integrative literature review disadvantages

A Step-by-Step Guide to Conducting an Integrative Review

• © 2020
• Coleen E. Toronto 0 ,
• Ruth Remington 1

School of Nursing, Curry College, Milton, USA

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Department of Nursing, Framingham State University, Framingham, USA

• Defines the key features that distinguish the integrative review from other types of literature reviews
• Guides the reader through the complete process of conducting the integrative review
• Promotes valid and reliable integrative reviews that support evidence-base nursing practice
• Offers clear, and practical step-by-step instructions
• Makes connections to published nursing research
• Appropriate for any nurse author of an integrative review, student, clinician, academic or researcher

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Table of contents (7 chapters)

Front matter, overview of the integrative review.

Coleen E. Toronto

Formulating Review Question

• Karen Devereaux Melillo

Searching Systematically and Comprehensively

• Jane Lawless, Margaret J. Foster

Quality Appraisal

Ruth Remington

Analysis and Synthesis

• Patricia A. Dwyer

Discussion and Conclusion

• Coleen E. Toronto, Ruth Remington

Dissemination of the Integrative Review

• Kristen A. Sethares
• Integrative review process
• Literature reviews
• Systematic literature search
• Nursing Research
• Integrative Review Method

About this book

Editors and affiliations, about the editors.

Coleen Toronto , PhD, RN, CNE, is an Associate Professor in the School of Nursing at Curry College, USA. Dr. Toronto is a BSN graduate of Northeastern University, received her master’s in nursing education from Framingham State University, and her PhD in nursing from University of Massachusetts Dartmouth. Dr. Toronto is a Certified Nurse Educator (CNE). Her research interests include integrative review methodology, nursing education, health literacy and Delphi methodology.

Bibliographic Information

Book Title : A Step-by-Step Guide to Conducting an Integrative Review

Editors : Coleen E. Toronto, Ruth Remington

DOI : https://doi.org/10.1007/978-3-030-37504-1

Publisher : Springer Cham

eBook Packages : Medicine , Medicine (R0)

Copyright Information : Springer Nature Switzerland AG 2020

Softcover ISBN : 978-3-030-37503-4 Published: 18 February 2020

eBook ISBN : 978-3-030-37504-1 Published: 17 February 2020

Edition Number : 1

Number of Pages : XII, 106

Number of Illustrations : 3 b/w illustrations, 8 illustrations in colour

Topics : Nursing Research , Nursing Education , Research Skills

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• Integrative Review

What is an Integrative Review?

An  integrative review provides a broader summary of the literature and includes findings from a range of research designs. It gathers and synthesizes  both empirical and theoretical evidence  relevant to a clearly defined problem. It may include case studies, observational studies, and meta-analyses, but may also include practice applications, theory, and guidelines. It is the only approach that allows for the combination of diverse methodologies. Its aim is to develop a holistic understanding   of the topic, present the state of the science and contribute to theory development.  The integrative review has been advocated as important for evidence-based practice initiatives in nursing  (Hopia et al., 2016).

Integrative reviews are popular in nursing because they use diverse data sources to investigate the complexity of nursing practice. An integrative review addresses the current state of the evidence, the quality of the available evidence, identifies gaps in the literature and suggests future directions for research and practice The clinical question(s)   of an integrative review   is broader  than that of a systematic review, yet should be clearly stated and well-defined. As with a systematic review, an integrative review requires a transparent and rigorous systematic approach  (Remington & Toronto, 2020).

Integrative reviews synthesize research data from various research designs to reach comprehensive and reliable conclusions. An integrative review helps to develop a comprehensive understanding of the topic by synthesizing  all forms of available evidence (Dhollande et al., 2021). They allow healthcare professionals to use all available evidence from both  qualitative and quantitative research to provide a more holistic understanding of the topic, which can then be applied to clinical practice. Sampling for an integrative review may include experimental and nonexperimental (empirical) and theoretical literature (Remington & Toronto, 2020). 

From:  Kutcher, & LeBaron, V. T. (2022). A simple guide for completing an integrative review using an example article.  Journal of Professional Nursing,  40 , 13-19. https://doi.org/10.1016/j.profnurs.2022.02.004

See Table 2: Steps of the integrative review (IR) process with key points and lessons learned

Steps of the Integrative Review Process

1: Select a Topic:  Formulate a purpose and/or review question(s).   An integrative review can be used to answer research questions related to nursing and other disciplines.   Clearly identify a problem from a gap in the literature. Perform a quick search for other literature reviews related to the topic of interest to avoid duplication. Integrative review questions should be  broad in scope, but narrow enough that the search is manageable.  It should be  well-defined,  and  clearly stated . Provide background on the topic and justification for the integrative review. Do a quick literature search to determine if any recent integrative or other types of reviews on or related to the topic have been performed.

