of 1 to cluster randomized studies [ 185 , 186 , 187 ].

Statistical analysis

Sample size.

Sample size refers to the number of participants (or groups/clusters) in a given study [ 188 ].

The sample size of a PFS should be based on the feasibility objectives of the study.

Sample sizes do not have to be based upon a formal sample size calculation (i.e., power).

Sample sizes should be pre-specified and justified.

Sample size estimates should consider the representativeness of the target population or subgroup, setting, and other relevant contextual aspects that may influence how and why an intervention works.

Sample characteristics should be clearly described and may refer to individuals and/or clusters (e.g., churches, workplaces, neighborhoods, schools).

Where relevant, studies should clearly report factors impacting the sample size (e.g., availability of funds, time constraints).

Investigators are encouraged to report the a priori power achieved by the sample size selected for a PFS.

It is widely recognized that most PFS are underpowered to detect clinically significant/public health important effects in outcomes. Selecting the appropriate sample size for a PFS, however, can vary across studies based on the objectives. In some instances, formal power calculations can be conducted/presented, but one should avoid the temptation of presenting a PFS as being well-powered by assuming implausibly large effects and/or event rates and using non-relevant outcomes. Sample size justification can be made based on other factors including, but not limited to, the availability of resources, the number of potential participants within a given setting, representativeness of the sample to the target population, complexities regarding the intervention, or the experiences of the investigators working with the population/setting [ 189 , 190 , 191 , 192 , 193 ]. Regardless of the approach taken, researchers need to ensure they have sufficient numbers (i.e., sample size) to make informed decisions based on the feasibility metrics and objectives of a PFS and acknowledge any limitations that the usually small sample size confers.

Preliminary impact

Preliminary impact is the ability of an intervention, during a PFS to produce a desired or intended result [ 194 ].

PFS need not be powered to detect statistically significant differences in outcomes, but one or more outcomes, as appropriate to the research, can be assessed.

When outcomes are collected, changes in outcome data (e.g., estimated effect sizes) can be used to aid in decisions regarding the conduct of a subsequent larger-scale trial (e.g., sample size needed).

In many cases, it may be necessary to demonstrate an intervention “moves” outcomes in the appropriate direction and is not causing harm. In this scenario, it is recommended statistical testing can be performed but to avoid the interpretation of p values as conclusive evidence of an intervention’s impact in a larger-scale trial.

Interpretations of performed statistical tests should not include a justification for (or against) proceeding to a subsequent large-scale intervention or for making claims about the likely success of the study. Interpretations should help guide, but not dominate, the decision to proceed to a large-scale intervention.

Investigators should avoid misusing language such as “statistically significant” to describe their interpretation of outcomes from a PFS.

Where pilot and/or feasibility estimates of impact on primary, secondary, or tertiary outcomes are reported these should be pre-specified, with point estimates and a measure of variability reported for all time points.

For studies presenting both feasibility and outcome data, outcome data should be relegated to a secondary or exploratory focus.

In some circumstances, it may be appropriate to evaluate, in a preliminary/exploratory fashion, the potential impact of an intervention on proximal or distill outcomes in a PFS. Where outcomes are assessed and reported, researchers need to understand the evidence is neither definitive nor necessarily very indicative of an intervention’s impact within a larger-scale trial. Nevertheless, the evaluation of outcomes within a PFS can provide useful, additional information to help inform decisions about whether the intervention is ready to be tested at a larger scale. When reporting outcomes, researchers should avoid using misleading language centered on the presence or lack of “statistical significance”. All reported outcome assessments should be secondary to feasibility metrics, which are the primary focus of most PFS. Further, it is suggested that journals should not require by default outcome assessments and/or formal hypothesis testing for manuscripts that report on PFS nor base publishing decisions on the outcomes of potential efficacy analyses if reported.

Pre-registration and protocol publishing

Pre-registration and protocol publishing refers to an a priori process of documenting planned intervention design and analyses [ 195 ].

Pre-registration and a protocol made publicly available (via peer-reviewed journal, pre-print server, or other forms of public dissemination) contributes to transparency and ensures that changes between what is planned, what is conducted, and what is ultimately reported are communicated and justified.

We acknowledge there is a certain degree of flexibility when it comes to PFS between what is proposed and what actually transpires in the execution of the study. Pre-registration of PFS needs to balance the developmental/exploratory nature of these types of studies with the need to document and adhere to general protocols that are the foundation of rigorous and transparent science. The goal of pre-registration is not to create an inflexible scope of work that cannot adapt to uncertainties encountered in the study, but to communicate changes to a protocol and to justify why those changes were made.

Pre-registration of study objectives can be appropriate and at times required based upon funding stipulations. While some PFS are not pre-registered, many can be found on existing trial registries. These include Clinical Trials [ 196 ] and other emerging pre-print servers and open-science repositories, such as Open Science Framework [ 197 , 198 ]. Protocol publishing is also becoming increasingly common for PFS. Pre-registration and protocol publishing may help to provide details about a PFS as well as ensure deviations, although necessary at times, are clearly documented.

Study labeling

Study labeling refers to naming/presenting a PFS with appropriate naming conventions for the study being conducted [ 2 , 3 ].

At a minimum, researchers should make sure studies are clearly labeled to indicate their preliminary nature and reflect the aims and objectives of the study in both the title and abstract with either “pilot”, “feasibility”, “proof-of-concept”, “formative”, or other relevant label(s).

PFS should be clearly labeled to identify and separate them within the intervention development and evaluation literature. One of the benefits of clearly labeling PFS is the ease of identification of these types of studies to understand the evolution of behavioral interventions. Because PFS are often smaller in scale, clear identification also helps to distinguish these types of studies from studies that are small in scale and lack an emphasis on intervention development, refinement, and scaling.

A number of different taxonomies have been proposed to label these types of studies. However, we recognize researchers can and do use terms referring to preliminary studies interchangeably or utilize a combination of them to describe a single study [ 79 , 136 , 167 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 ]. In the absence of a universal consensus of terms, it is recommended investigators clearly label their PFS with one or more widely used terms that identify the preliminary nature of the study. These terms could include “pilot”, “feasibility”, “proof-of-concept”, “preliminary”, “evidentiary”, “vanguard”, and/or “exploratory”. Thus, investigators should identify the most appropriate term(s) that describe the objective of their study. This should consider the stage and number of tests/evaluations of an intervention.

Framework and guideline usage

The utilization of published frameworks/guidelines to guide the development, implementation, and reporting of PFS.

Where possible, researchers should choose an appropriate framework to structure PFS and use it to guide the design, conduct, analysis, and reporting of said study.

Findings from PFS should be disseminated in a way that adheres to reporting guidelines to facilitate transparency and allow for replication.

There are many existing guidelines, checklists, frameworks, and recommendations that can be useful for the design, conduct, implementation, analysis, and reporting of PFS [ 9 , 211 ]. The use of these publications is associated with higher study quality and reporting [ 9 ]. Guidelines include those developed specifically for PFS and also include those designed outside of the preliminary study context but are highly relevant to many aspects of PFS. Investigators should be familiar with existing guidance and utilize it appropriately, based on the specific objectives of their PFS.

PFS play a pivotal role in the development, refinement, implementation, and sustainability of successful behavioral interventions. This is evidenced by their emphasis on funding agencies [ 4 , 212 , 213 , 214 , 215 , 216 ] and depiction within translational science frameworks [ 117 , 118 , 217 , 218 ]. We identified 161 publications offering some form of guidelines, checklists, frameworks, or recommendations for PFS. Through a Delphi study utilizing expert perspectives, we developed a comprehensive set of considerations which span the continuum of development, conduct, implementation, evaluation, and reporting of behavioral intervention PFS. We believe this will serve as a valuable resource for researchers in the behavioral sciences.

Continued challenges with PFS

While this consolidation of considerations for PFS was developed for broad applicability, there were strong opposing views among the Delphi study participants on some of the considerations that represent continued challenges with PFS. The most striking opposing opinions were observed within the “statistical analysis” theme and were present in both the “sample size” and “preliminary impact” considerations. For example, several respondents in the Delphi study believed sample size estimates for a larger-scale trial can be informed by the estimated intervention effect sizes generated from a PFS, and formal hypothesis testing can be performed and associated p values interpreted in a preliminary study. Other respondents expressed strong opinions that the sample of a PFS need not be representative of the target population. Conversely, the vast majority of respondents agreed that sample size justifications should be based on the feasibility objectives of a given PFS and argued against hypothesis testing (i.e., formal statistical testing and interpretation of p values) during the early phases of intervention development. There have been arguments made for reporting confidence intervals instead of p values for any non-feasibility-related outcomes assessed during PFS [ 219 , 220 , 221 , 222 ]. However, respondents of our Delphi study were quick to point out there is little practical difference between the use of p values or confidence intervals, especially if the PFS is underpowered from the start.

Opposing views were identified throughout the Delphi process for other considerations as well, including “study labeling” and “pre-registration and protocol publishing”. For study labeling, some respondents appreciated the distinction between “pilot”, “feasibility”, and other “preliminary study” terminology, while others worried that these distinctions were not well known and may cause undue confusion. Many participants of the Delphi study indicated they would rather there be no distinction, voicing concerns that adopting rigid taxonomies would create research silos and hinder cross-purpose innovation. Ultimately, we chose not to take a definitive stance on this issue, but rather make researchers aware they should be labeling PFS in some way to aid in the identification of these types of studies. On the topic of pre-registration and protocol publishing, some Delphi respondents argued that pre-registration and protocol publishing for PFS was asking too much and that this type of work should be reserved only for larger-scale trials. Others fully supported the idea of pre-registration and protocol publishing for PFS, arguing it aids in transparency and reproducibility. Again, these are decisions ultimately left up to the researchers conducting PFS, but it is likely that registration will be increasingly requested and enforced (e.g., by funders). The lack of registration of all PFS means that one cannot understand the totality of the efforts that are made in that space for developing and assessing the feasibility of an intervention.

It is important to understand that what may be viewed as common and accepted practice may not be widely held everywhere and the reasons for this vary according to country, funder, and disciplinary norms. It may be that differing opinions stem from differences between what commonly accepted/promoted translational science frameworks espouse and the realities of conducting PFS, which are often conducted with limited resources and abbreviated timelines. In addition, there may be different levels of expectations about what is proposed in these frameworks and the expectations of funding agencies and grant reviewers [ 223 ]. Such disagreements can prove problematic for behavioral scientists when seeking funding or wanting to publish findings from their PFS. Reconciliation on these topics is unlikely, and perhaps unnecessary, yet it is important to acknowledge what can and cannot be accomplished by a PFS. We believe appropriately tending to these issues throughout all phases of design, conduct, interpretation, and reporting should help preemptively dissuade critiques that could stymie the progress of intervention development and implementation.

Progress for PFS

While disagreements were noted for a few considerations, most respondents agreed on the content of most topics. For example, participants of the Delphi study agreed that feasibility outcomes, including recruitment, retention, acceptability, and fidelity should take priority over preliminary impact and should be used and presented as the primary outcomes of PFS. This also aligns with developing well-designed problems and aims of PFS, most of which should answer questions regarding uncertainties (feasibility) of an intervention. Respondents also agreed progression criteria are useful when developing and deploying PFS, although some recommended caution on the use of progression criteria that are too rigid when making decisions about scaling up PFS to the next stage. Finally, and perhaps most salient, participants agreed on the importance of PFS as a critical step in successful large-scale intervention development and implementation. However, one cannot exclude the presence of selection bias in favor of the importance of PFS among authors who have authored guidelines on them and even more so among authors who responded to our surveys.

Use of the considerations

We believe the considerations in this paper span the continuum of PFS, from development to reporting, and will be useful for researchers planning to conduct their very first PFS to well-seasoned interventionists. We envision these consolidated considerations being used in practice and as an educational tool for trainees. On a broader scale, we are hopeful this consolidation may improve PFS in the future, reducing research waste and leading to the development of high-quality, scalable behavioral interventions with maximal reach and public health impact. In addition to the considerations themselves, we provide a crosswalk of all published guidelines, checklists, frameworks, and recommendations related to PFS in Additional file 2 in an effort to amplify the voices of experts in this field. Researchers reading this study and those who want to know more about a particular consideration are encouraged to utilize the crosswalk located in Additional file 1 to identify further reading, which may provide more specific guidance on a particular topic. While not the focus of this consolidation, we also believe many of the considerations are cross-cutting with large-scale implementation and dissemination research. Researchers doing this type of work may look to certain considerations to guide aspects of their larger-scale study as well.

Strengths and limitations

These consolidated considerations have several strengths. First, they were created based on information gathered from 161 published guidelines, checklists, frameworks, and recommendations on the topic of PFS. We relied on authors from these very same 161 publications to voice their opinions about the most important PFS-related topics via a three-round Delphi study. The total sample of participants across three rounds of the Delphi process represented over 35% of the 161 publications. Participants had, on average, 23 years of experience since their terminal degree, representing a collective 1150 years of experience across respondents. Moreover, we supplement this consolidation with a review of those 161 guidelines, checklists, frameworks, and recommendations, creating one of the largest collective sources of information on PFS published to date. This study is not without limitations. While we had a moderate representation of Delphi participants across publications, we were only able to recruit 10% (50 out of 496 identified authors) of our target population for the Delphi process. Further, while there was an equal distribution of males and females, the sample was largely White. Other than age and years of terminal degree, we did not collect other demographic information on the Delphi participants, although the median year of publication for the publications represented in our sample was slightly more recent (2015) than the total sample of possible publications (2013) from which authors were sampled. For the considerations themselves, there is still no true consensus on many of the topics presented. Differences of opinion were observed throughout the Delphi process and can be found across the published literature. Despite this, we believe the consolidated considerations could be a valuable resource for behavioral interventionists conducting PFS on a broad range of public health topics.

This is one of the first studies to attempt to garner consensus on a broad range of considerations regarding PFS for the behavioral sciences. We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. We identified 20 considerations for PFS, which fall into six categories, including intervention design , study design , conduct of trial , implementation of intervention , statistical analysis , and reporting . We also provide a list of the available publications on each of the specific considerations for further reading and use and have aligned these publications with the considerations set forth in this paper. Researchers may use these considerations alongside the previously published literature to guide decision making about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.

Availability of data and materials

The datasets used and analyzed during the current study are freely available at https://osf.io/kyft7/ .

Indig D, Lee K, Grunseit A, Milat A, Bauman A. Pathways for scaling up public health interventions. BMC Public Health. 2018;18(1):68. https://doi.org/10.1186/s12889-017-4572-5 .

Article   Google Scholar  

Eldridge SM, Lancaster GA, Campbell MJ, et al. Defining feasibility and pilot studies in preparation for randomised controlled trials: development of a conceptual framework. Plos One. 2016;11(3):e0150205. https://doi.org/10.1371/journal.pone.0150205 . Lazzeri C, ed.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Bond C, Lancaster GA, Campbell M, et al. Pilot and feasibility studies: extending the conceptual framework. Pilot Feasibil Stud. 2023;9(1):24. https://doi.org/10.1186/s40814-023-01233-1 .

National Institutes of Health. NIH Planning Grant Program (R34) .; 2019. https://grants.nih.gov/grants/funding/r34.htm . Accessed 13 July, 2023

Moher D, Altman DG, Schulz KF, Simera I. How to develop a reporting guideline. In: Moher D, Altman DG, Schulz KF, Simera I, Wager E, eds. Guidelines for Reporting Health Research: A User’s Manual. John Wiley & Sons, Ltd; 2014:14–21. https://doi.org/10.1002/9781118715598.ch2

Moher D, Schulz KF, Simera I, Altman DG. Guidance for developers of health research reporting guidelines. Plos Med. 2010;7(2):e1000217. https://doi.org/10.1371/journal.pmed.1000217 .

Article   PubMed   PubMed Central   Google Scholar  

Eldridge SM, Chan CL, Campbell MJ, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ. Published online October 24 2016;i5239. https://doi.org/10.1136/bmj.i5239

O’Cathain A, Croot L, Duncan E, et al. Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open. 2019;9(8):e029954. https://doi.org/10.1136/bmjopen-2019-029954 .

Pfledderer CD, Von Klinggraeff L, Burkart S, et al. Use of guidelines, checklists, frameworks, and recommendations in behavioral intervention preliminary studies and associations with reporting comprehensiveness: a scoping bibliometric review. Pilot Feasibil Stud. 2023;9:161. https://doi.org/10.1186/s40814-023-01389-w .

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. Published online September 29, 2008:a1655. https://doi.org/10.1136/bmj.a1655

Bowen DJ, Kreuter M, Spring B, et al. How we design feasibility studies. Am J Prev Med. 2009;36(5):452–7. https://doi.org/10.1016/j.amepre.2009.02.002 .

Pearson N, Naylor PJ, Ashe MC, Fernandez M, Yoong SL, Wolfenden L. Guidance for conducting feasibility and pilot studies for implementation trials. Pilot Feasibil Stud. 2020;6(1):167. https://doi.org/10.1186/s40814-020-00634-w .

Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique: Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15. https://doi.org/10.1046/j.1365-2648.2000.t01-1-01567.x .

Article   CAS   PubMed   Google Scholar  

Keeney S, Hasson F, McKenna HP. The Delphi Technique in Nursing and Health Research. Oxford: Wiley-Blackwell; 2011.

Mellor K, Albury C, Dutton SJ, Eldridge S, Hopewell S. Recommendations for progression criteria during external randomised pilot trial design, conduct, analysis and reporting. Pilot Feasibil Stud. 2023;9(1):59. https://doi.org/10.1186/s40814-023-01291-5 . s40814-023-01291-01295.