Quality Appraisal Tools for Integrative Reviews

Critical Appraisal Skills Programme (CASP) Checklists  Appraisal checklists designed for use with Systematic Reviews, Randomized Controlled Trials, Cohort Studies,  Case Control  Studies, Economic Evaluations, Diagnostic Studies, Qualitative studies and Clinical Prediction Rule.

Mixed Methods Appraisal Tool (MMAT)  The MMAT is a critical appraisal tool that is designed for the appraisal stage of systematic mixed studies reviews, i.e., reviews that include qualitative, quantitative and mixed methods studies. It permits to appraise the methodological quality of five categories to studies: qualitative research, randomized controlled trials, non-randomized studies, quantitative descriptive studies, and mixed methods studies. (Hong et al., 2018).

Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., Vedel, I., & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers.  Education for Information, 34 (4), 285–291. https://doi.org/10.3233/EFI-180221

More Information

For more information on integrative reviews:

Dhollande, S., Taylor, A., Meyer, S., & Scott, M. (2021). Conducting integrative reviews: A guide for novice nursing researchers.  Journal of Research in Nursing, 26( 5), 427–438. https://doi.org/10.1177/1744987121997907

Evans, D. (2007). Integrative reviews: Overview of methods. In C. Webb, & B. Roe (Eds.),  Reviewing research evidence for nursing practice: Systematic reviews  (pp. 135 - 148). John Wiley & Sons, Incorporated.

Hopia, Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review.  Scandinavian Journal of Caring Sciences,  30 (4), 662–669. https://doi.org/10.1111/scs.12327

Kutcher, & LeBaron, V. T. (2022). A simple guide for completing an integrative review using an example article.  Journal of Professional Nursing,  40 , 13-19. https://doi.org/10.1016/j.profnurs.2022.02.004

Oermann, M. H., & Knafl, K. A. (2021). Strategies for completing a successful integrative review.  Nurse Author & Editor (Blackwell) ,  31 (3/4), 65–68. https://doi-org.libproxy.adelphi.edu/10.1111/nae2.30

Toronto, C. E., & Remington, R. (Eds.). (2020).  A step-by-step guide to conducting an integrative review . Springer.

Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology.  Journal of Advanced Nursing ,  52 (5), 546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

Whittemore, R. (2007). Rigour in integrative reviews. In C. Webb, & B. Roe (Eds.),  Reviewing research evidence for nursing practice: Systematic reviews  (pp. 149 - 156). John Wiley & Sons, Incorporated.

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• Next: Scoping Review >>
• Types of Questions
• Key Features and Limitations
• Is a Systematic Review Right for Your Research?
• Scoping Review
• Rapid Review
• Meta-Analysis/Meta-Synthesis
• Selecting a Review Type
• Reducing Bias
• Guidelines for Student Researchers
• Training Resources
• Register Your Protocol
• Handbooks & Manuals
• Reporting Guidelines
• PRESS 2015 Guidelines
• Search Strategies
• Selected Databases
• Grey Literature
• Handsearching
• Citation Searching
• Study Types & Terminology
• Quantitative vs. Qualitative Research
• Critical Appraisal of Studies
• Broad Functionality Programs & Tools
• Search Strategy Tools
• Deduplication Tools
• CItation Screening
• Critical Appraisal Tools
• Quality Assessment/Risk of Bias Tools
• Data Collection/Extraction
• Meta Analysis Tools
• Books on Systematic Reviews
• Finding Systematic Review Articles in the Databases
• Systematic Review Journals
• More Resources
• Evidence-Based Practice Research in Nursing
• Citation Management Programs
• Last Updated: May 3, 2024 5:52 PM
• URL: https://libguides.adelphi.edu/Systematic_Reviews

Systematic Reviews & Other Review Types

• What is a Systematic Review?
• What is a Scoping Review?
• What is a literature review?
• What is a Rapid Review?
• What is a Mixed Methods Review?
• What is a Network Meta-Analysis?
• What is an Overview of Reviews?
• What is a Meta-Syntheses?

What is an Integrative Review?

• What is a Diagnostic Test Accuracy Review?
• What is a Living Systematic Review?

Broadest type of research review methods.

"A review method that summarizes past empirical or theoretical literature to provide a more comprehensive understanding of a particular phenomenon or healthcare problem (Broome 1993).

An integrative review is best designed to:

• review experimental and non-experimental research simultaneously
• define concepts
• review theories
• review evidence/point out gaps in the literature
• analyze methodological issues

Source: Whittemore et al (2005)

Other names for an Integrative Review

IR, Integrative Literature Review, Systematic Integrative Review

How an Integrative Review differs from a Systematic Review

Timeframe: 12+ months

Question: Formulation of a problem, may be related to practice and/or policy.

Sources and searches:  Comprehensive but with a specific focus,  integrated methodologies-experimental and non-experimental research.  Purposive Sampling may be employed. Database searching is recommended along with grey literature searching.  " Other recommended approaches to searching the literature include ancestry searching, journal hand searching, networking, and searching research registries."  Search is transparent and reproducible.

Selection:  Selected as related to problem identified or question, Inclusion of empirical and theoretical reports and diverse study methodologies. 

Appraisal:  "How quality is evaluated in an integrative review will vary depending on the sampling frame."  Limited/varying methods of critical appraisal and can be complex.   "In a review that encompasses theoretical and empirical sources, two quality criteria instruments could be developed for each type of source and scores could be used as criteria for inclusion/exclusion or as a variable in the data analysis stage."

Synthesis: Qualitative/narrative synthesis for qualitative and quantitative studies. Data extracted for study characteristics and concept.  Synthesis may be in the form of a table or model to portray results. "Extracted data are compared item by item so that similar data are categorized and grouped together."  

The method consists of:

• data reduction
• data display
• data comparison
• conclusion  drawing,
• verification 

Source:  Whittemore et al (2005)

Limitations of an Integrative Review

• The combination and complexity of incorporating diverse methodologies can contribute to lack of rigor, inaccuracy, and bias.
• Methods of analysis, synthesis, and conclusion drawing remain poorly formulated.

Temple Attribution

Adapted with permission from Temple University Libraries. https://guides.temple.edu/systematicreviews

• Last Updated: Mar 13, 2024 4:27 PM
• URL: https://touromed.libguides.com/review_types

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Neal Haddaway

October 19th, 2020, 8 common problems with literature reviews and how to fix them.

3 comments | 315 shares

Estimated reading time: 5 minutes

Literature reviews are an integral part of the process and communication of scientific research. Whilst systematic reviews have become regarded as the highest standard of evidence synthesis, many literature reviews fall short of these standards and may end up presenting biased or incorrect conclusions. In this post, Neal Haddaway highlights 8 common problems with literature review methods, provides examples for each and provides practical solutions for ways to mitigate them.

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Researchers regularly review the literature – it’s an integral part of day-to-day research: finding relevant research, reading and digesting the main findings, summarising across papers, and making conclusions about the evidence base as a whole. However, there is a fundamental difference between brief, narrative approaches to summarising a selection of studies and attempting to reliably and comprehensively summarise an evidence base to support decision-making in policy and practice.

So-called ‘evidence-informed decision-making’ (EIDM) relies on rigorous systematic approaches to synthesising the evidence. Systematic review has become the highest standard of evidence synthesis and is well established in the pipeline from research to practice in the field of health . Systematic reviews must include a suite of specifically designed methods for the conduct and reporting of all synthesis activities (planning, searching, screening, appraising, extracting data, qualitative/quantitative/mixed methods synthesis, writing; e.g. see the Cochrane Handbook ). The method has been widely adapted into other fields, including environment (the Collaboration for Environmental Evidence ) and social policy (the Campbell Collaboration ).

Despite the growing interest in systematic reviews, traditional approaches to reviewing the literature continue to persist in contemporary publications across disciplines. These reviews, some of which are incorrectly referred to as ‘systematic’ reviews, may be susceptible to bias and as a result, may end up providing incorrect conclusions. This is of particular concern when reviews address key policy- and practice- relevant questions, such as the ongoing COVID-19 pandemic or climate change.

These limitations with traditional literature review approaches could be improved relatively easily with a few key procedures; some of them not prohibitively costly in terms of skill, time or resources.

In our recent paper in Nature Ecology and Evolution , we highlight 8 common problems with traditional literature review methods, provide examples for each from the field of environmental management and ecology, and provide practical solutions for ways to mitigate them.