Stirman SW, Miller CJ, Toder K, Calloway A. Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implement Sci. 2013;8(1):65. https://doi.org/10.1186/1748-5908-8-65 .

Swindle T, Martinez A, Børsheim E, Andres A. Adaptation of an exercise intervention for pregnant women to community-based delivery: a study protocol. BMJ Open. 2020;10(9):e038582. https://doi.org/10.1136/bmjopen-2020-038582 .

Sizemore KM, Gray S, Wolfer C, et al. A proof of concept pilot examining feasibility and acceptability of the positively healthy just-in-time adaptive, ecological momentary, intervention among a sample of sexual minority men living with HIV. J Happiness Stud. 2022;23(8):4091–118. https://doi.org/10.1007/s10902-022-00587-2 .

Duarte N, Hughes SL, Paúl C. Cultural adaptation and specifics of the fit & strong! program in Portugal. Transl Behav Med. 2019;9(1):67–75. https://doi.org/10.1093/tbm/iby003 .

Article   PubMed   Google Scholar  

Eylem O, Van Straten A, De Wit L, Rathod S, Bhui K, Kerkhof AJFM. Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention. Pilot Feasibil Stud. 2021;7(1):30. https://doi.org/10.1186/s40814-021-00772-9 .

Mathews E, Thomas E, Absetz P, et al. Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP). BMC Public Health. 2017;17(1):974. https://doi.org/10.1186/s12889-017-4986-0 .

Zullig LL, McCant F, Silberberg M, Johnson F, Granger BB, Bosworth HB. Changing CHANGE: adaptations of an evidence-based telehealth cardiovascular disease risk reduction intervention. Transl Behav Med. 2018;8(2):225–32. https://doi.org/10.1093/tbm/ibx030 .

Hill JL, Zoellner JM, You W, et al. Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation. BMC Public Health. 2019;19(1):122. https://doi.org/10.1186/s12889-019-6450-9 .

Sánchez-Franco S, Arias LF, Jaramillo J, et al. Cultural adaptation of two school-based smoking prevention programs in Bogotá Colombia. Transl Behav Med. 2021;11(8):1567–78. https://doi.org/10.1093/tbm/ibab019 .

Lloyd J, Bjornstad G, Borek A, et al. Healthy parent carers programme: mixed methods process evaluation and refinement of a health promotion intervention. BMJ Open. 2021;11(8):e045570. https://doi.org/10.1136/bmjopen-2020-045570 .

Meiksin R, Allen E, Crichton J, et al. Protocol for pilot cluster RCT of project respect: a school-based intervention to prevent dating and relationship violence and address health inequalities among young people. Pilot Feasibil Stud. 2019;5(1):13. https://doi.org/10.1186/s40814-019-0391-z .

Sebire SJ, Banfield K, Jago R, et al. A process evaluation of the PLAN-A intervention (Peer-Led physical Activity iNtervention for Adolescent girls). BMC Public Health. 2019;19(1):1203. https://doi.org/10.1186/s12889-019-7545-z .

Mueller S, Soriano D, Boscor A, et al. MANTRA: development and localization of a mobile educational health game targeting low literacy players in low and middle income countries. BMC Public Health. 2020;20(1):1171. https://doi.org/10.1186/s12889-020-09246-8 .

Gaume J, Grazioli VS, Paroz S, Fortini C, Bertholet N, Daeppen JB. Developing a brief motivational intervention for young adults admitted with alcohol intoxication in the emergency department – results from an iterative qualitative design. Plos One. 2021;16(2):e0246652. https://doi.org/10.1371/journal.pone.0246652 . Alam A (Neeloy, ed).

Siu AL, Zimbroff RM, Federman AD, et al. The effect of adapting Hospital at Home to facilitate implementation and sustainment on program drift or voltage drop. BMC Health Serv Res. 2019;19(1):264. https://doi.org/10.1186/s12913-019-4063-8 .

Martin S, Rassi C, Antonio V, et al. Evaluating the feasibility and acceptability of a community dialogue intervention in the prevention and control of schistosomiasis in Nampula province, Mozambique. Plos One. 2021;16(8):e0255647. https://doi.org/10.1371/journal.pone.0255647 . Diemert DJ, ed.

Ellis-Hill C, Thomas S, Gracey F, et al. HeART of Stroke: randomised controlled, parallel-arm, feasibility study of a community-based arts and health intervention plus usual care compared with usual care to increase psychological well-being in people following a stroke. BMJ Open. 2019;9(3):e021098. https://doi.org/10.1136/bmjopen-2017-021098 .

Walton A, Nahum-Shani I, Crosby L, Klasnja P, Murphy S. Optimizing digital integrated care via micro-randomized trials. Clin Pharmacol Ther. 2018;104(1):53–8. https://doi.org/10.1002/cpt.1079 .

Odukoya OO, Manortey S, Takemoto M, Alder S, Okuyemi KS. Body, Soul and Spirit, an adaptation of two evidence-based interventions to promote physical activity and healthy eating among adults in churches in Lagos Nigeria: a three-arm cluster randomized controlled pilot trial. Pilot Feasibil Stud. 2020;6(1):59. https://doi.org/10.1186/s40814-020-00600-6 .

Malden S, Hughes AR, Gibson AM, et al. Adapting the ToyBox obesity prevention intervention for use in Scottish preschools: protocol for a feasibility cluster randomised controlled trial. BMJ Open. 2018;8(10):e023707. https://doi.org/10.1136/bmjopen-2018-023707 .

Istanboulian L, Rose L, Yunusova Y, Dale CM. Protocol for a mixed method acceptability evaluation of a codesigned bundled COmmunication intervention for use in the adult ICU during the COVID-19 PandEmic: the COPE study. BMJ Open. 2021;11(9):e050347. https://doi.org/10.1136/bmjopen-2021-050347 .

McKay H, Nettlefold L, Bauman A, et al. Implementation of a co-designed physical activity program for older adults: positive impact when delivered at scale. BMC Public Health. 2018;18(1):1289. https://doi.org/10.1186/s12889-018-6210-2 .

Klasnja P, Smith S, Seewald NJ, et al. Efficacy of contextually tailored suggestions for physical activity: a micro-randomized optimization trial of HeartSteps. Ann Behav Med. 2019;53(6):573–82. https://doi.org/10.1093/abm/kay067 .

Murray E, Daff K, Lavida A, Henley W, Irwin J, Valabhji J. Evaluation of the digital diabetes prevention programme pilot: uncontrolled mixed-methods study protocol. BMJ Open. 2019;9(5):e025903. https://doi.org/10.1136/bmjopen-2018-025903 .

Rodrigues AmorimAdegboye A, Cocate PG, Benaim C, et al. Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial. Trials. 2020;21(1):244. https://doi.org/10.1186/s13063-020-4142-5 .

Northridge ME, Metcalf SS, Yi S, Zhang Q, Gu X, Trinh-Shevrin C. A protocol for a feasibility and acceptability study of a participatory, multi-level, dynamic intervention in urban outreach centers to improve the oral health of low-income Chinese Americans. Front Public Health. 2018;6:29. https://doi.org/10.3389/fpubh.2018.00029 .

Nicolson GH, Hayes C, Darker C. A theory-based multicomponent intervention to reduce occupational sedentary behaviour in professional male workers: protocol for a cluster randomised crossover pilot feasibility study. Pilot Feasibil Stud. 2020;6(1):175. https://doi.org/10.1186/s40814-020-00716-9 .

Thomas DSK, Bull S, Nyanza EC, Hampanda K, Liedtke M, Ngallaba SE. An mHealth pilot designed to increase the reach of prevention of mother-to-child transmission of HIV (PMTCT) across the treatment cascade in a resource-constrained setting in Tanzania. Plos One. 2019;14(2):e0212305. https://doi.org/10.1371/journal.pone.0212305 . Biemba G, ed.

Lemanska A, Poole K, Griffin BA, et al. Community pharmacy lifestyle intervention to increase physical activity and improve cardiovascular health of men with prostate cancer: a phase II feasibility study. BMJ Open. 2019;9(6):e025114. https://doi.org/10.1136/bmjopen-2018-025114 .

Logie CH, Daniel C, Newman PA, Loutfy MR. An HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: study protocol for an N-of-1 pilot study. BMJ Open. 2012;2(4):e001634. https://doi.org/10.1136/bmjopen-2012-001634 .

Coulman E, Hastings R, Gore N, et al. The Early Positive Approaches to Support (E-PAtS) study: study protocol for a feasibility cluster randomised controlled trial of a group programme (E-PAtS) for family caregivers of young children with intellectual disability. Pilot Feasibil Stud. 2020;6(1):147. https://doi.org/10.1186/s40814-020-00689-9 .

Njuguna IN, Beima-Sofie K, Mburu CW, et al. Adolescent transition to adult care for HIV-infected adolescents in Kenya (ATTACH): study protocol for a hybrid effectiveness-implementation cluster randomised trial. BMJ Open. 2020;10(12):e039972. https://doi.org/10.1136/bmjopen-2020-039972 .

Bradford N, Condon P, Pitt E, Tyack Z, Alexander K. Optimising symptom management in children with cancer using a novel mobile phone application: protocol for a controlled hybrid effectiveness implementation trial (RESPONSE). BMC Health Serv Res. 2021;21(1):942. https://doi.org/10.1186/s12913-021-06943-x .

Maughan-Brown B, Smith P, Kuo C, et al. A conditional economic incentive fails to improve linkage to care and antiretroviral therapy initiation among HIV-positive adults in Cape Town South Africa. AIDS Patient Care STDs. 2018;32(2):70–8. https://doi.org/10.1089/apc.2017.0238 .

Kramer F, Labudek S, Jansen CP, et al. Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing. Pilot Feasibil Stud. 2020;6(1):6. https://doi.org/10.1186/s40814-019-0539-x .

Doody P, Lord JM, Whittaker AC. Assessing the feasibility and impact of an adapted resistance training intervention, aimed at improving the multi-dimensional health and functional capacity of frail older adults in residential care settings: protocol for a feasibility study. Pilot Feasibil Stud. 2019;5(1):86. https://doi.org/10.1186/s40814-019-0470-1 .

Morris AS, Murphy RC, Shepherd SO, Healy GN, Edwardson CL, Graves LEF. A multi-component intervention to sit less and move more in a contact centre setting: a feasibility study. BMC Public Health. 2019;19(1):292. https://doi.org/10.1186/s12889-019-6615-6 .

Millar A, Tip L, Lennon R, et al. The introduction of mindfulness groups to a psychiatric rehabilitation in-patient setting: a feasibility study. BMC Psychiatry. 2020;20(1):322. https://doi.org/10.1186/s12888-020-02725-7 .

Rasheed MA, Bharuchi V, Mughis W, Hussain A. Development and feasibility testing of a play-based psychosocial intervention for reduced patient stress in a pediatric care setting: experiences from Pakistan. Pilot Feasibil Stud. 2021;7(1):63. https://doi.org/10.1186/s40814-021-00781-8 .

Azar KMJ, Nasrallah C, Szwerinski NK, et al. Implementation of a group-based diabetes prevention program within a healthcare delivery system. BMC Health Serv Res. 2019;19(1):694. https://doi.org/10.1186/s12913-019-4569-0 .

Tsakos G, Brocklehurst PR, Watson S, et al. Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study. Pilot Feasibil Stud. 2021;7(1):138. https://doi.org/10.1186/s40814-021-00872-6 .

Clemson L, Laver K, Jeon YH, et al. Implementation of an evidence-based intervention to improve the wellbeing of people with dementia and their carers: study protocol for ‘Care of People with dementia in their Environments (COPE)’ in the Australian context. BMC Geriatr. 2018;18(1):108. https://doi.org/10.1186/s12877-018-0790-7 .

Hawkins J, Madden K, Fletcher A, et al. Development of a framework for the co-production and prototyping of public health interventions. BMC Public Health. 2017;17(1):689. https://doi.org/10.1186/s12889-017-4695-8 .

Gillespie J, Hughes A, Gibson AM, Haines J, Taveras E, Reilly JJ. Protocol for Healthy Habits Happy Homes (4H) Scotland: feasibility of a participatory approach to adaptation and implementation of a study aimed at early prevention of obesity. BMJ Open. 2019;9(6):e028038. https://doi.org/10.1136/bmjopen-2018-028038 .

Griva K, Chia JMX, Goh ZZS, et al. Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis: protocol for a randomised controlled trial (HED-Start). BMJ Open. 2021;11(9):e053588. https://doi.org/10.1136/bmjopen-2021-053588 .

Chudleigh J, Holder P, Moody L, et al. Process evaluation of co-designed interventions to improve communication of positive newborn bloodspot screening results. BMJ Open. 2021;11(8):e050773. https://doi.org/10.1136/bmjopen-2021-050773 .

Maindal HT, Timm A, Dahl-Petersen IK, et al. Systematically developing a family-based health promotion intervention for women with prior gestational diabetes based on evidence, theory and co-production: the Face-it study. BMC Public Health. 2021;21(1):1616. https://doi.org/10.1186/s12889-021-11655-2 .

Bray EA, George A, Everett B, Salamonson Y, Ramjan L. Protocol for developing a healthcare transition intervention for young people with spinal cord injuries using a participatory action research approach. BMJ Open. 2021;11(7):e053212. https://doi.org/10.1136/bmjopen-2021-053212 .

Goffe L, Hillier-Brown F, Hildred N, et al. Feasibility of working with a wholesale supplier to co-design and test acceptability of an intervention to promote smaller portions: an uncontrolled before-and-after study in British Fish & Chip shops. BMJ Open. 2019;9(2):e023441. https://doi.org/10.1136/bmjopen-2018-023441 .

Livings R, Naylor JM, Gibson K, et al. Implementation of a community-based, physiotherapy-led, multidisciplinary model of care for the management of knee osteoarthritis: protocol for a feasibility study. BMJ Open. 2020;10(7):e039152. https://doi.org/10.1136/bmjopen-2020-039152 .

Guagliano JM, Brown HE, Coombes E, et al. The development and feasibility of a randomised family-based physical activity promotion intervention: the Families Reporting Every Step to Health (FRESH) study. Pilot Feasibil Stud. 2019;5(1):21. https://doi.org/10.1186/s40814-019-0408-7 .

Kassavou A, Houghton V, Edwards S, Brimicombe J, Sutton S. Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations. BMJ Open. 2019;9(1):e024121. https://doi.org/10.1136/bmjopen-2018-024121 .

Payne Riches S, Piernas C, Aveyard P, Sheppard JP, Rayner M, Jebb SA. The Salt Swap intervention to reduce salt intake in people with high blood pressure: protocol for a feasibility randomised controlled trial. Trials. 2019;20(1):584. https://doi.org/10.1186/s13063-019-3691-y .

Degroote L, Van Dyck D, De Bourdeaudhuij I, De Paepe A, Crombez G. Acceptability and feasibility of the mHealth intervention ‘MyDayPlan’ to increase physical activity in a general adult population. BMC Public Health. 2020;20(1):1032. https://doi.org/10.1186/s12889-020-09148-9 .

Bodschwinna D, Lorenz I, Bauereiss N, Gündel H, Baumeister H, Hoenig K. PartnerCARE—a psycho-oncological online intervention for partners of patients with cancer: study protocol for a randomised controlled feasibility trial. BMJ Open. 2020;10(10):e035599. https://doi.org/10.1136/bmjopen-2019-035599 .

Lowthian JA, Green M, Meyer C, et al. Being Your Best: protocol for a feasibility study of a codesigned approach to reduce symptoms of frailty in people aged 65 years or more after transition from hospital. BMJ Open. 2021;11(3):e043223. https://doi.org/10.1136/bmjopen-2020-043223 .

Goff LM, Moore AP, Rivas C, Harding S. Healthy Eating and Active Lifestyles for Diabetes (HEAL-D): study protocol for the design and feasibility trial, with process evaluation, of a culturally tailored diabetes self-management programme for African-Caribbean communities. BMJ Open. 2019;9(2):e023733. https://doi.org/10.1136/bmjopen-2018-023733 .

Vandervelde S, Scheepmans K, Milisen K, et al. Reducing the use of physical restraints in home care: development and feasibility testing of a multicomponent program to support the implementation of a guideline. BMC Geriatr. 2021;21(1):77. https://doi.org/10.1186/s12877-020-01946-5 .

Simpson S, Wyke S, Mercer SW. Adaptation of a mindfulness-based intervention for incarcerated young men: a feasibility study. Mindfulness. 2019;10(8):1568–78. https://doi.org/10.1007/s12671-018-1076-z .

Jumbe S, James WY, Madurasinghe V, et al. Evaluating NHS Stop Smoking Service engagement in community pharmacies using simulated smokers: fidelity assessment of a theory-based intervention. BMJ Open. 2019;9(5):e026841. https://doi.org/10.1136/bmjopen-2018-026841 .

Langford R, Jago R, White J, et al. A physical activity, nutrition and oral health intervention in nursery settings: process evaluation of the NAP SACC UK feasibility cluster RCT. BMC Public Health. 2019;19(1):865. https://doi.org/10.1186/s12889-019-7102-9 .

Appel JM, Fullerton K, Hennessy E, et al. Design and methods of shape up under 5: integration of systems science and community-engaged research to prevent early childhood obesity. Plos One. 2019;14(8):e0220169. https://doi.org/10.1371/journal.pone.0220169 . Nkomazana O, ed.