There is a lack of awareness and appreciation of the methods needed to ensure systematic reviews are as free from bias and as reliable as possible: demonstrated by recent, flawed, high-profile reviews. We call on review authors to conduct more rigorous reviews, on editors and peer-reviewers to gate-keep more strictly, and the community of methodologists to better support the broader research community. Only by working together can we build and maintain a strong system of rigorous, evidence-informed decision-making in conservation and environmental management.

Note: This article gives the views of the authors, and not the position of the LSE Impact Blog, nor of the London School of Economics. Please review our  comments policy  if you have any concerns on posting a comment below

Image credit:  Jaeyoung Geoffrey Kang  via unsplash

About the author

Neal Haddaway is a Senior Research Fellow at the Stockholm Environment Institute, a Humboldt Research Fellow at the Mercator Research Institute on Global Commons and Climate Change, and a Research Associate at the Africa Centre for Evidence. He researches evidence synthesis methodology and conducts systematic reviews and maps in the field of sustainability and environmental science. His main research interests focus on improving the transparency, efficiency and reliability of evidence synthesis as a methodology and supporting evidence synthesis in resource constrained contexts. He co-founded and coordinates the Evidence Synthesis Hackathon (www.eshackathon.org) and is the leader of the Collaboration for Environmental Evidence centre at SEI. @nealhaddaway

Why is mission creep a problem and not a legitimate response to an unexpected finding in the literature? Surely the crucial points are that the review’s scope is stated clearly and implemented rigorously, not when the scope was finalised.

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#9. Most of them are terribly boring. Which is why I teach students how to make them engaging…and useful.

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Social Media Use for Research Participant Recruitment: Integrative Literature Review

Elizabeth mirekuwaa darko.

1 College of Health Sciences, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada

Manal Kleib

Joanne olson, associated data.

Top 10 Universities in Canada QS World University Rankings 2021.

Search strategy for keywords and subject headings of the search terms used in each database.

Characteristics of included studies.

Critical Appraisal Skills Program critical appraisal tools used to critically appraise and evaluate each of the included studies.

List of excluded studies.

Tentative guidelines to assist health sciences researchers in social media recruitment.

Social media tools have provided health researchers with the opportunity to engage with communities and groups in a nonconventional manner to recruit participants for health research. Using social media to advertise research opportunities and recruit participants facilitates accessibility to participants from broad geographical areas and diverse populations. However, little guidance is provided by ethics review boards for researchers to effectively use this recruitment method in their research.

This study sought to explore the literature on the use of social media for participant recruitment for research studies and identify the best practices for recruiting participants using this method.

An integrative review approach was used to synthesize the literature. A total of 5 health sciences databases, namely, EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost), were searched using predefined keywords and inclusion and exclusion criteria. The initial search was conducted in October 2020 and was updated in February 2022. Descriptive and content analyses were applied to synthesize the results, and the findings are presented in a narrative and tabular format.

A total of 96 records were included in this review, 83 (86%) from the initial search and 13 (14%) from the updated search. The publication year ranged between 2011 and 2022, with most publications (63/96, 66%) being from the United States. Regarding recruitment strategy, 45% (43/96) of the studies exclusively used social media, whereas 51% (49/96) used social media in conjunction with other strategies. The remaining 4% (4/96) provided guidelines and recommendations for social media recruitment. Notably, 38% (36/96) of these studies involved hard-to-reach populations. The findings also revealed that the use of social media is a cost-effective and efficient strategy for recruiting research participants. Despite the expanded use across different populations, there is limited participation of older adults in social media recruitment.

Conclusions

This review provides important insights into the current use of social media for health research participant recruitment. Ethics boards and research support services in academic institutions are encouraged to explicitly provide researchers with guidelines on the use of social media for health research participant recruitment. A preliminary guideline prepared based on the findings of this review is proposed to spark further development in this area.

Introduction

In this digital age, advancements in technology have created opportunities for researchers to use new techniques to recruit research participants. For health researchers, technological innovations present an opportunity to use digital platforms such as social media, the internet, web applications, multimedia, and smartphones to effectively and efficiently engage the community for research recruitment [ 1 ]. These digital platforms provide an additional source for participant recruitment for health research studies [ 2 ]. Within health sciences, social media is being quickly adopted because of its increased use as a method of communication with the public [ 3 ]. For many researchers, recruiting participants for trials can be a daunting task that can result in study delays or the termination of trials [ 4 ]. Less than one-third of trials reach their original target within a specified time frame, and approximately one-third required extension [ 5 ]. Hence, reaching targeted participants through social media platforms provides an important avenue for facilitating researchers’ work.