Myers B, Carney T, Browne FA, Wechsberg WM. A trauma-informed substance use and sexual risk reduction intervention for young South African women: a mixed-methods feasibility study. BMJ Open. 2019;9(2):e024776. https://doi.org/10.1136/bmjopen-2018-024776 .

Brewer LC, Hayes SN, Caron AR, et al. Promoting cardiovascular health and wellness among African-Americans: community participatory approach to design an innovative mobile-health intervention. Plos One. 2019;14(8):e0218724. https://doi.org/10.1371/journal.pone.0218724 . Newton RL, ed.

Mitchell KR, Purcell C, Simpson SA, et al. Feasibility study of peer-led and school-based social network Intervention (STASH) to promote adolescent sexual health. Pilot Feasibil Stud. 2021;7(1):125. https://doi.org/10.1186/s40814-021-00835-x .

on behalf of the REACH-HF investigators, Greaves CJ, Wingham J, et al. Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping. Pilot Feasibil Stud. 2016;2(1):37. https://doi.org/10.1186/s40814-016-0075-x .

Lang CC, Smith K, Wingham J, et al. A randomised controlled trial of a facilitated home-based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: the REACH-HFpEF Pilot Study. BMJ Open. 2018;8(4):e019649. https://doi.org/10.1136/bmjopen-2017-019649 .

Abuhaloob L, Helles N, Mossey P, Freeman R. An ADePT evaluation for incorporating the TIPPS periodontal health intervention into primary care antenatal programmes to enhance infant birth weight in Palestine: a feasibility study. Pilot Feasibil Stud. 2021;7(1):91. https://doi.org/10.1186/s40814-021-00827-x .

Davis M, Wolk CB, Jager-Hyman S, et al. Implementing nudges for suicide prevention in real-world environments: project INSPIRE study protocol. Pilot Feasibil Stud. 2020;6(1):143. https://doi.org/10.1186/s40814-020-00686-y .

Barnett M, Miranda J, Kia-Keating M, Saldana L, Landsverk J, Lau AS. Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol. BMJ Open. 2019;9(7):e028988. https://doi.org/10.1136/bmjopen-2019-028988 .

Lucas-Thompson R, Seiter N, Broderick PC, et al. Moving 2 Mindful (M2M) study protocol: testing a mindfulness group plus ecological momentary intervention to decrease stress and anxiety in adolescents from high-conflict homes with a mixed-method longitudinal design. BMJ Open. 2019;9(11):e030948. https://doi.org/10.1136/bmjopen-2019-030948 .

Clouse K, Phillips TK, Camlin C, et al. CareConekta: study protocol for a randomized controlled trial of a mobile health intervention to improve engagement in postpartum HIV care in South Africa. Trials. 2020;21(1):258. https://doi.org/10.1186/s13063-020-4190-x .

McCrabb S, Mooney K, Elton B, Grady A, Yoong SL, Wolfenden L. How to optimise public health interventions: a scoping review of guidance from optimisation process frameworks. BMC Public Health. 2020;20(1):1849. https://doi.org/10.1186/s12889-020-09950-5 .

Neuhaus M, Healy GN, Fjeldsoe BS, et al. Iterative development of Stand Up Australia: a multi-component intervention to reduce workplace sitting. Int J Behav Nutr Phys Act. 2014;11(1):21. https://doi.org/10.1186/1479-5868-11-21 .

Fanning J, Brooks AK, Ip E, et al. A mobile health behavior intervention to reduce pain and improve health in older adults with obesity and chronic pain: the MORPH pilot trial. Front Digit Health. 2020;2:598456. https://doi.org/10.3389/fdgth.2020.598456 .

Larsen B, Greenstadt ED, Olesen BL, Marcus BH, Godino J, Zive MM. An mHealth physical activity intervention for latina adolescents: iterative design of the Chicas Fuertes study. JMIR Form Res. 2021;5(6):e26195. https://doi.org/10.2196/26195 .

Pagoto S, Tulu B, Agu E, Waring ME, Oleski JL, Jake-Schoffman DE. Using the Habit App for weight loss problem solving: development and feasibility study. JMIR MHealth UHealth. 2018;6(6):e145. https://doi.org/10.2196/mhealth.9801 .

Forsyth R, Purcell C, Barry S, et al. Peer-led intervention to prevent and reduce STI transmission and improve sexual health in secondary schools (STASH): protocol for a feasibility study. Pilot Feasibil Stud. 2018;4(1):180. https://doi.org/10.1186/s40814-018-0354-9 .

Nixon AC, Bampouras TM, Gooch HJ, et al. The EX-FRAIL CKD trial: a study protocol for a pilot randomised controlled trial of a home-based EXercise programme for pre-frail and FRAIL, older adults with chronic kidney disease. BMJ Open. 2020;10(6):e035344. https://doi.org/10.1136/bmjopen-2019-035344 .

Woodford J, Wikman A, Cernvall M, et al. Study protocol for a feasibility study of an internet-administered, guided, CBT-based, self-help intervention (ENGAGE) for parents of children previously treated for cancer. BMJ Open. 2018;8(6):e023708. https://doi.org/10.1136/bmjopen-2018-023708 .

Huang H, Yang P, Xue J, et al. Evaluating the individualized treatment of traditional Chinese medicine: a pilot study of N-of-1 trials. Evid Based Complement Alternat Med. 2014;2014:1–10. https://doi.org/10.1155/2014/148730 .

Hernandez LM, Wetter DW, Kumar S, Sutton SK, Vinci C. Smoking cessation using wearable sensors: protocol for a microrandomized trial. JMIR Res Protoc. 2021;10(2):e22877. https://doi.org/10.2196/22877 .

Militello L, Sobolev M, Okeke F, Adler DA, Nahum-Shani I. Digital prompts to increase engagement with the Headspace App and for stress regulation among parents: feasibility study. JMIR Form Res. 2022;6(3):e30606. https://doi.org/10.2196/30606 .

Kang M, Ragan BG, Park JH. Issues in outcomes research: an overview of randomization techniques for clinical trials. J Athl Train. 2008;43(2):215–21. https://doi.org/10.4085/1062-6050-43.2.215 .

Nair B. Clinical trial designs. Indian Dermatol Online J. 2019;10(2):193–201. https://doi.org/10.4103/idoj.IDOJ_475_18 .

Kendall JM. Designing a research project: randomised controlled trials and their principles. Emerg Med J. 2003;20(2):164–8. https://doi.org/10.1136/emj.20.2.164 .

D’Agostino RB, Kwan H. Measuring effectiveness What to expect without a randomized control group. Med Care. 1995;33(4 Suppl):AS95-105.

PubMed   Google Scholar  

Kravitz RL, Aguilera A, Chen EJ, et al. Feasibility, acceptability, and influence of mHealth-supported N-of-1 trials for enhanced cognitive and emotional well-being in US volunteers. Front Public Health. 2020;8:260. https://doi.org/10.3389/fpubh.2020.00260 .

Golbus JR, Dempsey W, Jackson EA, Nallamothu BK, Klasnja P. Microrandomized trial design for evaluating just-in-time adaptive interventions through mobile health technologies for cardiovascular disease. Circ Cardiovasc Qual Outcomes. 2021;14(2):e006760. https://doi.org/10.1161/CIRCOUTCOMES.120.006760 .

Pratt D, Mitchell H, Fitzpatrick L, Lea J. A single-group pilot feasibility and acceptability study of the broad minded affective coping technique for suicidal adults in crisis. J Behav Cogn Ther. 2022;32(4):290–6. https://doi.org/10.1016/j.jbct.2022.07.002 .

Dierick F, Bouché AF, Guérin S, et al. Quasi-experimental pilot study to improve mobility and balance in recurrently falling nursing home residents by voluntary non-targeted side-stepping exercise intervention. BMC Geriatr. 2022;22(1):1006. https://doi.org/10.1186/s12877-022-03696-y .

Agarwal G, Gaber J, Richardson J, et al. Pilot randomized controlled trial of a complex intervention for diabetes self-management supported by volunteers, technology, and interprofessional primary health care teams. Pilot Feasibil Stud. 2019;5(1):118. https://doi.org/10.1186/s40814-019-0504-8 .

Milat AJ, King L, Bauman AE, Redman S. The concept of scalability: increasing the scale and potential adoption of health promotion interventions into policy and practice. Health Promot Int. 2013;28(3):285–98. https://doi.org/10.1093/heapro/dar097 .

Smith JM, De Graft-Johnson J, Zyaee P, Ricca J, Fullerton J. Scaling up high-impact interventions: how is it done? Int J Gynecol Obstet. 2015;130:S4–10. https://doi.org/10.1016/j.ijgo.2015.03.010 .

Wulandari LPL, Kaldor J, Guy R. Uptake and acceptability of assisted and unassisted HIV self-testing among men who purchase sex in brothels in Indonesia: a pilot intervention study. BMC Public Health. 2020;20(1):730. https://doi.org/10.1186/s12889-020-08812-4 .

Thomas ED, Zohura F, Hasan MT, et al. Formative research to scale up a handwashing with soap and water treatment intervention for household members of diarrhea patients in health facilities in Dhaka, Bangladesh (CHoBI7 program). BMC Public Health. 2020;20(1):831. https://doi.org/10.1186/s12889-020-08727-0 .

Gagnon MP, Ndiaye MA, Larouche A, et al. Optimising patient active role with a user-centred eHealth platform (CONCERTO+) in chronic diseases management: a study protocol for a pilot cluster randomised controlled trial. BMJ Open. 2019;9(4):e028554. https://doi.org/10.1136/bmjopen-2018-028554 .

Bowden JL, Egerton T, Hinman RS, et al. Protocol for the process and feasibility evaluations of a new model of primary care service delivery for managing pain and function in patients with knee osteoarthritis (PARTNER) using a mixed methods approach. BMJ Open. 2020;10(2):e034526. https://doi.org/10.1136/bmjopen-2019-034526 .

Whittaker SL, Taylor NF, Hill KD, Ekegren CL, Brusco NK. Self-managed occupational therapy and physiotherapy for adults receiving inpatient rehabilitation (‘My Therapy’): protocol for a mixed-methods process evaluation. BMC Health Serv Res. 2021;21(1):810. https://doi.org/10.1186/s12913-021-06463-8 .

Bloom I, Welch L, Vassilev I, et al. Findings from an exploration of a social network intervention to promote diet quality and health behaviours in older adults with COPD: a feasibility study. Pilot Feasibil Stud. 2020;6(1):15. https://doi.org/10.1186/s40814-020-0553-z .

Jackson C, Huque R, Ahmed F, et al. Children Learning About Second-hand Smoke (CLASS II): a mixed methods process evaluation of a school-based intervention. Pilot Feasibil Stud. 2021;7(1):112. https://doi.org/10.1186/s40814-021-00853-9 .

Czajkowski SM, Powell LH, Adler N, et al. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015;34(10):971–82. https://doi.org/10.1037/hea0000161 .

Onken LS, Carroll KM, Shoham V, Cuthbert BN, Riddle M. Reenvisioning clinical science: unifying the discipline to improve the public health. Clin Psychol Sci. 2014;2(1):22–34. https://doi.org/10.1177/2167702613497932 .

Onken L. Implementation science at the national institute on aging: the principles of it. Public Policy Aging Rep. 2022;32(1):39–41. https://doi.org/10.1093/ppar/prab034 . Kaskie B, ed.

Beets MW, Von Klinggraeff L, Weaver RG, Armstrong B, Burkart S. Small studies, big decisions: the role of pilot/feasibility studies in incremental science and premature scale-up of behavioral interventions. Pilot Feasibil Stud. 2021;7(1):173. https://doi.org/10.1186/s40814-021-00909-w .

Von Klinggraeff L, Dugger R, Okely AD, et al. Early-stage studies to larger-scale trials: investigators’ perspectives on scaling-up childhood obesity interventions. Pilot Feasibil Stud. 2022;8(1):31. https://doi.org/10.1186/s40814-022-00991-8 .

Pressman A, Law H, Stahl R, et al. Conducting a pilot randomized controlled trial of community-based mindfulness-based stress reduction versus usual care for moderate-to-severe migraine: protocol for the Mindfulness and Migraine Study (M&M). Trials. 2019;20(1):257. https://doi.org/10.1186/s13063-019-3355-y .

on behalf of the PD_Manager consortium, Antonini A, Gentile G, et al. Acceptability to patients, carers and clinicians of an mHealth platform for the management of Parkinson’s disease (PD_Manager): study protocol for a pilot randomised controlled trial. Trials. 2018;19(1):492. https://doi.org/10.1186/s13063-018-2767-4 .

Cardwell K, Smith SM, Clyne B, et al. Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study. BMJ Open. 2020;10(6):e035087. https://doi.org/10.1136/bmjopen-2019-035087 .

Adams N, Skelton DA, Howel D, et al. Feasibility of trial procedures for a randomised controlled trial of a community based group exercise intervention for falls prevention for visually impaired older people: the VIOLET study. BMC Geriatr. 2018;18(1):307. https://doi.org/10.1186/s12877-018-0998-6 .

Sahota P, Christian M, Day R, Cocks K. The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme. Pilot Feasibil Stud. 2019;5(1):152. https://doi.org/10.1186/s40814-019-0542-2 .

Huberty J, Matthews J, Leiferman J, Cacciatore J, Gold KJ. A study protocol of a three-group randomized feasibility trial of an online yoga intervention for mothers after stillbirth (The Mindful Health Study). Pilot Feasibil Stud. 2018;4(1):12. https://doi.org/10.1186/s40814-017-0162-7 .

Yang MJ, Sutton SK, Hernandez LM, et al. A Just-In-Time Adaptive intervention (JITAI) for smoking cessation: feasibility and acceptability findings. Addict Behav. 2023;136:107467. https://doi.org/10.1016/j.addbeh.2022.107467 .

Karkar R, Schroeder J, Epstein DA, et al. TummyTrials: a feasibility study of using self-experimentation to detect individualized food triggers. In: Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems. ACM; 2017:6850–6863. https://doi.org/10.1145/3025453.3025480

Munson SA, Schroeder J, Karkar R, Kientz JA, Chung CF, Fogarty J. The importance of starting with goals in N-of-1 studies. Front Digit Health. 2020;2:3. https://doi.org/10.3389/fdgth.2020.00003 .

McGrattan AM, McEvoy CT, Vijayakumar A, et al. A mixed methods pilot randomised controlled trial to develop and evaluate the feasibility of a Mediterranean diet and lifestyle education intervention ‘THINK-MED’ among people with cognitive impairment. Pilot Feasibil Stud. 2021;7(1):3. https://doi.org/10.1186/s40814-020-00738-3 .

Davies M, Kristunas CA, Huddlestone L, et al. Increasing uptake of structured self-management education programmes for type 2 diabetes in a primary care setting: a feasibility study. Pilot Feasibil Stud. 2020;6(1):71. https://doi.org/10.1186/s40814-020-00606-0 .

Jobst S, Leppla L, Köberich S. A self-management support intervention for patients with atrial fibrillation: a randomized controlled pilot trial. Pilot Feasibil Stud. 2020;6(1):87. https://doi.org/10.1186/s40814-020-00624-y .

Tarrant M, Carter M, Dean SG, et al. Singing for people with aphasia (SPA): results of a pilot feasibility randomised controlled trial of a group singing intervention investigating acceptability and feasibility. BMJ Open. 2021;11(1):e040544. https://doi.org/10.1136/bmjopen-2020-040544 .

Mama SK, Bhuiyan N, Bopp MJ, McNeill LH, Lengerich EJ, Smyth JM. A faith-based mind–body intervention to improve psychosocial well-being among rural adults. Transl Behav Med. 2020;10(3):546–54. https://doi.org/10.1093/tbm/ibz136 .

Stephenson A, Garcia-Constantino M, Murphy MH, McDonough SM, Nugent CD, Mair JL. The “Worktivity” mHealth intervention to reduce sedentary behaviour in the workplace: a feasibility cluster randomised controlled pilot study. BMC Public Health. 2021;21(1):1416. https://doi.org/10.1186/s12889-021-11473-6 .

Hallingberg B, Turley R, Segrott J, et al. Exploratory studies to decide whether and how to proceed with full-scale evaluations of public health interventions: a systematic review of guidance. Pilot Feasibil Stud. 2018;4(1):104. https://doi.org/10.1186/s40814-018-0290-8 .

Chatters R, Newbould L, Sprange K, et al. Recruitment of older adults to three preventative lifestyle improvement studies. Trials. 2018;19(1):121. https://doi.org/10.1186/s13063-018-2482-1 .

DeFrank G, Singh S, Mateo KF, et al. Key recruitment and retention strategies for a pilot web-based intervention to decrease obesity risk among minority youth. Pilot Feasibil Stud. 2019;5(1):109. https://doi.org/10.1186/s40814-019-0492-8 .

Greidanus MA, De Rijk AE, De Boer AGEM, et al. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health. 2021;21(1):1433. https://doi.org/10.1186/s12889-021-11357-9 .

Kroska EB, Hoel S, Victory A, et al. Optimizing an acceptance and commitment therapy microintervention via a mobile app with two cohorts: protocol for micro-randomized trials. JMIR Res Protoc. 2020;9(9):e17086. https://doi.org/10.2196/17086 .

Treweek S, Bevan S, Bower P, et al. Trial forge guidance 1: what is a Study Within A Trial (SWAT)? Trials. 2018;19(1):139. https://doi.org/10.1186/s13063-018-2535-5 .