Social media refers to a group of internet-based communication services through which users create and participate in web-based exchanges, contribute user-created content such as videos, or join web-based communities to share information and ideas [ 6 ]. The trends and patterns of social engagement worldwide help provide researchers, policy makers, and other stakeholders with an overview of the different social media applications that users are engaged with [ 7 ] and how these tools could potentially be used to leverage health research. With a global population of 7.8 billion inhabitants [ 8 ], internet users stand at 4.54 billion, representing a 59% penetration rate, and active social media users at 3.80 billion, representing 49% [ 9 , 10 ]. Active social media platforms users include Facebook (63%), YouTube (61%), WhatsApp (48%), Facebook Messenger (38%), Instagram (36%), Twitter (23%), and Snapchat (13%) [ 9 , 11 ]. Social media provides an appropriate medium for user connection and communication, information collection and dissemination, knowledge sharing, discussion, and collaboration with communities for professional networking and business purposes [ 12 - 14 ].

Despite the numerous benefits and opportunities associated with social media, its use in the recruitment of research participants is still evolving. Health researchers using digital platforms for research participant recruitment encounter challenges such as efficiency, cost, information reliability, informed consent, confidentiality, privacy-related concerns [ 15 ], internet accessibility, information overload, informed consent, and interaction quality [ 12 , 13 ]. In traditional recruitment methods, researchers often face costs associated with personnel and resources, administrative changes, time-consuming recruitment processes, recruitment bias, and population homogeneity [ 16 - 20 ]. Cost plays an essential part in the success of a research process as a higher fraction of the cost is allocated to participant recruitment [ 21 ]. The cost involved in research studies varies and is dependent on certain factors such as the targeted population, geographical location, and type of recruitment approach [ 18 ]. To overcome the challenges associated with the cost of participant recruitment, researchers need metrics to determine the cost of recruitment.

To access social media, users are required to create a profile that requires certain mandatory information such as first name and last name, email address, or mobile phone number [ 22 ]. Although interested social media users willingly provide these data, they are often unknowingly signing away their privacy, which increases the possibility of privacy breaches [ 23 ]. Although research ethics boards (REBs) require removing identifying information of research participants from data using unique identifiers, such guidelines are rendered ineffective in the context of social media data as participants’ relational links are predictive of their attributes [ 24 ]. Nonetheless, Narayanan and Shmatikov [ 25 ] stated that such anonymization of participants’ data might be insufficient to protect social media networks’ privacy.

Researchers need guidance to navigate the ethical and logistical issues associated with using social platforms as a recruitment tool other than the “Terms and Conditions” stated by the application software providers [ 26 ]. Therefore, researchers often turn to ethics boards within their institutions for guidance on social media and internet recruitment; however, this information is not always readily available. To determine this, we reviewed the REBs of the top 10 higher education institutions in Canada to identify any standard ethical guidelines currently being used or recommended for using social media tools to recruit participants for research studies beyond adopting the Tri-Council Policy Statement on research. We used the QS World University Ranking criteria, which determine universities’ rankings worldwide based on 6 metrics [ 27 ]. This strategy was deemed appropriate as these universities are known for their high-impact research productivity. The results revealed that only 3 universities had guidelines available on social media use in research studies, which further supported the need for this integrative review ( Multimedia Appendix 1 ). A standard protocol that could be adopted by postsecondary institutions, research organizations, and researchers could help mitigate the pitfalls researchers encounter during participant recruitment for research via social media applications. Such protocols may facilitate the research process, expedite data collection, and ensure that digital research recruitment practices protect participants’ data and rights.

Regarding the published literature, only 1 review [ 15 ] examined the evidence of cost, effectiveness, and the characteristics of participants recruited through Facebook compared with other web-based, social media, and traditional recruitment methods for adult health research. Little is known about the use of other social media platforms for participant recruitment in health research. Therefore, this study was warranted to address these gaps in the literature.

Objectives and Research Questions

This review sought to examine the evidence available on all the applications identified as social media tools and identify the best practices to facilitate participant recruitment through these tools. We addressed the following research questions:

• What are the different social media tools commonly used by health science researchers for recruiting research participants and in what populations?
• What is the proportion of nursing researchers who use social media platforms for recruitment?
• What are the benefits and challenges of using social media to recruit research participants?
• What are the best practices and ethical considerations for using social media tools to recruit research participants?