Treweek S, Bevan S, Bower P, et al. Trial forge guidance 2: how to decide if a further Study Within A Trial (SWAT) is needed. Trials. 2020;21(1):33. https://doi.org/10.1186/s13063-019-3980-5 .

Vetrovsky T, Cupka J, Dudek M, et al. A pedometer-based walking intervention with and without email counseling in general practice: a pilot randomized controlled trial. BMC Public Health. 2018;18(1):635. https://doi.org/10.1186/s12889-018-5520-8 .

Smith JD, Berkel C, Rudo-Stern J, et al. The family check-up 4 Health (FCU4Health): applying implementation science frameworks to the process of adapting an evidence-based parenting program for prevention of pediatric obesity and excess weight gain in primary care. Front Public Health. 2018;6:293. https://doi.org/10.3389/fpubh.2018.00293 .

Dillingham R, Ingersoll K, Flickinger TE, et al. PositiveLinks: a mobile health intervention for retention in HIV care and clinical outcomes with 12-month follow-up. AIDS Patient Care STDs. 2018;32(6):241–50. https://doi.org/10.1089/apc.2017.0303 .

Orkin A, Campbell D, Handford C, et al. Protocol for a mixed-methods feasibility study for the surviving opioid overdose with naloxone education and resuscitation (SOONER) randomised control trial. BMJ Open. 2019;9(11):e029436. https://doi.org/10.1136/bmjopen-2019-029436 .

Krutsinger DC, Yadav KN, Cooney E, Brooks S, Halpern SD, Courtright KR. A pilot randomized trial of five financial incentive strategies to increase study enrollment and retention rates. Contemp Clin Trials Commun. 2019;15:100390. https://doi.org/10.1016/j.conctc.2019.100390 .

Phillips S, Kanter J, Mueller M, et al. Feasibility of an mHealth self-management intervention for children and adolescents with sickle cell disease and their families. Transl Behav Med. 2021;11(3):724–32. https://doi.org/10.1093/tbm/ibaa132 .

Nikles J, Mitchell GK, Schluter P, et al. Aggregating single patient (n-of-1) trials in populations where recruitment and retention was difficult: the case of palliative care. J Clin Epidemiol. 2011;64(5):471–80. https://doi.org/10.1016/j.jclinepi.2010.05.009 .

Taylor G, Aveyard P, Bartlem K, et al. IntEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety (ESCAPE): protocol for a randomised and controlled, multicentre, acceptability, feasibility and implementation trial. Pilot Feasibil Stud. 2019;5(1):16. https://doi.org/10.1186/s40814-018-0385-2 .

Clouse K, Mongwenyana C, Musina M, et al. Acceptability and feasibility of a financial incentive intervention to improve retention in HIV care among pregnant women in Johannesburg South Africa. AIDS Care. 2018;30(4):453–60. https://doi.org/10.1080/09540121.2017.1394436 .

Ortiz JA, Smith BW, Shelley BM, Erickson KS. Adapting mindfulness to engage latinos and improve mental health in primary care: a pilot study. Mindfulness. 2019;10(12):2522–31. https://doi.org/10.1007/s12671-019-01229-0 .

Fuchs JD, Stojanovski K, Vittinghoff E, et al. A mobile health strategy to support adherence to antiretroviral preexposure prophylaxis. AIDS Patient Care STDs. 2018;32(3):104–11. https://doi.org/10.1089/apc.2017.0255 .

Myers ND, Lee S, Bateman AG, et al. Accelerometer-based assessment of physical activity within the fun for wellness online behavioral intervention: protocol for a feasibility study. Pilot Feasibil Stud. 2019;5(1):73. https://doi.org/10.1186/s40814-019-0455-0 .

Gooding K, Phiri M, Peterson I, Parker M, Desmond N. Six dimensions of research trial acceptability: how much, what, when, in what circumstances, to whom and why? Soc Sci Med. 2018;213:190–8. https://doi.org/10.1016/j.socscimed.2018.07.040 .

Hoel S, Victory A, Sagorac Gruichich T, et al. A mixed-methods analysis of mobile ACT responses from two cohorts. Front Digit Health. 2022;4:869143. https://doi.org/10.3389/fdgth.2022.869143 .

Coughlin LN, Nahum-Shani I, Bonar EE, et al. Toward a just-in-time adaptive intervention to reduce emerging adult alcohol use: testing approaches for identifying when to intervene. Subst Use Misuse. 2021;56(14):2115–25. https://doi.org/10.1080/10826084.2021.1972314 .

Mande A, Moore SL, Banaei-Kashani F, Echalier B, Bull S, Rosenberg MA. Assessment of a mobile health iPhone app for semiautomated self-management of chronic recurrent medical conditions using an N-of-1 trial framework: feasibility pilot study. JMIR Form Res. 2022;6(4):e34827. https://doi.org/10.2196/34827 .

Dopp AR, Parisi KE, Munson SA, Lyon AR. A glossary of user-centered design strategies for implementation experts. Transl Behav Med. 2019;9(6):1057–64. https://doi.org/10.1093/tbm/iby119 .

Rose H, McKinley J, eds. The Routledge Handbook of Research Methods in Applied Linguistics. London: Routledge; 2020.

Lewis JR. The system usability scale: past, present, and future. Int J Human-Computer Interact. 2018;34(7):577–90. https://doi.org/10.1080/10447318.2018.1455307 .

Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979;2(3):197–207. https://doi.org/10.1016/0149-7189(79)90094-6 .

Sidani S, Epstein DR, Bootzin RR, Moritz P, Miranda J. Assessment of preferences for treatment: validation of a measure: PREFERENCE MEASURE. Res Nurs Health. 2009;32(4):419–31. https://doi.org/10.1002/nur.20329 .

An M, Dusing SC, Harbourne RT, Sheridan SM, START-Play Consortium. What really works in intervention? Using fidelity measures to support optimal outcomes. Phys Ther. 2020;100(5):757–65. https://doi.org/10.1093/ptj/pzaa006 .

Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50. https://doi.org/10.1007/s10464-008-9165-0 .

Rivard M, Mello C, Mestari Z, et al. Using prevent teach reinforce for young children to manage challenging behaviors in public specialized early intervention services for autism. J Autism Dev Disord. 2021;51(11):3970–88. https://doi.org/10.1007/s10803-020-04856-y .

Stagg HR, Abubakar I, Campbell CN, et al. IMPACT study on intervening with a manualised package to achieve treatment adherence in people with tuberculosis: protocol paper for a mixed-methods study, including a pilot randomised controlled trial. BMJ Open. 2019;9(12):e032760. https://doi.org/10.1136/bmjopen-2019-032760 .

Kilbride C, Scott DJM, Butcher T, et al. Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): protocol of an intervention feasibility trial. BMJ Open. 2018;8(11):e026620. https://doi.org/10.1136/bmjopen-2018-026620 .

Dumas JE, Lynch AM, Laughlin JE, Phillips Smith E, Prinz RJ. Promoting intervention fidelity. Am J Prev Med. 2001;20(1):38–47. https://doi.org/10.1016/S0749-3797(00)00272-5 .

Walton H, Spector A, Roberts A, et al. Developing strategies to improve fidelity of delivery of, and engagement with, a complex intervention to improve independence in dementia: a mixed methods study. BMC Med Res Methodol. 2020;20(1):153. https://doi.org/10.1186/s12874-020-01006-x .

Nomikos PA, Hall M, Fuller A, et al. Fidelity assessment of nurse-led non-pharmacological package of care for knee pain in the package development phase of a feasibility randomised controlled trial based in secondary care: a mixed methods study. BMJ Open. 2021;11(7):e045242. https://doi.org/10.1136/bmjopen-2020-045242 .

Hall M, Fuller A, Nomikos PA, et al. East Midlands knee pain multiple randomised controlled trial cohort study: cohort establishment and feasibility study protocol. BMJ Open. 2020;10(9):e037760. https://doi.org/10.1136/bmjopen-2020-037760 .

Horne JC, Hooban KE, Lincoln NB, Logan PA. Regaining Confidence after Stroke (RCAS): a feasibility randomised controlled trial (RCT). Pilot Feasibil Stud. 2019;5(1):96. https://doi.org/10.1186/s40814-019-0480-z .

Porter KJ, Brock DJ, Estabrooks PA, et al. SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes. BMC Public Health. 2019;19(1):1273. https://doi.org/10.1186/s12889-019-7567-6 .

Watson A, Timperio A, Brown H, Hesketh KD. Process evaluation of a classroom active break (ACTI-BREAK) program for improving academic-related and physical activity outcomes for students in years 3 and 4. BMC Public Health. 2019;19(1):633. https://doi.org/10.1186/s12889-019-6982-z .

Hind D, Drabble SJ, Arden MA, et al. Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process evaluation. BMJ Open. 2020;10(10):e039089. https://doi.org/10.1136/bmjopen-2020-039089 .

Tibbitts B, Porter A, Sebire SJ, et al. Action 3:30R: process evaluation of a cluster randomised feasibility study of a revised teaching assistant-led extracurricular physical activity intervention for 8 to 10 year olds. BMC Public Health. 2019;19(1):1111. https://doi.org/10.1186/s12889-019-7347-3 .

Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health Ment Health Serv Res. 2011;38(2):65–76. https://doi.org/10.1007/s10488-010-0319-7 .

Wijana MB, Feldman I, Ssegonja R, Enebrink P, Ghaderi A. A pilot study of the impact of an integrated individual- and family therapy model for self-harming adolescents on overall healthcare consumption. BMC Psychiatry. 2021;21(1):374. https://doi.org/10.1186/s12888-021-03375-z .

Roberts JL, Williams J, Griffith GM, et al. Soles of the feet meditation intervention for people with intellectual disability and problems with anger and aggression—a feasibility study. Mindfulness. 2020;11(10):2371–85. https://doi.org/10.1007/s12671-020-01454-y .

Fallin-Bennett A, Lofwall M, Waters T, et al. Behavioral and Enhanced Perinatal Intervention (B-EPIC): a randomized trial targeting tobacco use among opioid dependent pregnant women. Contemp Clin Trials Commun. 2020;20:100657. https://doi.org/10.1016/j.conctc.2020.100657 .

Krebs P, Sherman SE, Wilson H, et al. Text2Connect: a health system approach to engage tobacco users in quitline cessation services via text messaging. Transl Behav Med. 2020;10(1):292–301. https://doi.org/10.1093/tbm/ibz033 .

Bailey DP, Edwardson CL, Pappas Y, et al. A randomised-controlled feasibility study of the REgulate your SItting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: study protocol. Pilot Feasibil Stud. 2021;7(1):76. https://doi.org/10.1186/s40814-021-00816-0 .

Karnon J, Qizilbash N. Economic evaluation alongsiden-of-1 trials: getting closer to the margin. Health Econ. 2001;10(1):79–82. https://doi.org/10.1002/1099-1050(200101)10:1%3c79::AID-HEC567%3e3.0.CO;2-Z .

Dichter MN, Berg A, Hylla J, et al. Evaluation of a multi-component, non-pharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes (MoNoPol-sleep): study protocol for a cluster-randomized exploratory trial. BMC Geriatr. 2021;21(1):40. https://doi.org/10.1186/s12877-020-01997-8 .

Williams J, Fairbairn E, McGrath R, et al. A feasibility hybrid II randomised controlled trial of volunteer ‘Health Champions’ supporting people with serious mental illness manage their physical health: study protocol. Pilot Feasibil Stud. 2021;7(1):116. https://doi.org/10.1186/s40814-021-00854-8 .

Teare MD, Dimairo M, Shephard N, Hayman A, Whitehead A, Walters SJ. Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: a simulation study. Trials. 2014;15(1):264. https://doi.org/10.1186/1745-6215-15-264 .

Azariah S, Saxton P, Franklin R, Forster R, Werder S, Jenkins R. NZPrEP Demonstration Project: protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) to determine feasibility, acceptability, adverse and behavioural effects of PrEP provision to gay and bisexual men in publicly funded sexual health clinics in Auckland, New Zealand. BMJ Open. 2019;9(6):e026363. https://doi.org/10.1136/bmjopen-2018-026363 .

Dawkins L, Bauld L, Ford A, et al. A cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain. Plos One. 2020;15(10):e0240968. https://doi.org/10.1371/journal.pone.0240968 . Leroyer C, ed.

Farragher JF, Thomas C, Ravani P, Manns B, Elliott MJ, Hemmelgarn BR. Protocol for a pilot randomised controlled trial of an educational programme for adults on chronic haemodialysis with fatigue (Fatigue-HD). BMJ Open. 2019;9(7):e030333. https://doi.org/10.1136/bmjopen-2019-030333 .

Shani P, Raeesi K, Walter E, et al. Qigong mind-body program for caregivers of cancer patients: design of a pilot three-arm randomized clinical trial. Pilot Feasibil Stud. 2021;7(1):73. https://doi.org/10.1186/s40814-021-00793-4 .

Croke A, Moriarty F, Boland F, et al. Integrating clinical pharmacists within general practice: protocol for a pilot cluster randomised controlled trial. BMJ Open. 2021;11(3):e041541. https://doi.org/10.1136/bmjopen-2020-041541 .

Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. 2011;45(5):626–9. https://doi.org/10.1016/j.jpsychires.2010.10.008 .

American Psychological Association. Preregistration .; 2021. https://www.apa.org/pubs/journals/resources/preregistration . Accessed 12 July, 2023

National Library of Medicine. Clinical trials. Published online 2023. https://clinicaltrials.gov/ . Accessed 12 July, 2023

Center for Open Science. Open Science Framework. Published online 2023. https://osf.io/ . Accessed 12 July, 2023

Foster ED, Deardorff A. Open Science Framework (OSF). J Med Libr Assoc. 2017;105(2):203. https://doi.org/10.5195/jmla.2017.88 .

Article   PubMed Central   Google Scholar  

Murphy ME, McSharry J, Byrne M, et al. Supporting care for suboptimally controlled type 2 diabetes mellitus in general practice with a clinical decision support system: a mixed methods pilot cluster randomised trial. BMJ Open. 2020;10(2):e032594. https://doi.org/10.1136/bmjopen-2019-032594 .

Torres S, Sales CMD, Guerra MP, Simões MP, Pinto M, Vieira FM. Emotion-focused cognitive behavioral therapy in comorbid obesity with binge eating disorder: a pilot study of feasibility and long-term outcomes. Front Psychol. 2020;11:343. https://doi.org/10.3389/fpsyg.2020.00343 .

Ritchwood TD, Massa C, Kamanga G, Pettifor A, Hoffman I, Corneli A. Understanding of perceived infectiousness and its influence on sexual behavior among individuals with acute HIV infection in Lilongwe, Malawi (HPTN 062). AIDS Educ Prev. 2020;32(3):260–70. https://doi.org/10.1521/aeap.2020.32.3.260 .

Eaton AD, Chan Carusone S, Craig SL, et al. The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community. BMJ Open. 2019;9(3):e026674. https://doi.org/10.1136/bmjopen-2018-026674 .

Holliday R, Preshaw PM, Ryan V, et al. A feasibility study with embedded pilot randomised controlled trial and process evaluation of electronic cigarettes for smoking cessation in patients with periodontitis. Pilot Feasibil Stud. 2019;5(1):74. https://doi.org/10.1186/s40814-019-0451-4 .

Wilchesky M, Mueller G, Morin M, et al. The OptimaMed intervention to reduce inappropriate medications in nursing home residents with severe dementia: results from a quasi-experimental feasibility pilot study. BMC Geriatr. 2018;18(1):204. https://doi.org/10.1186/s12877-018-0895-z .

Garcia DO, Valdez LA, Bell ML, et al. A gender- and culturally-sensitive weight loss intervention for Hispanic males: the ANIMO randomized controlled trial pilot study protocol and recruitment methods. Contemp Clin Trials Commun. 2018;9:151–63. https://doi.org/10.1016/j.conctc.2018.01.010 .

Johannessen T, Ree E, Strømme T, Aase I, Bal R, Wiig S. Designing and pilot testing of a leadership intervention to improve quality and safety in nursing homes and home care (the SAFE-LEAD intervention). BMJ Open. 2019;9(6):e027790. https://doi.org/10.1136/bmjopen-2018-027790 .

Deady M, Johnston D, Milne D, et al. Preliminary effectiveness of a smartphone app to reduce depressive symptoms in the workplace: feasibility and acceptability study. JMIR MHealth UHealth. 2018;6(12):e11661. https://doi.org/10.2196/11661 .

Juszczyk D, Gillison F. Juicy June: a mass-participation snack-swap challenge—results from a mixed methods feasibility study. Pilot Feasibil Stud. 2018;4(1):119. https://doi.org/10.1186/s40814-018-0310-8 .

Beasley JM, Kirshner L, Wylie-Rosett J, Sevick MA, DeLuca L, Chodosh J. BRInging the Diabetes prevention program to GEriatric populations (BRIDGE): a feasibility study. Pilot Feasibil Stud. 2019;5(1):129. https://doi.org/10.1186/s40814-019-0513-7 .

Prochilo GA, Costa RJS, Hassed C, Chambers R, Molenberghs P. A 16-week aerobic exercise and mindfulness-based intervention on chronic psychosocial stress: a pilot and feasibility study. Pilot Feasibil Stud. 2021;7(1):64. https://doi.org/10.1186/s40814-020-00751-6 .

Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network. https://www.equator-network.org/ . Accessed 22 Aug, 2023

National Institute of Diabetes and Digestive and Kidney Diseases. U34: Implementation Planning Cooperative Agreement .; 2023. https://www.niddk.nih.gov/research-funding/process/apply/funding-mechanisms/u34-multi-center-clinical-studies . Accessed 13 July, 2023

NIH Central Resource for Grants and Funding Information. Grants & Funding: P20 .; 2023. https://grants.nih.gov/grants/funding/ac_search_results.htm?text_curr=p20 . Accessed 13 July, 2023

UK Research and Innovation. Funding for Biomedical Research and Innovation .; 2022. https://www.ukri.org/what-we-do/developing-people-and-skills/mrc/funding-for-biomedical-research-and-innovation/pilot-projects-and-small-grants/ . Accessed 13 July, 2023

Canadian Institutes of Health Research. Health Research Training Platform Pilot .; 2022. https://cihr-irsc.gc.ca/e/52278.html . Accessed 13, 2023

National Health and Medical Research Council. Research Translation .; 2023. Accessed July 13, 2023. https://www.nhmrc.gov.au/research-policy/research-translation-and-impact

National Institute of Environmental Health Sciences. Translational Research Framework .; 2019. https://www.niehs.nih.gov/research/programs/translational/framework-details/index.cfm . Accessed 13 July, 2023

Wichman C, Smith LM, Yu F. A framework for clinical and translational research in the era of rigor and reproducibility. J Clin Transl Sci. 2021;5(1):e31. https://doi.org/10.1017/cts.2020.523 .

Lee EC, Whitehead AL, Jacques RM, Julious SA. The statistical interpretation of pilot trials: should significance thresholds be reconsidered? BMC Med Res Methodol. 2014;14(1):41. https://doi.org/10.1186/1471-2288-14-41 .

Sim J. Should treatment effects be estimated in pilot and feasibility studies? Pilot Feasibil Stud. 2019;5(1):107. https://doi.org/10.1186/s40814-019-0493-7 .

Teresi JA, Yu X, Stewart AL, Hays RD. Guidelines for designing and evaluating feasibility pilot studies. Med Care. 2022;60(1):95–103. https://doi.org/10.1097/MLR.0000000000001664 .

Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for planning pilot studies in clinical and translational research. Clin Transl Sci. 2011;4(5):332–7. https://doi.org/10.1111/j.1752-8062.2011.00347.x .

Beets MW, Pfledderer C, Von Klinggraeff L, Burkart S, Armstrong B. Fund behavioral science like the frameworks we endorse: the case for increased funding of preliminary studies by the National Institutes of Health. Pilot Feasibil Stud. 2022;8(1):218. https://doi.org/10.1186/s40814-022-01179-w .

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Acknowledgements

The authors would like to thank all experts who provided valuable input through the Delphi process of this study.

Research reported in this abstract was supported by The National Heart, Lung, and Blood Institute of the National Institutes of Health under award number R01HL149141 (Beets), F31HL158016 (von Klinggraeff), and F32HL154530 (Burkart) as well as by the Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under award number P20GM130420 for the Research Center for Child Well-Being. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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CDP - Conceptualization; methodology; software; formal analysis; investigation; data curation; writing—original draft; writing—review and editing; visualization; and supervision. LV—Methodology; investigation; data curation; writing—original draft; writing—review and editing; and formal analysis. SB—Methodology; investigation; data curation; writing—original draft; writing—review and editing; and formal analysis. AB—Methodology; writing—original draft; writing—review and editing; and formal analysis. DL—Writing—original draft and writing—review and editing. RJ—Writing—original draft and writing—review and editing. AO—Writing—original draft and writing—review and editing. ES—Writing—original draft and writing—review and editing. JPA—Writing—original draft; writing—review and editing; and formal analysis. JT—Writing—original draft and writing—review and editing. XL—Writing—original draft and writing—review and editing. MWB—Conceptualization; methodology; software; formal analysis; investigation; data curation; writing—original draft; writing—review and editing; visualization; supervision; and funding acquisition. All authors read and approved the final manuscript.

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Literature crosswalk.

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Summary table of considerations.

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Pfledderer, C.D., von Klinggraeff, L., Burkart, S. et al. Consolidated guidance for behavioral intervention pilot and feasibility studies. Pilot Feasibility Stud 10 , 57 (2024). https://doi.org/10.1186/s40814-024-01485-5

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Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review

• Udoka Okpalauwaekwe 1 ,
• Clifford Ballantyne 2 ,
• Scott Tunison 3 &
• Vivian R. Ramsden 4  

BMC Public Health volume  22 , Article number:  1630 ( 2022 ) Cite this article

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Indigenous youth in Canada face profound health inequities which are shaped by the rippling effects of intergenerational trauma, caused by the historical and contemporary colonial policies that reinforce negative stereotypes regarding them. Moreover, wellness promotion strategies for these youth are replete with individualistic Western concepts that excludes avenues for them to access holistic practices grounded in their culture. Our scoping review explored strategies, approaches, and ways health and wellness can be enhanced by, for, and with Indigenous youth in Canada by identifying barriers/roadblocks and facilitators/strengths to enhancing wellness among Indigenous youth in Canada.

We applied a systematic approach to searching and critically reviewing peer-reviewed literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews [PRISMA-ScR] as a reporting guideline. Our search strategy focused on specific keywords and MeSH terms for three major areas: Indigenous youth, health, and Canada. We used these keywords, to systematically search the following electronic databases published in English between January 01, 2017, to May 22, 2021: Medline [Ovid], PubMed, ERIC, Web of Science, Scopus, and iportal. We also used hand-searching and snowballing methods to identify relevant articles. Data collected were analysed for contents and themes.

From an initial 1695 articles collated, 20 articles met inclusion criteria for this review. Key facilitators/strengths to enhancing health and wellness by, for, and with Indigenous youth that emerged from our review included: promoting culturally appropriate interventions to engage Indigenous youth; using strength-based approaches; reliance on the wisdom of community Elders; taking responsibility; and providing access to wellness supports. Key barriers/roadblocks included: lack of community support for wellness promotion activities among Indigenous youth; structural/organizational issues within Indigenous communities; discrimination and social exclusion; cultural illiteracy among youth; cultural discordance with mainstream health systems and services; and addictions and risky behaviours.

This scoping review extracted 20 relevant articles about ways to engage Indigenous youth in health and wellness enhancement. Our findings demonstrate the importance of promoting health by, and with Indigenous youth, by engaging them in activities reflexive of their cultural norms, rather than imposing control measures that are incompatible with their value systems.

Peer Review reports

Introduction

The term ‘Indigenous’ is internationally recognized to describe a distinct group of people that live within or are attached to geographically distinct ancestral territories [ 1 , 2 ]. In Canada, the term Indigenous is an inclusive term used to refer to the First Nations, Métis, and Inuit people, each of which has unique histories, cultural traditions, languages, and beliefs [ 3 , 4 , 5 ]. Indigenous peoples are the fastest-growing population in Canada, with a population estimated at 1.8 million, which is 5.1% of the Canadian population [ 6 , 7 ]. Within this population, 63% identify as First Nation, 33% as Métis, and 4% as Inuit [ 6 , 7 ]. Indigenous youth are the youngest population in Canada, with over 50% of Indigenous youth under 25 years [ 7 ]. Projections of Indigenous peoples in Canada have estimated a 33.3 to 78.7% increase in Indigenous populations, with the youth making up the largest proportion of the Indigenous population by 2041 [ 6 , 7 ].

Before European contact in North America, Indigenous peoples in Canada lived and thrived with their cultures, languages, and distinct ways of knowing [ 2 ]. However, Indigenous peoples in Canada rank lower in almost every health determinant when compared with non-Indigenous Canadians [ 8 , 9 , 10 ]. A report on health disparities in Saskatoon, Saskatchewan, described First Nations peoples to be “more likely to experience poor health outcomes in essentially every indicator possible” (page 27) [ 11 ]. This greater burden of ill health among Indigenous peoples in Canada has been attributed to systemic racism (associated with differences in power, resources, capacities, and opportunities) [ 9 , 10 , 12 , 13 ] and intergenerational trauma (stemming from the past and ongoing legacy of colonization such as experienced through the Indian residential and Day school systems, the Sixties Scoop, and the ongoing waves of Indigenous child and youth apprehensions seen in the foster and child care structures that remove Indigenous children from their family, community and traditional lands) [ 3 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 17 ]. These traumatic historical events, along with ongoing inequities, such as: socioeconomic and environmental dispossession; loss of language; disruption of ties to Indigenous families, community, land and cultural traditions; have been reported to exacerbate drastically and cumulatively the physical, mental, social and spiritual health of Indigenous peoples in Canada, creating “soul wounds” (3 p.208) that require interventions beyond the Westernized biomedical models of health and healing [ 3 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].

In the same way, Indigenous youth in Canada face some of the most profound health inequities when compared with non-Indigenous youth which can be further shaped by the rippling effects of intergenerational trauma caused by the historical and contemporary colonial policies that reinforce or legitimize negative stereotypes regarding Indigenous youth in Canada [ 2 , 10 , 14 , 20 , 22 , 23 , 24 , 25 , 26 , 27 ]. When compared with their non-Indigenous peers, Indigenous youth in Canada have been reported to be more likely to have higher rates of chronic conditions [e.g., diabetes, obesity, chronic respiratory diseases, heart diseases, etc.] [ 14 ], discrimination [ 28 , 29 ], youth incarceration and state care [ 12 , 20 , 30 ], poverty [ 31 ], homelessness [ 32 ], higher adverse mental health conditions [ 20 , 33 , 34 , 35 , 36 , 37 ], higher suicide rates [ 33 , 38 , 39 ], and lower overall life expectancies [ 24 , 40 , 41 , 42 ].

Indigenous peoples’ perception of health and wellness is shaped by their worldview and traditional knowledge [ 43 , 44 ]. While the Western concept of health broadly defines health as the state of complete physical, mental, social well-being, and not merely the absence of disease [ 45 ], Indigenous peoples understand health in a holistic way [ 26 ] that seeks balance between the physical, mental, emotional, and spiritual aspects of an Indigenous person in reciprocal relationships with their families, communities, the land, the environment, their ancestors, and future generations [ 46 , 47 , 48 ]. Unfortunately, this holistic concept of health and wellness opposes the individualistic and biomedically focused Western worldview of health, which is a dominant lens commonly used in health research, projects, and programs involving Indigenous communities [ 46 ]. This practice further perpetuates the legacy of colonization and excludes avenues for Indigenous communities to access holistic healing practices “grounded in their culture” [ 43 , 49 , 50 ]. For example, health research involving Indigenous peoples in Canada tends to focus on Indigenous health deficits and identified social determinants in the communities, more often and without proper representation [ 43 ]. Additionally, there is the imposition of research on rather than with youth [ 43 , 44 ]; and the failure to acknowledge Indigenous worldviews in research, to ensure in benefits them [ 43 ].

Authentically engaging with Indigenous youth has been cited by Indigenous scholars as one of the ways of achieving and enhancing wellness by, for, and with youth [ 51 , 52 ]. This is characterized by meaningful and sustained involvement of the youth in program planning, development, and decision-making to promote self-confidence and positive relationships [ 53 ]. Authentic engagement involves working with rather than on youth as research partners or program planning participants [ 54 ]. This shift to working with rather than on implies respect for the knowledge of the lived experiences of the youth involved [ 54 , 55 , 56 ] and is based on meaningful relationships built over time among all involved [ 53 , 57 , 58 ]. Research has shown that engaging youth (Indigenous or non-Indigenous) as partners in a project/program fosters a sense of belonging, self-determination, and self-actualization within their community; thus, enhancing community wellness [ 54 , 56 , 58 , 59 ].

This paper explores what is known in the peer-reviewed literature about strategies, approaches, and ways to engage Indigenous youth in health and wellness enhancement. Our main objective is to use information gathered from this review to inform youth engagement strategies, by considering the facilitators/strengths and barriers/roadblocks to enhancing wellness with Indigenous youth. We define facilitators in this context as factors that improve, enhance, strengthen, or motivate a journey to health, wellness, and self-determination. These are considered ‘strengths’ in the language of Indigenous peoples as they support equitable strength-based pathways towards reconciliation. Conversely, barriers are roadblocks, and demotivating factors or processes that limit and challenge Indigenous peoples’ access to achieving health and wellness. Our overarching research question was, in what ways can Indigenous youth enhance health and wellness for themselves, their family, and the Indigenous communities where they live?

Sub-questions included:

What factors do Indigenous youth in Canada identify as facilitators/strengths to enhancing health and wellness?

What factors do Indigenous youth in Canada identify as barriers/roadblocks to enhancing health and wellness?

Methodology and methods

Scoping reviews help provide an overview of the research available on a given area of interest where evidence is emerging [ 60 ]. While there are several accepted approaches to such reviews, this scoping review was undertaken using the Joanna Briggs Institute (JBI) Guideline for scoping reviews [ 61 ]. This approach was based on the Arksey and O’Malley methodological framework [ 62 ], which was further advanced by Levac et al. [ 60 ], and Peter et al. [ 61 ]. Our search strategy focused on primary sources that elucidated youth-driven, youth-led, or youth-engaged strategies carried out by, for, and with Indigenous youth to enhance health and wellness. We chose to explore all health programs and research inquiry that explore health challenges on the physical, mental, emotional, and spiritual aspects of an Indigenous person to encompass the definition of health and wellness as defined and understood from an Indigenous perspective. This scoping review is reported in accordance with the guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR) [ 63 ]. See Supplementary material file 1 for PRISMA-SCR checklist.

Protocol registration and reporting information

There was no pre-published or registered protocol before the commencement of this study.

Eligibility criteria

Types of studies.

A priori inclusion criteria for articles in this study included: 1] peer-reviewed journal articles reporting health and wellness programs, initiatives, and/or strategies among Indigenous youth in Canada, and 2] peer-reviewed journal articles published between January 01, 2017, to May 22, 2021. We chose a 5-year time frame to limit our findings to the most updated peer-reviewed literature which could provide implications for the growing body of work done in the field of Indigenous research among youth. Systematic reviews, meta-analyses, study protocols, opinion pieces, and narrative reviews were excluded.

Participants

Peer-reviewed studies involving Indigenous youth (First Nations, Métis, and Inuit) in Canada were eligible for inclusion. We considered the fluidity of definitions for youth by age range as literature sources generally defined youth in stages between adolescence to early adulthood [ 6 , 64 , 65 ]. In Canada, the Government of Canada uses several age brackets to identify youth depending on context, program, or policies in question. For example, Statistics Canada defines youth as between 15 to 29 years [ 6 ], Health Canada in the first State of Youth Report defined youth as between 12 to 30 years [ 65 ] when referring to statistical reports, and as between 13 to 36 years when referring to youth-led programs and policies [ 65 ]. However, for the purposes of this review we defined and referred to Indigenous youth or young people as between 10 to 24 years to be more representative of a broader definition of youth which is in keeping with Indigenous peoples’ worldviews, languages, and cultures and more representative of a broader definition of youth as offered by Sawyer et al. [ 64 ].

Information sources and search strategy

With the assistance of an Academic Reference Librarian, search terms were identified, which were categorized and combined into three conceptual MeSH terms that we adapted for the database-specific search strategy. These terms included: Indigenous youth (including synonyms and MeSH terms), health (including synonyms and MeSH terms) and Canada. Thus, studies were then identified for this scoping review by searching electronic databases and hand-searching reference lists of included articles.

Initially, the following databases (Medline (Ovid), PubMed, ERIC, Web of Science and Scopus) were used to identify relevant articles published between January 1, 2017, and April 30, 2021. This constituted our first search. We then carried out a second search (updated search) on May 22, 2021, using the same search queries on the same library databases; in addition, we included the University of Saskatchewan’s Indigenous Studies Portal (iPortal) [ 66 ] to ensure we had as many hits as possible for our search query on focused studies with Indigenous communities. To ensure exhaustiveness, we employed hand-searching techniques and snowballing methods to identify articles relevant to the research questions by reviewing reference lists of relevant articles that met the eligibility criteria. Following this, all the identified articles were collated in Endnote Reference Manager version X9.3 [ 67 ] and exported, after removing duplicates, into Distiller SR [ 68 ], a web-based systematic review and meta-analysis software. The syntax used on electronic databases and the University of Saskatchewan’s iPortal to identify potentially relevant articles for inclusion into this review study is outlined in Table  1 .

Selection of sources of evidence

Two iterative stages were employed to select sources of evidence for this review study. First, we created screening, coding, and data extraction forms using Distiller SR [ 68 ] for each stage. In the first stage, UO screened titles and abstracts of all articles using the following keywords: Indigenous youth; health; wellness; engagement and Canada. In the second stage, UO independently screened and reviewed the full-text articles (FTAs) of citations included from the first stage. The questions in Table  2 were used to screen the eligibility for inclusion of the article for data extraction. A second reviewer (ST) also independently reviewed and screened every 10th FTA citation from the first phase to check inter-rater reliability.

Data charting process and data items

Data were extracted using a pre-designed data extraction form on DistillerSR [ 68 ]. All extracted data were exported into Microsoft Excel [ 69 ] for data cleaning and analysis. The title fields used to extract data from included articles are shown in Table  3 .

Critical appraisal of individual sources of evidence

Conjointly, UO and CB appraised each article included considering characteristics and methodological quality using the JBI Critical Appraisal Tool for qualitative and quantitative studies [ 70 ]. The JBI Critical Appraisal Tool was designed to evaluate the rigour, trustworthiness, relevance, and potential for bias in study designs, conduct, and analysis [ 70 ]. Results on the critical appraisals are summarized in Supplementary material file  2 .

Synthesis of results

We categorized findings in this review as facilitators/strengths and barriers/roadblocks to enhancing wellness by, for, and with Indigenous youth, further describing how youth described wellness promotion. We met weekly via videoconference to discuss, review, and revisit our study evaluation protocol to ensure we adhered strictly to the scoping review guidelines.

As a result of our literature search, 1671 articles from five library databases and 24 articles through hand-search and snowball methods were identified. Of the 1695 articles, 253 were excluded as duplicates on EndNote vX9.3 using the ‘remove duplicates’ function on the software. Another 1227 articles were excluded following screening of title and abstracts on Distiller SR which we had fed with a series of screening questions (see Table 2 ) that were reviewed independently by two reviewers (UO and ST). Inter-rater reliability (Cohen’s kappa) calculated was 0.886, standard error = 0.147, p -value = 0.001. Where there were conflicts in article inclusion ratings, a third reviewer (CB), was brought in to discuss and provide a resolution. This left 215 articles for full-text article (FTA) screening. After reviewing 215 FTAs, a further 195 articles were excluded, leaving 20 articles for inclusion into the final review. Articles were excluded in the eligibility stage for the following reasons, 1) articles not focused on Indigenous youth or Indigenous communities, 2) articles not focused on Indigenous health and/or wellness, 3) articles not primarily focused in Canadian settings, 4) articles not written in English, 5) articles considered irrelevant or not applicable to addressing the research objectives or research questions of our study, 6) articles other than original research (i.e., we excluded review studies, opinion papers, and conference abstracts). A flowchart of article selection can be found in Fig.  1 .

PRISMA flowchart showing selection of articles for scoping review

Characteristics of sources of evidence

The general and methodological characteristics of all 20 included articles are summarized in Table  4 . Of these, one study was published in 2017, two in 2018, eleven in 2019, four in 2020 and two in 2021. Five (25%) studies that were included were set in the province of Ontario, four (20%) in the province of Saskatchewan, three (15%) in the Northwest Territories and two in the province of Alberta. Fifty percent (10/20) of the studies recruited or focused on Indigenous (First Nations, Métis, and Inuit) people as study participants, seven (35%) studies recruited or concentrated on First Nations peoples only, and three (15%), on Inuit peoples only. Sixteen (80%) articles were qualitative studies, three (15%) used mixed methods, and one (5%) was a quantitative study. Eleven (55%) studies used participatory research approaches (which included photovoice, community-based participatory research (CBPR) or participatory action research (PAR)) in their study designs, seven (35%) integrated Indigenous research methods (e.g., the two-eyed seeing approach) into their study design, and five (25%) studies used descriptive or inferential evaluation strategies in their study design. Interviews, focus-group discussions, and discussion circles were the most common data collection methodology used in 17 (85%) of the studies included. Youth were commonly engaged in non-cultural activities in twelve (60%) of the studies and employed a youth-adult co-led strategy in 16 (80%) of the included studies.

Results of individual sources of evidence

All included studies provided answers relevant to one or more of the research questions with the potential for changing practice and strategies for engagement. All the included studies explored, investigated, or evaluated issues addressing health and wellness among Indigenous youth in Canada. The age range of youth involved in included studies ranged between 11 to 24 years. All studies utilized fun and interactive strategies to engage youth in their respective studies with the outcomes aimed at promoting health, developing capacity in youth participants and engaging youth in collaborating on sustainable outcomes for and with their communities [ 5 , 8 , 40 , 44 , 57 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ], save for one [ 16 ]. The summary of individual sources of evidence is described in Table  5 .

The key facilitators/strengths and barriers/roadblocks to enhancing health and wellness by, for, and with Indigenous youth that emerged from the included studies are described in Table  6 , in descending order of major themes for the frequency of citation by included articles per theme. The facilitators/strengths and barriers/roadblocks have also been categorized into sub-themes under five major themes for facilitators/strengths and six major themes for barriers/roadblocks. Health outcomes/programs examined by included studies included suicide prevention [ 40 ], mental health promotion [ 71 , 74 ], HIV prevention [ 75 ], wellness promotion through youth empowerment and cultural activism [5, 8, 16, 57, 72,,76, 77, 78,79, 80], social health [ 76 , 83 ], land-based healing and wellness [ 77 , 82 ], art-media based therapy and wellness [ 44 , 73 , 81 , 84 ]. An overview of the facilitators/strengths and barriers/roadblocks to enhancing health and wellness by, for, and with Indigenous youth is presented in Fig.  2 .

Summary of facilitators/strengths and barriers/roadblocks to enhancing wellness by, for and with Indigenous youth

Facilitators/strengths to enhancing health and wellness by, for, and with indigenous youth

Five major themes emerged and were identified as facilitators/strengths to enhancing health and wellness by, for, and with Indigenous youth in Canada. The most identified facilitator/strength of health and wellness among Indigenous youth in Canada, identified in 19 [95%] of the included studies, was the promotion of strength-based approaches to engaging with youth in the community [ 5 , 8 , 16 , 44 , 57 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ]. A number of sub-themes also emerged from this major theme to include: peer-mentoring [ 5 , 8 , 44 , 57 , 71 , 73 , 74 , 75 , 76 , 79 , 80 , 81 , 82 , 83 , 84 ]; engaging youth in programs that developed and promoted self-determination, capacity building and empowerment [ 5 , 8 , 44 , 57 , 72 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 82 , 83 , 84 ]; building positive relationships and social connections with others, nature and the environment [ 5 , 8 , 44 , 57 , 72 , 73 , 76 , 77 , 79 , 80 , 81 , 82 , 83 , 84 ]; showing kindness to one another [ 5 , 16 , 44 , 57 , 77 , 79 , 80 , 81 , 83 ]; and engaging youth in cultural activities [ 57 , 76 , 82 , 83 ] that stimulate or encourage mutual learning, enhance critical consciousness and cause transformative change [ 5 , 8 , 75 , 76 , 79 , 81 ]. The next most common facilitator identified in 16 [80%] of included studies was enhancing cultural identity and connectedness through youth engagement in cultural activities [ 8 , 16 , 40 , 44 , 57 , 71 , 72 , 75 , 76 , 77 , 79 , 80 , 81 , 82 , 83 , 84 ]. Other facilitators included: reliance on the wisdom, skills, and teachings of community Elders, Traditional Knowledge Keepers and community leaders in the pursuit of health and wellness promotion with Indigenous youth [ 5 , 16 , 44 , 72 , 77 , 79 , 80 , 81 , 83 , 84 ]; taking responsibility for one’s journey to wellness [ 44 , 57 , 72 , 74 , 79 , 80 , 82 , 83 ]; and providing access to health services and other wellness supports (including traditional health services) for youth in Indigenous communities [ 76 , 78 ]. A summary of the facilitators/strengths is provided in Fig. 2 .

Barriers/roadblocks to enhancing health and wellness by, for, and with indigenous youth

Six major themes emerged and identified as barriers/roadblocks to enhancing health and wellness by, for and with Indigenous youth in Canada. The most identified barrier/roadblock to enhancing health and wellness identified in 55% (11/20) of the included articles was a lack of community support [including social, financial, and organizational support] for wellness promotion strategies among Indigenous youth [ 5 , 44 , 57 , 72 , 74 , 75 , 76 , 77 , 78 , 80 , 81 ]. Structural and organizational issues within Indigenous communities regarding wellness promotion strategies were identified as the second most common barrier/roadblock to enhancing wellness in 50% [10/20] of included studies [ 5 , 8 , 72 , 73 , 76 , 77 , 78 , 81 , 82 , 83 ]. These structural and organizational issues included: Indigenous community problems or concerns affecting the sustainability of instituted wellness programs/strategies [ 5 , 8 , 78 , 81 ]; dogmatism and debates about definitions regarding traditions of health among Indigenous communities [ 72 , 77 , 82 , 83 ]; social and structural instability within communities (e.g., leadership concerns) [ 8 , 76 , 83 ]; modest to low capacity of service providers (e.g. vendors, health service centers, social service centers, etc.) to meet the demands of communities [ 73 , 78 , 81 ]; and the misperception of a lack of control for self-governance in Indigenous communities [ 81 ]. Discrimination and social exclusion of Indigenous youth were also identified as a barrier/roadblock to enhancing wellness in eight (40%) studies included [ 5 , 8 , 44 , 57 , 74 , 76 , 80 , 83 ]. Forms of discrimination and social exclusion identified as subthemes included: Racism (e.g., personal, interpersonal, structural and systemic racism) [ 5 , 8 , 76 , 80 , 83 ]; low self-esteem and a low view of self-identity leading to self-deprecation and self-exclusion from engaging in youth activities [ 8 , 44 , 76 , 80 , 83 ]; mental health stigmatization [ 73 , 74 , 76 ]; lack of inclusivity of traditional Indigenous activities into Canadian teaching institutions [ 76 , 77 ]; and all forms of bullying, abuse and hunger [ 57 , 80 ]. Other barriers/roadblocks included: cultural illiteracy among Indigenous youth [ 44 , 57 , 73 , 74 , 75 , 83 , 84 ]; friction between Western and Traditional methods of promoting health and wellness [ 5 , 74 , 76 , 77 ]; and risky behaviours such as gang activity, substance use/abuse and addictions [ 44 , 57 , 75 , 76 , 80 ]. A summary of the barriers/roadblocks is provided in Fig. 2 .

Scoping reviews determine the extent, range, and quality of evidence on any chosen topic [ 60 , 61 , 62 , 63 ]. In addition, they can be used to map and describe what is known about an identified topic to identify existing gaps in the literature regarding the chosen topic [ 60 , 61 , 62 , 63 ]. In this scoping review, the peer-reviewed evidence regarding facilitators/strengths and barriers/roadblocks to enhancing health and wellness by, for and with Indigenous youth in Canada were mapped and synthesized. Key facilitators/strengths highlighted included: promoting culturally appropriate interventions [ 8 , 16 , 40 , 44 , 57 , 71 , 72 , 75 , 76 , 77 , 79 , 80 , 81 , 82 , 83 , 84 ] using strength-based approaches [ 5 , 8 , 16 , 44 , 57 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ]. Key barriers to enhancing health and wellness by, for and with Indigenous youth identified in this review were the lack of community support for wellness promotion activities among Indigenous youth [ 5 , 44 , 57 , 72 , 74 , 75 , 76 , 77 , 78 , 80 , 81 ] and structural/organizational issues within Indigenous communities [ 5 , 8 , 72 , 73 , 76 , 77 , 78 , 81 , 82 , 83 ].

Strength-based approaches empower community members, academic researchers, and policymakers to effect community change while focusing on what has worked in the past and the community vision for success in the future [ 79 ]. This is contrasted with the common narrative in most studies exploring Indigenous health and wellness that focused on why and where the community has failed to thrive [ 79 ]. Promoting strength-based interventions by, for, and with Indigenous youth works in parallel with ensuring that health interventions are culturally appropriate [ 44 , 79 ] because Indigenous epistemologies or ways of knowing see reality as intricate processes of interdependent relationships between humans, nature, and the spirit world [ 44 , 77 ]. As such, wellness promotion in Indigenous communities should emphasize support for their traditional values such as respect, trust, non-judgement, and relationality, all of which support cultural revitalization [ 26 , 71 ].

Conversely, wellness promotion in Indigenous communities should disavow the use of Western-based epistemologies that embrace and emphasize control over risk factors and health [ 44 , 79 ]. The definition and perception of health and wellness by Indigenous peoples are starkly different from the Western perspective of health promotion [ 44 , 79 ] which was found in our study to be a barrier/roadblock to enhancing health and wellness by, for and with Indigenous youth [ 8 , 43 , 44 , 76 ]. Because of these contrasting and conflicting views on health and wellness, research carried out with Indigenous communities must be grounded in their culture. Elder Jim Dumont – a professor of Native Studies and a member of the Shawanaga First Nation on Eastern Georgian Bay, when describing the role of Indigenous culture in facilitating wellness among Indigenous peoples, defined Indigenous culture as a “ facilitator to spiritual expression” [ 85 p.11]. He described Indigenous culture as “an expression of the life-ways, the spiritual, psychological, social, and material practice of the Indigenous worldview, which attends to the whole person’s spiritual desire to live life to the fullest” [ 85 p.9]. This was the way of life for Indigenous peoples before colonization [ 2 ]. Back then, Indigenous peoples honoured and utilized traditional methods and practices connected to their respective unceded homelands to promote and sustain health and wellness by themselves within their respective communities [ 2 , 16 , 86 ]. These cultural practices provided and promoted health and wellness for the community, the peoples, the lands, and the environment [ 2 ].

Furthermore, Indigenous wellness promotion by, for and with Indigenous youth should go beyond making mainstream health promotion strategies more culturally appropriate. Indigenous wellness promotion should also invite youth as partners and co-researchers to authentically engage with the community, acknowledging their needs while working together with them to identify opportunities for change (which should include shared power and responsibilities in the relationship dynamic). This must be the fundamental principle for any work done by, for, or with Indigenous communities (i.e., authentic engagement) [ 54 , 55 , 59 ]. Authentic engagement is working and walking with rather than on communities [ 54 ] in a way that encourages respectful, compassionate, and genuine interest in the work undertaken by all partners involved [ 54 , 55 , 57 , 87 , 88 ]. In authentically engaging with Indigenous communities, emphasis should be placed on connecting with , rather than controlling, community members [ 44 , 89 ]. By doing so, enhances a community’s ability to answer their issues by identifying their community strengths and assets, considering opportunities for change, and co-creating meaningful solutions to mitigate them.

The Tri-Council Policy Statement (TCPS) on Ethical Conduct for Research involving Humans indicates in Chapter 9 that, where research involves First Nations, Métis, and Inuit peoples and their communities, they are to have a role in shaping and co-creating research that affects them; with respect being given to the autonomy of these communities and the individuals within them to decide to participate [ 90 ]. Our study showed that where youth were engaged as partners and co-researchers, promoted self-determination, capacity building and ultimately enhanced wellness [ 8 , 40 , 44 , 57 , 72 , 74 , 75 , 76 , 77 , 79 , 84 ].

From the outcomes of this review, youth were engaged as partners or co-researcher in 55% of the included articles using research approaches such as community-based participatory research [CBPR], photovoice, visual voice, participatory videography, performative arts, participatory narrative, and storytelling methods [ 8 , 40 , 44 , 57 , 72 , 74 , 75 , 76 , 77 , 79 , 84 ]. This review demonstrated that these methods helped foster an environment for transformative learning, reciprocal transfer of expertise, shared decision-making, and co-ownership of the research processes [ 8 , 40 , 44 , 57 , 72 , 74 , 75 , 76 , 77 , 79 , 84 ]. For example, Goodman et al. identified that through photovoice, youth identified how racism negatively influenced the types of social supports and relationships formed in their community, leading to improved access to mental health-promoting social programs [ 76 ]. Anang et al. reported that engaging Indigenous youth as co-researchers in exploring ways to promote suicide prevention revitalized awareness of their cultural identity, which was identified as a protective factor to youth suicide [ 40 ]. A group of First Nation girls involved in the Girl Power Program designed to build and foster empowerment using youth participatory action research approach indicated that working as co-researchers/co-creators in the program empowered them to find healing from wounded spirits, which helped enhance positive changes towards wellness through āhkamēyimowin (perseverance) [ 57 ]. Thus, we can conclude from our study that engaging youth as partners in research processes optimizes their personal experiences and gives them a voice which can stimulate action.

Engaging Indigenous youth in the co-creation of wellness strategies should also involve community Elders, Traditional Knowledge Keepers, and other Indigenous community leaders. This review demonstrated that reliance on the wisdom of Elders, Traditional Knowledge Keepers and Indigenous community leaders facilitated and enhanced wellness among Indigenous youth [ 5 , 16 , 44 , 72 , 77 , 79 , 80 , 81 , 83 , 84 , 91 ]. Elders, Traditional Knowledge Keepers, and Indigenous community leaders play a central role in increasing awareness related to the community’s histories, languages, knowledge, and ways of knowing [ 91 , 92 ]. For non-Indigenous researchers and allies, Elders and Traditional Knowledge Keepers can provide formal and informal teachings on: histories of the Indigenous community in question, their world views, languages in the community, arts, crafts and songs, value systems in the nation/community; knowledge of traditional plants and medicines; clan teachings in the nation/community; ceremonial knowledge or protocols; and understanding of wellness in the community that can increase cultural awareness and build Indigenous research competencies for non-Indigenous researchers and allies [ 91 , 92 , 93 ]. Hence, engaging Elders, Knowledge Keepers and Indigenous community leaders in youth wellness programs can provide an avenue for mutual learning, guiding non-Indigenous researchers/allies towards cultural appropriateness in co-developing youth-driven wellness strategies.

Practical implications

Overall, this review emphasized the importance of promoting wellness among Indigenous youth using ‘ culture as strength ’ rather than imposing control measures on Indigenous values. The historical experiences of Indigenous youth have revealed traumatic and distressful pasts propagated by the cumulative intergenerational impacts of colonization which evolved from Residential Schools, Day Schools, and the Sixties Scoop [ 15 , 16 , 33 , 94 , 95 ]. The 2015 Truth and Reconciliation Commission of Canada’s 96 Calls-to-Action stressed the need to decolonize mainstream health promotion strategies and embrace the promotion of self-determination in the use of and access to traditional knowledge, therapies, and healing practices Indigenous peoples [ 95 , 96 ]. This review provided a foundation for authentically engaging Indigenous youth in the co-creation of culturally appropriate wellness promotion strategies/programs driven and sustained by authentically engaged Indigenous youth in the community. Considering the number of qualitative studies we found in our review, a meta-synthesis of qualitative studies may guide future directions based on the findings in our study to further pursue to understand, appraise, summarize, and combine qualitative evidence to address the specific research questions particularly around the influences and experiences of cultural connectedness and wellness among Indigenous youth in Canada. Nonetheless, this review also contributes to the growing literature identifying strength-based approaches to enhancing health and wellness among Indigenous peoples in Canada.