An integrative review guided by the Whittemore and Knafl [ 28 ] framework was conducted. This review type allows for the inclusion of diverse research methodologies and data sources to understand and generate new knowledge on the phenomenon of interest [ 28 , 29 ]. A comprehensive search strategy was formulated in consultation with a health science librarian. The initial search was conducted on October 11, 2020, and updated on February 24, 2022, in the EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost) databases using a search strategy of keywords and subject headings through an iterative process ( Multimedia Appendix 2 ). The criteria for eligibility were (1) all types of published research on primary and secondary studies, including qualitative, quantitative, and mixed methods; (2) discussion papers, white papers, reports, brief reports, specific guidelines, conference proceedings, dissertations, and published manuscripts that reported on social media use; (3) research reports published between January 2000 and February 2022; and (4) research reports that focused on research participant recruitment and advertisements on social media platforms, including all types of populations and health sciences disciplines, and (5) all geographical locations. The following articles were excluded: (1) non–English-language articles; (2) unpublished manuscripts and non–peer-reviewed publications such as descriptive papers, editorial papers, opinion papers, letters, book reviews, and article reviews; (3) review articles (scoping, integrative, narrative, and systematic) already published on the topic; and (4) all non–health sciences articles. The time frame for the published reports was chosen to capture the contemporary views that reflect the trends and popularity of digital platforms in participant recruitment.

Data Evaluation and Analysis

Records from the databases (initial search N=1197) were retrieved and imported into the Covidence Management Software for data screening and extraction. Overall, 2 reviewers (EMD and MK) independently conducted the screening process in Covidence, screening titles and abstracts, followed by full-text screening. All decisions made to either include or exclude records against the predetermined inclusion and exclusion criteria were documented. Where conflicts arose, the 2 reviewers consulted and resolved them through a voting process. We conducted another search on February 24, 2022, to update the results. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Protocols template in Covidence was used to map out the screening process, and the results as shown in Figure 1 .

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 flow diagram.

The following details were extracted from the included records: name or names of the author or authors, year of publication, country of publication, study design, study population, total number recruited, total number of participants enrolled or recruited through social media, social media platform used, other recruitment strategies, type of advertisement (paid or not paid), incentives provided, whether the study was funded, limitations of social media reported by the authors, and duration of advertisement ( Multimedia Appendix 3 [ 2 , 18 , 20 , 30 - 115 ]). The extracted data from these records were analyzed by identifying codes and categories to characterize emerging themes, patterns, trends, and relationships to aid in synthesizing the findings logically and coherently. In addition, descriptive statistics were applied where appropriate to describe and summarize the data pertinent to the distribution of research and other characteristics. The Critical Appraisal Skills Program [ 116 ] was used per the research methodology to appraise and evaluate each of the included studies critically to ensure the quality of the available evidence included in this review ( Multimedia Appendix 4 [ 18 , 20 , 31 , 50 , 53 , 54 , 55 , 58 , 60 , 61 , 76 , 77 , 81 , 106 , 109 , 114 ]). The studies were assessed and rated as “low quality” or “moderate quality” based on their theoretical or methodological rigor [ 28 ]. Ethics approval was not required as this study did not involve human participants.

In total, 1197 records were retrieved from the initial database search; in Covidence, 441 (36.8%) duplicate records were removed from the imported references, and a total of 756 (63.2%) records were moved for screening. In the first stage of screening, the titles and abstracts of each record were screened for full-text review. In the second stage of screening, 187 full-text studies were reviewed entirely and assessed for eligibility for inclusion or exclusion. For records that were not available in the full text, the Health Science Library was contacted to obtain those records. A total of 6 articles that reported on conference proceedings were retrieved but did not have any substantial information, as reported in the abstracts. Nonetheless, the full texts of these articles were requested through library services but could not be retrieved; thus, a decision was made to exclude them from the results. It should be noted that although the Covidence software automatically removes duplicates, there were instances of errors where some records were missed; therefore, removing these duplicates manually was warranted. Of the initial search, a total of 83 records were included. The updated search returned a total of 89 records. Of the 89 articles, after 11 (12%) duplicates were removed, a total of 78 (88%) articles were screened. A total of 23 articles underwent full-text review, of which 10 (43%) were excluded as they did not meet the inclusion criteria, and 13 (57%) articles were retained and included in the review. Finally, 96 records were included in the review. In total, 114 records were excluded ( Multimedia Appendix 5 ).