Study limitations

This review aimed to provide an entire scope of all original studies published in peer-reviewed journals to allow for as broad a scope of literature synthesis as possible. However, this study is not without limitations. First, the search was limited to multiple library databases, including the University of Saskatchewan’s Indigenous Studies Portal (iPortal) [ 66 ]. Although this review produced many peer-reviewed and original studies, there is a potential that other relevant articles and reports were missed because we did not search the grey literature. Secondly, because this review was limited to peer-reviewed articles published in English, it is possible that potentially relevant studies in other languages were omitted. Moreover, the outcomes of this review are limited to the nature of the data reported in the articles included in the review. Additionally, we acknowledge the differences and nuances in Indigenous practices, values and culture which limits the generalizability of our review findings. Lastly, some of the studies in the scoping review utilized Indigenous study designs and methods that could not be appropriately evaluated using the JBI Critical Appraisal Tools [ 70 ].

This scoping review identified ways health and wellness can be enhanced by, for, and with Indigenous youth by identifying facilitators/strengths and barriers/roadblocks to enhancing health and wellness among Indigenous youth from identified studies published between January 1, 2017, and May 22, 2021. The outcomes of this review showed that promoting culturally based and appropriate interventions using strength-based approaches were key facilitators/strengths to enhancing health and wellness among Indigenous youth. Thus, the outcomes demonstrate the continued need to promote programs grounded in culture as a part of enhancing health and wellness while authentically engaging Indigenous youth in health and wellness strategies, interventions, and programs.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Abbreviations

Community-based participatory research

First Nations

Full-Text Articles

University of Saskatchewan’s Indigenous Studies Portal

Joanna Briggs Institute

Medical Subject Headings

Participatory action research

Preferred Reporting Items for Systematic Reviews and Meta Analyses

Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews

United Nations Department of Economic and Social Affairs (UNDESA). Who are Indigenous peoples. 2020. Available from: https://www.un.org/esa/socdev/unpfii/documents/5session_factsheet1.pdf . Assessed 02 Feb 2022.

Google Scholar  

Government of Canada. Indigenous peoples and communities. 2021. Available from: https://www.rcaanc-cirnac.gc.ca/eng/1100100013785/1529102490303 . Assessed 02 Feb 2022.

Allen L, Hatala A, Ijaz S, Courchene ED, Bushie EB. Indigenous-led health care partnerships in Canada. CMAJ. 2020;192(9):E208–16. https://doi.org/10.1503/cmaj.190728 .

Article   PubMed   PubMed Central   Google Scholar  

Latimer M, Sylliboy JR, MacLeod E, Rudderham S, Francis J, Hutt-MacLeod D, et al. Creating a safe space for first nations youth to share their pain. Pain Rep. 2018;3(Suppl 1):e682. https://doi.org/10.1097/PR9.0000000000000682 .

Lopresti S, Willows ND, Storey KE, McHugh TF. Indigenous youth mentorship program: key implementation characteristics of a school peer mentorship program in Canada. Health Promot Int. 2021;36(4):913–23. https://doi.org/10.1093/heapro/daaa090 .

Article   PubMed   Google Scholar  

Statistics Canada. Projections of the Indigenous populations and households in Canada, 2016 to 2041: overview of data sources, methods, assumptions and scenarios. 2021. Ottawa, ON. Cat. No. 17-2-0001. Available from: https://www150.statcan.gc.ca/n1/pub/17-20-0001/172000012021001-eng.htm . Assessed 02 Feb 2022.

Statistics Canada. Indigenous population in Canada – Projections to 2041. 2021. Ottawa, ON. Cat. No. 17-2-0001. Available from: https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2021066-eng.htm . Assessed 02 Feb 2022.

Merati N, Salsberg J, Saganash J, Iserhoff J, Moses KH, Law S. Cree youth engagement in health planning. Int J Indig Health. 2020;15(1):73–89. https://doi.org/10.32799/ijih.v15i1.33985 .

Article   Google Scholar  

Adelson N. The embodiment of inequity: health disparities in Aboriginal Canada. Can J Public Health. 2005;96(Suppl 2):S45–61. https://doi.org/10.1007/BF03403702 .

National Collaborating Centre for Indigenous Health (NCCIH). An overview of Aboriginal health in Canada. 2012. Available from: http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/101/abororiginal_health_web.pdf . Assessed 02 Feb 2022.

Lemstra M, Neudorf C. Health disparity in Saskatoon: analysis to intervention summary. 2008. Available from: https://www.alliancehealth.ca/wp-content/uploads/2019/06/HD-Summary.pdf . Assessed 02 Feb 2022.

Kirmayer LJ, Brass G. Addressing global health disparities among indigenous peoples. Lancet. 2016;388(10040):105–6. https://doi.org/10.1016/s0140-6736(16)30194-5 .

Kirmayer LJ, Gone JP, Moses J. Rethinking historical trauma. Transcult Psychiatry. 2014;51(3):299–319. https://doi.org/10.1177/1363461514536358 .

Phillips-Beck W, Sinclair S, Campbell R, Star L, Cidro J, Wicklow B, et al. Early-life origins of disparities in chronic diseases among indigenous youth: pathways to recovering health disparities from intergenerational trauma. J Dev Orig Health Dis. 2019;10(1):115–22. https://doi.org/10.1017/S2040174418000661 .

Article   CAS   PubMed   Google Scholar  

Barker B, Sedgemore K, Tourangeau M, Lagimodiere L, Milloy J, Dong H, et al. Intergenerational trauma: the relationship between residential schools and the child welfare system among young people who use drugs in Vancouver, Canada. J Adolesc Health. 2019;65(2):248–54. https://doi.org/10.1016/j.jadohealth.2019.01.022 .

Gray AP, Cote W. Cultural connectedness protects mental health against the effect of historical trauma among Anishinabe young adults. Public Health. 2019;176:77–81. https://doi.org/10.1016/j.puhe.2018.12.003 .

Wilk P, Maltby A, Cooke M, Forsyth J. The effect of parental residential school attendance and parental involvement on indigenous youth's participation in sport and physical activity during school. Int J Indig Health. 2019;14(2):133–49. https://doi.org/10.32799/ijih.v14i2.31929 .

Frohlich KL, Ross N, Richmond C. Health disparities in Canada today: some evidence and a theoretical framework. Health Policy. 2006;79(2–3):132–43. https://doi.org/10.1016/j.healthpol.2005.12.010 .

Greenwood ML, de Leeuw SN. Social determinants of health and the future well-being of Aboriginal children in Canada. Paediatr Child Health. 2012;17(7):381–4. https://doi.org/10.1093/pch/17.7.381 .

Kim PJ. Social determinants of health inequities in indigenous Canadians through a life course approach to colonialism and the residential school system. Health Equity. 2019;3(1):378–81. https://doi.org/10.1089/heq.2019.0041 .

King J, Masotti P, Dennem J, Hadani S, Linton J, Lockhart B, et al. The culture is prevention project: adapting the cultural connectedness scale for multi-tribal communities. Am Indian Alsk Native Ment Health Res. 2019;26(3):104–35. https://doi.org/10.5820/aian.2603.2019.104 .

Smylie J, O'Brien K, Beaudoin E, Daoud N, Bourgeois C, George EH, et al. Long-distance travel for birthing among indigenous and non-indigenous pregnant people in Canada. CMAJ. 2021;193(25):E948–e55. https://doi.org/10.1503/cmaj.201903 .

Pollock NJ, Healey GK, Jong M, Valcour JE, Mulay S. Tracking progress in suicide prevention in indigenous communities: a challenge for public health surveillance in Canada. BMC Public Health. 2018;18(1):1320. https://doi.org/10.1186/s12889-018-6224-9 .

Pollock NJ, Mulay S, Valcour J, Jong M. Suicide rates in Aboriginal communities in Labrador, Canada. Am J Public Health. 2016;106(7):1309–15. https://doi.org/10.2105/AJPH.2016.303151 .

Lucente G, Kurzawa J, Danseco E. Moving towards racial equity in the child and youth mental health sector in Ontario, Canada. Adm Policy Ment Health. 2021:1–4. https://doi.org/10.1007/s10488-021-01153-3 .

Sasakamoose J, Scerbe A, Wenaus I, Scandrett A. First Nation and Métis youth perspectives of health. Qual Inq. 2016;22(8):636–50. https://doi.org/10.1177/1077800416629695 .

Wood L, Kamper D, Swanson K. Spaces of hope? Youth perspectives on health and wellness in indigenous communities. Health Place. 2018;50:137–45. https://doi.org/10.1016/j.healthplace.2018.01.010 .

Bauer GR, Mahendran M, Braimoh J, Alam S, Churchill S. Identifying visible minorities or racialized persons on surveys: can we just ask? Can J Public Health. 2020;111(3):371–82. https://doi.org/10.17269/s41997-020-00325-2 .

Janzen B, Karunanayake C, Rennie D, Katapally T, Dyck R, McMullin K, et al. Racial discrimination and depression among on-reserve first nations people in rural Saskatchewan. Can J Public Health. 2018;108(5–6):e482–e7. https://doi.org/10.17269/cjph.108.6151 .

Kirmayer LJ, Brass GM, Tait CL. The mental health of Aboriginal peoples: transformations of identity and community. Can J Psychiatr. 2000;45(7):607–16. https://doi.org/10.1177/070674370004500702 .

Article   CAS   Google Scholar  

Victor J, Linds W, Episkenew J-A, Goulet L, Benjoe D, Brass D, et al. Kiskenimisowin (self-knowledge): co-researching wellbeing with Canadian first nations youth through participatory visual methods. Int J Indig Health. 2016;11(1):262–78. https://doi.org/10.18357/ijih111201616020 .

Ansloos JP, Wager AC. Surviving in the cracks: a qualitative study with indigenous youth on homelessness and applied community theatre. Int J Qual Stud Educ. 2019;33(1):50–65. https://doi.org/10.1080/09518398.2019.1678785 .

Bombay A, McQuaid RJ, Schwartz F, Thomas A, Anisman H, Matheson K. Suicidal thoughts and attempts in first nations communities: links to parental Indian residential school attendance across development. J Dev Orig Health Dis. 2019;10(1):123–31. https://doi.org/10.1017/S2040174418000405 .

Gabel C, Pace J, Ryan C. Using photovoice to understand intergenerational influences on health and well-being in a southern Labrador Inuit community. Int J Indig Health. 2016;11(1):75–91. https://doi.org/10.18357/ijih111201616014 .

Grande AJ, Elia C, Peixoto C, Jardim PTC, Dazzan P, Veras AB, et al. Mental health interventions for suicide prevention among indigenous adolescents: a systematic review protocol. BMJ Open. 2020;10(5):e034055. https://doi.org/10.1136/bmjopen-2019-034055 .

Hartshorn KJ, Whitbeck LB, Prentice P. Substance use disorders, comorbidity, and arrest among indigenous adolescents. Crime Delinq. 2015;61(10):1311–32. https://doi.org/10.1177/0011128712466372 .

Boksa P, Hutt-MacLeod D, Clair L, Brass G, Bighead S, MacKinnon A, et al. Demographic and clinical presentations of youth using enhanced mental health services in six indigenous communities from the ACCESS open minds network. Can J Psychiatr. 2022;67(3):179–91. https://doi.org/10.1177/07067437211055416 .

Abraham ZK, Sher L. Adolescent suicide as a global public health issue. Int J Adolesc Med Health. 2017;31(4):20170036. https://doi.org/10.1515/ijamh-2017-0036 .

Ansloos J. Rethinking indigenous suicide. Int J Indig Health. 2018;13(2):8–28. https://doi.org/10.18357/ijih.v13i2.32061 .

Anang P, Naujaat Elder EH, Gordon E, Gottlieb N, Bronson M. Building on strengths in Naujaat: the process of engaging Inuit youth in suicide prevention. Int J Circumpolar Health. 2019;78(2):1508321. https://doi.org/10.1080/22423982.2018.1508321 .

Barker B, Goodman A, DeBeck K. Reclaiming indigenous identities: culture as strength against suicide among indigenous youth in Canada. Can J Public Health. 2017;108(2):e208–e10. https://doi.org/10.17269/cjph.108.5754 .

Lemstra M, Rogers M, Moraros J, Grant E. Risk indicators of suicide ideation among on-reserve first nations youth. Paediatr Child Health. 2013;18(1):15–20. https://doi.org/10.1093/pch/18.1.15 .

Plazas PC, Cameron BL, Milford K, Hunt LR, Bourque-Bearskin L, Santos SA. Engaging indigenous youth through popular theatre: knowledge mobilization of indigenous peoples’ perspectives on access to healthcare services. Action Res. 2019;17(4):492–509. https://doi.org/10.1177/1476750318789468 .

Sanchez-Pimienta CE, Masuda J, M'Wikwedong indigenous friendship C. From controlling to connecting: M'Wikwedong as a place of urban indigenous health promotion in Canada. Health Promot Int. 2021;36(3):703–13. https://doi.org/10.1093/heapro/daaa066 .

Leonardi F. The definition of health: towards new perspectives. Int J Health Serv. 2018;48(4):735–48. https://doi.org/10.1177/0020731418782653 .

Snowshoe A, Crooks CV, Tremblay PF, Hinson RE. Cultural connectedness and its relation to mental wellness for first nations youth. J Prim Prev. 2017;38(1–2):67–86. https://doi.org/10.1007/s10935-016-0454-3 .

Auger M, Howell T, Gomes T. Moving toward holistic wellness, empowerment and self-determination for indigenous peoples in Canada: can traditional indigenous health care practices increase ownership over health and health care decisions? Can J Public Health. 2016;107(4–5):e393–e8. https://doi.org/10.17269/cjph.107.5366 .

Brady M. Cultural considerations in play therapy with Aboriginal children in Canada. First Peoples Child Fam Rev. 2015;10(2):95–109.

Rabbitskin N, Ermine, W, Walsh, K, Gilbert, L; in Interagency Coalition on AIDS and Development publications. Case Study: Sturgeon Lake traditional health program. 2010. Available from: http://www.icad-cisd.com/our-resources/icad-publications-and-resources/case-study-sturgeon-lake-traditional-health-program/ . Assessed 23 Sept 2021.

Sturgeon Lake First Nation. Sturgeon Lake First Nation wholistic influenza pandemic planning. 2007. Available from: https://fnpa.ca/wp-content/uploads/2020/03/Sturgeon-Lake-First-Nation-Wholistic-Influenza-Plan.pdf . Assessed 23 Sept 2021.

Sturgeon Lake First Nation. Sturgeon Lake First Nation of Saskatchewan. Available from: http://www.slfn.ca/ . Accessed 23 Sept 2021.

Government of Canada. Sturgeon Lake First Nation-connectivity profile. 2020. Available from: https://www.aadnc-aandc.gc.ca/eng/1357840942279/1360166692704 . Assessed 23 Sept 2021.

Gaspar C. Āhkamēyimowin: walking together [Dissertation, University of Saskatchewan]. 2019. Available from: https://core.ac.uk/download/pdf/226154411.pdf . Assessed 23 Sept 2021.

Ramsden VR, Salsberg J, Herbert CP, Westfall JM, LeMaster J, Macaulay AC. Patient- and community-oriented research: how is authentic engagement identified in grant applications? Can Fam Physician. 2017;63(1):74–6.

PubMed   PubMed Central   Google Scholar  

Ramsden VR, Rabbitskin N, Westfall JM, Felzien M, Braden J, Sand J. Is knowledge translation without patient or community engagement flawed? Fam Pract. 2017;34(3):259–61. https://doi.org/10.1093/fampra/cmw114 .

Woolf SH, Zimmerman E, Haley A, Krist AH. Authentic engagement of patients and communities can transform research, practice, and policy. Health Aff (Millwood). 2016;35(4):590–4. https://doi.org/10.1377/hlthaff.2015.1512 .

Gaspar C, Sundown S, Kingfisher S, Thornton R, Bighead S, Girl Power program participants of Sturgeon Lake First Nation, et al. āhkamēyimowin (perseverance): walking together: codesigned research project resulted in empowering first nations girls. Can Fam Physician. 2019;65(12):930–2.

Wu HC, Kornbluh M, Weiss J, Roddy L. Measuring and understanding authentic youth engagement: the youth-adult partnership rubric. Afterschool Matters. 2016;23:8–17.

Allen ML, Salsberg J, Knot M, LeMaster JW, Felzien M, Westfall JM, et al. Engaging with communities, engaging with patients: amendment to the NAPCRG 1998 policy statement on responsible research with communities. Fam Pract. 2017;34(3):313–21. https://doi.org/10.1093/fampra/cmw074 .

Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. https://doi.org/10.1186/1748-5908-5-69 .

Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6. https://doi.org/10.1097/xeb.0000000000000050 .

Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. https://doi.org/10.1080/1364557032000119616 .

Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. https://doi.org/10.7326/m18-0850 .

Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health. 2018;2(3):223–8. https://doi.org/10.1016/s2352-4642(18)30022-1 .

Government of Canada. Canada’s first state of youth report: for youth, with youth, by youth. Ottawa: Canadian Heritage; 2021. Available from: https://www.canada.ca/en/canadian-heritage/campaigns/state-youth/report.html . Assessed 02 Feb 2022

University of Saskatchewan. University of Saskatchewan Indigenous studies portal research tool. Available at: https://iportal.usask.ca/ . Assessed 23 Sept 2021.

Clarivate Analytics. MacOS Endnote X9 version 9.2. [commercial computer software]. New York: Thomson Reuters Corporation; 2019.

Evidence Partners Incorporated. Distiller SR. Systematic Review and Literature Review Software. Ottawa: Evidence Partners Incorporated; 2021.

Microsoft Corporation. Microsoft Excel version 16.32. [commercial computer software]. New York: Microsoft; 2016.

Joanna Briggs Institute. Joanna Briggs Institute critical appraisal tools. 2014. Available from: https://joannabriggs.org/ebp/critical_appraisal_tools . Accessed 23 May 2021.

Crooks CV, Exner-Cortens D, Burm S, Lapointe A, Chiodo D. Two years of relationship-focused mentoring for first nations, Metis, and Inuit adolescents: promoting positive mental health. J Prim Prev. 2017;38(1–2):87–104. https://doi.org/10.1007/s10935-016-0457-0 .

Gaudet JC, Chilton C. Milo Pimatisiwin project: healthy living for Mushkegowuk youth. Int J Indig Health. 2018;13(1):20–40. https://doi.org/10.18357/ijih.v13i1.30264 .

Lys C, Gesink D, Strike C, Larkin J. Body mapping as a youth sexual health intervention and data collection tool. Qual Health Res. 2018;28(7):1185–98. https://doi.org/10.1177/1049732317750862 .

Etter M, Goose A, Nossal M, Chishom-Nelson J, Heck C, Joober R, et al. Improving youth mental wellness services in an indigenous context in Ulukhaktok, Northwest Territories: ACCESS open minds project. Early Interv Psychiatry. 2019;13(Suppl 1):35–41. https://doi.org/10.1111/eip.12816 .

Flicker S, Wilson C, Monchalin R, Oliver V, Prentice T, Jackson R, et al. “Stay strong, stay sexy, stay native”: storying indigenous youth HIV prevention activism. Action Res. 2017;17(3):323–43. https://doi.org/10.1177/1476750317721302 .

Goodman A, Snyder M, Wilson K, Whitford J. Healthy spaces: exploring urban indigenous youth perspectives of social support and health using photovoice. Health Place. 2019;56:34–42. https://doi.org/10.1016/j.healthplace.2019.01.004 .

Hatala AR, Morton D, Njeze C, Bird-Naytowhow K, Pearl T. Re-imagining miyo-wicehtowin: human-nature relations, land-making, and wellness among indigenous youth in a Canadian urban context. Soc Sci Med. 2019;230:122–30. https://doi.org/10.1016/j.socscimed.2019.04.012 .

Hutt-MacLeod D, Rudderham H, Sylliboy A, Sylliboy-Denny M, Liebenberg L, Denny JF, et al. Eskasoni first Nation's transformation of youth mental healthcare: partnership between a Mi'kmaq community and the ACCESS open minds research project in implementing innovative practice and service evaluation. Early Interv Psychiatry. 2019;13(Suppl 1):42–7. https://doi.org/10.1111/eip.12817 .

Lines LA, Yellowknives Dene First Nation Wellness Division, Jardine CG. Connection to the land as a youth-identified social determinant of indigenous peoples’ health. BMC Public Health. 2019;19(1):176. https://doi.org/10.1186/s12889-018-6383-8 .

Loebach J, Tilleczek K, Chaisson B, Sharp B. Keyboard warriors? Visualising technology and well-being with, for and by indigenous youth through digital stories. Vis Stud. 2019;34(3):281–97. https://doi.org/10.1080/1472586x.2019.1691050 .

Camargo Plazas P, Cameron BL, Milford K, Hunt LR, Bourque-Bearskin L, Santos SA. Engaging indigenous youth through popular theatre: knowledge mobilization of indigenous peoples’ perspectives on access to healthcare services. Action Res. 2018;17(4):492–509. https://doi.org/10.1177/1476750318789468 .

Hatala AR, Bird-Naytowhow K. Performing pimatisiwin: the expression of indigenous wellness identities through community-based theater. Med Anthropol Q. 2020;34(2):243–67. https://doi.org/10.1111/maq.12575 .

Njeze C, Bird-Naytowhow K, Pearl T, Hatala AR. Intersectionality of resilience: a strengths-based case study approach with indigenous youth in an urban Canadian context. Qual Health Res. 2020;30(13):2001–18. https://doi.org/10.1177/1049732320940702 .

Saini M, Roche S, Papadopoulos A, Markwick N, Shiwak I, Flowers C, et al. Promoting Inuit health through a participatory whiteboard video. Can J Public Health. 2020;111(1):50–9. https://doi.org/10.17269/s41997-019-00189-1 .

Canadian Institutes of Health Research (CIHR). Elder Jim Dumont, National Native Addictions Partnership Foundation in: Honouring our strengths; Indigenous culture as intervention in addictions treatment project - University of Saskatchewan. 2014. Available from: https://cyfn.ca/wp-content/uploads/2016/10/Honouring-our-strengths-Culture-as-treatment-resource-guide.pdf . Assessed 23 Sept 2021.

Fletcher S, Mullett J. Digital stories as a tool for health promotion and youth engagement. Can J Public Health. 2016;107(2):e183–e7. https://doi.org/10.17269/cjph.107.5266 .

Ramsden VR. Integrated primary health services model research team. Learning with the community. Evolution to transformative action research. Can Fam Physician. 2003;49(2):195–7 200–2.

CAS   PubMed   PubMed Central   Google Scholar  

Ramsden VR, McKay S, Crowe J. The pursuit of excellence: engaging the community in participatory health research. Glob Health Promot. 2010;17(4):32–42. https://doi.org/10.1177/1757975910383929 .

Ramsden VR, Cave AJ. Participatory methods to facilitate research. Can Fam Physician. 2002;48(3):548–9 553–4.

Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC), Social Sciences and Humanities Research Council of Canada (SSHRC). Tri-Council policy statement. Ethical conduct for research involving humans. Ottawa: Government of Canada; 2018. Available from: https://ethics.gc.ca/eng/documents/tcps2-2018-en-interactive-final.pdf . Assessed 17 Jan 2022

Kanewiyakiho ED, Sawchuk KF, Ramsden VR. Ask before you ask: co-developing meaningful research questions with indigenous elders. Can Fam Physician. 2021;67(12):947–8. https://doi.org/10.46747/cfp.6712947 .

Flicker S, O'Campo P, Monchalin R, Thistle J, Worthington C, Masching R, et al. Research done in “a good way”: the importance of indigenous Elder involvement in HIV community-based research. Am J Public Health. 2015;105(6):1149–54. https://doi.org/10.2105/AJPH.2014.302522 .

Rowe G, Straka S, Hart M, Callahan A, Robinson D, Robson G. Prioritizing indigenous elders’ knowledge for intergenerational well-being. Can J Aging. 2020;39(2):156–68.

Cooke MJ, Wilk P, Paul KW, Gonneville SL. Predictors of obesity among Métis children: socio-economic, behavioural and cultural factors. Can J Public Health. 2013;104(4):e298–303. https://doi.org/10.17269/cjph.104.3765 .

Truth and Reconciliation Commission of Canada (TRC). Honoring the truth, reconciling for the future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada. 2015. Available from: https://ehprnh2mwo3.exactdn.com/wp-content/uploads/2021/01/Executive_Summary_English_Web.pdf . Assessed 23 Sept 2021.

Truth and Reconciliation Commission of Canada (TRC). Truth and Reconciliation Commission of Canada: Calls to Action. 2015. Available from: https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/indigenous-people/aboriginal-peoples-documents/calls_to_action_english2.pdf . Assessed 23 Sept 2021.

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Funding provided by the Saskatchewan Health Research Foundation (SHRF) and the Canadian Institute of Health Research (CIHR)/Saskatchewan Center for Patient-Oriented Research (SCPOR) as part of the SHRF Leader Award held by Dr. Ramsden.

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Udoka Okpalauwaekwe

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Clifford Ballantyne

University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0X1, Canada

Scott Tunison

Research Division, Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7M 3Y5, Canada

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UO contributed to the conceptualization, methodology, design, data analysis, original draft writing, review, editing and revision of this study. CB was involved in and contributed to the methodology, data analysis, original draft review and editing of this study. ST was involved in and contributed to the conceptualization, methodology, data analysis, review and editing of several versions of this study. VRR was involved in and contributed to the conceptualization, methodology, data analysis, review and editing of this study. All authors (UO, CB, ST, and VRR) read and approved the final the final manuscript.

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Okpalauwaekwe, U., Ballantyne, C., Tunison, S. et al. Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review. BMC Public Health 22 , 1630 (2022). https://doi.org/10.1186/s12889-022-14047-2

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The Literature Review: A Foundation for High-Quality Medical Education Research

a  These are subscription resources. Researchers should check with their librarian to determine their access rights.

Despite a surge in published scholarship in medical education 1 and rapid growth in journals that publish educational research, manuscript acceptance rates continue to fall. 2 Failure to conduct a thorough, accurate, and up-to-date literature review identifying an important problem and placing the study in context is consistently identified as one of the top reasons for rejection. 3 , 4 The purpose of this editorial is to provide a road map and practical recommendations for planning a literature review. By understanding the goals of a literature review and following a few basic processes, authors can enhance both the quality of their educational research and the likelihood of publication in the Journal of Graduate Medical Education ( JGME ) and in other journals.

The Literature Review Defined

In medical education, no organization has articulated a formal definition of a literature review for a research paper; thus, a literature review can take a number of forms. Depending on the type of article, target journal, and specific topic, these forms will vary in methodology, rigor, and depth. Several organizations have published guidelines for conducting an intensive literature search intended for formal systematic reviews, both broadly (eg, PRISMA) 5 and within medical education, 6 and there are excellent commentaries to guide authors of systematic reviews. 7 , 8

• A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact.
• A literature review provides context, informs methodology, maximizes innovation, avoids duplicative research, and ensures that professional standards are met.
• Literature reviews take time, are iterative, and should continue throughout the research process.
• Researchers should maximize the use of human resources (librarians, colleagues), search tools (databases/search engines), and existing literature (related articles).
• Keeping organized is critical.

Such work is outside the scope of this article, which focuses on literature reviews to inform reports of original medical education research. We define such a literature review as a synthetic review and summary of what is known and unknown regarding the topic of a scholarly body of work, including the current work's place within the existing knowledge . While this type of literature review may not require the intensive search processes mandated by systematic reviews, it merits a thoughtful and rigorous approach.

Purpose and Importance of the Literature Review

An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the “journal-as-conversation” metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: “Imagine yourself joining a conversation at a social event. After you hang about eavesdropping to get the drift of what's being said (the conversational equivalent of the literature review), you join the conversation with a contribution that signals your shared interest in the topic, your knowledge of what's already been said, and your intention.” 9

The literature review helps any researcher “join the conversation” by providing context, informing methodology, identifying innovation, minimizing duplicative research, and ensuring that professional standards are met. Understanding the current literature also promotes scholarship, as proposed by Boyer, 10 by contributing to 5 of the 6 standards by which scholarly work should be evaluated. 11 Specifically, the review helps the researcher (1) articulate clear goals, (2) show evidence of adequate preparation, (3) select appropriate methods, (4) communicate relevant results, and (5) engage in reflective critique.

Failure to conduct a high-quality literature review is associated with several problems identified in the medical education literature, including studies that are repetitive, not grounded in theory, methodologically weak, and fail to expand knowledge beyond a single setting. 12 Indeed, medical education scholars complain that many studies repeat work already published and contribute little new knowledge—a likely cause of which is failure to conduct a proper literature review. 3 , 4

Likewise, studies that lack theoretical grounding or a conceptual framework make study design and interpretation difficult. 13 When theory is used in medical education studies, it is often invoked at a superficial level. As Norman 14 noted, when theory is used appropriately, it helps articulate variables that might be linked together and why, and it allows the researcher to make hypotheses and define a study's context and scope. Ultimately, a proper literature review is a first critical step toward identifying relevant conceptual frameworks.

Another problem is that many medical education studies are methodologically weak. 12 Good research requires trained investigators who can articulate relevant research questions, operationally define variables of interest, and choose the best method for specific research questions. Conducting a proper literature review helps both novice and experienced researchers select rigorous research methodologies.

Finally, many studies in medical education are “one-offs,” that is, single studies undertaken because the opportunity presented itself locally. Such studies frequently are not oriented toward progressive knowledge building and generalization to other settings. A firm grasp of the literature can encourage a programmatic approach to research.

Approaching the Literature Review

Considering these issues, journals have a responsibility to demand from authors a thoughtful synthesis of their study's position within the field, and it is the authors' responsibility to provide such a synthesis, based on a literature review. The aforementioned purposes of the literature review mandate that the review occurs throughout all phases of a study, from conception and design, to implementation and analysis, to manuscript preparation and submission.

Planning the literature review requires understanding of journal requirements, which vary greatly by journal ( table 1 ). Authors are advised to take note of common problems with reporting results of the literature review. Table 2 lists the most common problems that we have encountered as authors, reviewers, and editors.

Sample of Journals' Author Instructions for Literature Reviews Conducted as Part of Original Research Article a

Common Problem Areas for Reporting Literature Reviews in the Context of Scholarly Articles

Locating and Organizing the Literature

Three resources may facilitate identifying relevant literature: human resources, search tools, and related literature. As the process requires time, it is important to begin searching for literature early in the process (ie, the study design phase). Identifying and understanding relevant studies will increase the likelihood of designing a relevant, adaptable, generalizable, and novel study that is based on educational or learning theory and can maximize impact.

Human Resources

A medical librarian can help translate research interests into an effective search strategy, familiarize researchers with available information resources, provide information on organizing information, and introduce strategies for keeping current with emerging research. Often, librarians are also aware of research across their institutions and may be able to connect researchers with similar interests. Reaching out to colleagues for suggestions may help researchers quickly locate resources that would not otherwise be on their radar.

During this process, researchers will likely identify other researchers writing on aspects of their topic. Researchers should consider searching for the publications of these relevant researchers (see table 3 for search strategies). Additionally, institutional websites may include curriculum vitae of such relevant faculty with access to their entire publication record, including difficult to locate publications, such as book chapters, dissertations, and technical reports.

Strategies for Finding Related Researcher Publications in Databases and Search Engines

Search Tools and Related Literature

Researchers will locate the majority of needed information using databases and search engines. Excellent resources are available to guide researchers in the mechanics of literature searches. 15 , 16

Because medical education research draws on a variety of disciplines, researchers should include search tools with coverage beyond medicine (eg, psychology, nursing, education, and anthropology) and that cover several publication types, such as reports, standards, conference abstracts, and book chapters (see the box for several information resources). Many search tools include options for viewing citations of selected articles. Examining cited references provides additional articles for review and a sense of the influence of the selected article on its field.

Box Information Resources

• Web of Science a
• Education Resource Information Center (ERIC)
• Cumulative Index of Nursing & Allied Health (CINAHL) a
• Google Scholar

Once relevant articles are located, it is useful to mine those articles for additional citations. One strategy is to examine references of key articles, especially review articles, for relevant citations.

Getting Organized

As the aforementioned resources will likely provide a tremendous amount of information, organization is crucial. Researchers should determine which details are most important to their study (eg, participants, setting, methods, and outcomes) and generate a strategy for keeping those details organized and accessible. Increasingly, researchers utilize digital tools, such as Evernote, to capture such information, which enables accessibility across digital workspaces and search capabilities. Use of citation managers can also be helpful as they store citations and, in some cases, can generate bibliographies ( table 4 ).

Citation Managers

Knowing When to Say When

Researchers often ask how to know when they have located enough citations. Unfortunately, there is no magic or ideal number of citations to collect. One strategy for checking coverage of the literature is to inspect references of relevant articles. As researchers review references they will start noticing a repetition of the same articles with few new articles appearing. This can indicate that the researcher has covered the literature base on a particular topic.

Putting It All Together

In preparing to write a research paper, it is important to consider which citations to include and how they will inform the introduction and discussion sections. The “Instructions to Authors” for the targeted journal will often provide guidance on structuring the literature review (or introduction) and the number of total citations permitted for each article category. Reviewing articles of similar type published in the targeted journal can also provide guidance regarding structure and average lengths of the introduction and discussion sections.

When selecting references for the introduction consider those that illustrate core background theoretical and methodological concepts, as well as recent relevant studies. The introduction should be brief and present references not as a laundry list or narrative of available literature, but rather as a synthesized summary to provide context for the current study and to identify the gap in the literature that the study intends to fill. For the discussion, citations should be thoughtfully selected to compare and contrast the present study's findings with the current literature and to indicate how the present study moves the field forward.

To facilitate writing a literature review, journals are increasingly providing helpful features to guide authors. For example, the resources available through JGME include several articles on writing. 17 The journal Perspectives on Medical Education recently launched “The Writer's Craft,” which is intended to help medical educators improve their writing. Additionally, many institutions have writing centers that provide web-based materials on writing a literature review, and some even have writing coaches.

The literature review is a vital part of medical education research and should occur throughout the research process to help researchers design a strong study and effectively communicate study results and importance. To achieve these goals, researchers are advised to plan and execute the literature review carefully. The guidance in this editorial provides considerations and recommendations that may improve the quality of literature reviews.