Characteristics of Included Studies

The range of publication years of the articles included in the review was between 2011 and 2022 ( Multimedia Appendix 3 ). Most publications were from the United States (63/96, 66%) and Australia (20/96, 21%). Besides that, they were from Canada (5/96, 5%), the Netherlands (2/96, 2%), and the United Kingdom (2/96, 2%). There was only one publication from each of the following countries: Taiwan, Ecuador, India, and Brazil. Out of the 96 included studies, 92 (96%) were papers reporting primary research and 4 (4%) were reports on using social media. The methodological approaches used were cross-sectional studies (38/96, 40%), web-based surveys (15/96, 16%), secondary data analysis (14/96, 15%), randomized controlled trials (10/96, 10%), reports (4/96, 4%), mixed methods studies (4/96, 4%), qualitative studies (3/96, 3%), cohort studies (3/96, 3%), clinical trials (3/96, 3%), quasi-experimental studies (1/96, 1%), and longitudinal studies (1/96, 1%).

Social Media Use by Nursing Researchers and Other Health Researchers

We were interested in determining the proportion of nursing researchers using social media; however, this was not easy to identify as researchers have published studies that have used social media for the recruitment of research participants in a variety of interdisciplinary journals. On the basis of the journal names where these articles were published, these researchers could be from any health discipline, including nursing, medicine, psychology, rehabilitation, nutrition, pharmacy, or public health. Of the 96 included studies, 71 (74%) were published in general health science journals or interdisciplinary journals [ 18 , 20 , 26 , 30 - 92 , 117 - 121 ], and 25 (26%) were published in nursing-related journals [ 2 , 93 - 115 , 122 ].

Social Media Tools Commonly Used by Health Researchers

Researchers used a variety of social media platforms to recruit participants, as reported in the included studies. Researchers either exclusively used social media (43/96, 45%) or social media in conjunction with other recruitment methods (49/96, 51%) to recruit participants ( Multimedia Appendix 3 ). For studies that exclusively used social media, ≥1 social media platform was used simultaneously. Social media platforms included Facebook, Twitter, Craigslist, Instagram, YouTube, LinkedIn, Reddit, Snapchat, and Tumblr. For social media in conjunction with other recruitment strategies, researchers used the identified social media platforms in addition to blogs, social media, Grindr, and WhatsApp Messenger. It was noted that, at times, researchers used the term “social media” but did not specify the type of social media used. In both approaches, most participants relied on the use of Facebook for research recruitment.

Age Groups of Research Participants Recruited via Social Media

Although researchers used social media platforms for advertisement and recruitment of participants for research, they sometimes did not target specific populations. In addition, the age group distribution of these populations varied, and the definition of the age group differed depending on the study aims. To address this, initially, the range of age groups was specified as follows: children (aged <9 years), adolescents (aged 10-18 years), young adults (aged 19-35 years), middle-aged adults (aged 36-55 years), older adults (aged 56-64 years), and older adults aged ≥65 years. The included studies were then scanned against this categorization to identify which age group was most targeted for social media recruitment ( Table 1 ).

Age groups of research participants recruited via social media (N=92).

a Not available.

Populations Targeted in Social Media Recruitment and Their Characteristics

Researchers have targeted different populations in their research studies. Largely, there were many studies (46/96, 48%) that included the general population [ 2 , 18 , 20 , 31 , 32 , 36 , 37 , 40 , 41 , 43 , 46 , 47 , 49 , 51 , 54 , 55 , 58 , 60 , 63 , 64 , 65 , 67 , 69 , 70 , 71 , 72 , 73 , 74 , 77 , 79 , 80 , 84 , 85 , 91 , 92 , 93 , 94 , 104 , 106 , 108 , 112 , 114 , 115 , 119 , 120 ]. In addition, a significant proportion (36/96, 38%) of the included studies focused on recruiting hard-to-reach populations ( Table 2 ). Hard-to-reach populations are groups that are socially disadvantaged and present a challenge to access for researchers because of ethnicity, low income, or health literacy [ 123 , 124 ]. In this review, these populations had addiction problems, unique medical disease conditions, or lifestyle choices or belonged to an ethnic minority group. A few studies applied social media recruitment to target health care professionals as research participants (10/96, 10%) [ 96 , 98 , 99 , 100 , 101 , 103 , 105 , 106 , 107 , 113 ].

Hard-to-reach populations targeted in social media recruitment.

Cost-effectiveness, Efficacy, and Feasibility of Social Media in Comparison With Other Recruitment Methods

The costs of recruitment reported in all the included studies are presented in tabular form ( Tables 3 and ​ and4) 4 ) to help ascertain how money was dispensed, as well as the cost-effectiveness of each recruitment strategy. However, it was noted that although some researchers included personnel costs, advertising costs, and other recruitment costs in the total cost, other researchers did not include these costs. Hence, researchers should use only this information as a guide. Few studies specifically compared social media effectiveness to other platforms with the goal of establishing cost-effectiveness, efficacy, and feasibility. In this review, 7% (7/96) of the included studies aimed to determine the effectiveness of social media compared with other recruitment strategies [ 39 , 51 , 52 , 58 , 70 , 74 , 106 ], and 9% (9/96) of studies that did not compare social media platforms with any other strategy [ 30 , 38 , 41 , 46 , 63 , 72 , 73 , 93 , 111 ] found social media as an effective recruitment strategy in both instances.

Cost of social media recruitment methods.

b Records from the updated search.

Cost of other recruitment methods.

Few studies did not conclusively find social media to be cost-effective or efficient. The findings reported by these researchers differ because of the different populations targeted, scale of recruitment, and whether the research was funded. In their funded study, Moreno et al [ 18 ] found that in-person strategies yielded more participants in a geographic area at a lower cost than social media, and the cost per enrollee by social media was higher than that of traditional methods. In addition, Frandsen et al [ 48 ] suggested that Facebook was cost-effective in obtaining eligible participants at the initial stage of the recruitment process. The mailing of letters was cost-effective compared with Facebook, according to Waltman et al [ 106 ].

Best Practices and Strategies Used to Enhance Social Media Recruitment

Diverse advertisement strategies are adopted by researchers when recruiting research participants through social media platforms. Each social media platform advertisement differs in specification, advertisement content, word count, and design language [ 47 ]. In the included studies, researchers identified and used one or multiple paid, targeted advertisement campaigns with different themes to reach potential participants on various platforms within a specific advertisement duration. Some models of advertisement included the use of paid targeted advertisement [ 18 , 30 , 31 , 37 , 39 - 44 , 46 - 52 , 54 , 58 - 60 , 63 , 65 , 69 - 75 , 77 , 78 , 80 , 81 , 91 , 93 , 95 , 102 , 109 , 113 , 114 , 117 , 119 , 120 ]. In addition, some researchers used untargeted advertisements [ 38 , 62 , 111 ], untargeted but paid advertisements [ 45 , 74 ], “boosted” posts [ 94 , 106 ], posts [ 34 , 61 , 76 , 90 , 105 , 110 , 115 ], both advertisements and posts [ 55 , 57 , 64 , 68 ], tweets [ 79 , 104 , 108 ], targeted advertisements and posts [ 36 ], advertisements [ 56 ], blasts [ 33 ], paid and unpaid social media channels [ 32 , 35 ], and messengers [ 92 ] to strategically advertise and recruit their potential participants.

Another identified strategy was the use of cost-related model strategies to determine the cost of the advertisements. Researchers who are engaged with any social media platform to advertise and recruit participants are billed by cost per click, cost per thousand impressions, cost per view, or cost per action or per conversion [ 125 ]. With the cost per click model, researchers are billed when a potential participant clicks on the advertisement. This approach was one of the most preferred models for researchers in the included studies used for advertising. The cost per click model budget is set at a daily, weekly, or lifetime spending limit depending on the researcher’s choice [ 18 , 30 , 33 , 38 , 40 , 41 , 46 , 47 , 48 , 51 , 54 , 55 , 59 , 60 , 64 , 69 , 71 , 73 , 74 , 75 , 77 , 80 , 93 , 102 , 111 , 126 , 129 ].

Researchers also noted considerations related to the display and design of an advertisement for a desktop application, which differed from that of a mobile app, and this affected how participants viewed and reacted to the recruitment advertisement. The displayed advertisements targeted either the user’s browser or the newsfeed [ 91 , 117 ]. For Facebook, the advertisement is displayed on the user’s web browser [ 58 ] or on the right-side panel of the Facebook newsfeed or placed directly in the newsfeed [ 47 , 55 , 65 ]. For Instagram, images are displayed in a linear format. Snapchat images are displayed using the story feature [ 47 ], and on Grindr, advertisements are displayed as pop-ups [ 57 ]. Therefore, cost is an influencing factor that determines the placement of the advertisement and the social media application of choice, thereby influencing the decisions that researchers make regarding recruitment.

Some researchers identified ethical challenges inherent to social media recruitment, such as privacy, confidentiality, and informed consent, and provided strategies to minimize the challenges for the researcher and the potential participant. The strategies offered and reported in the included studies included the use of a study-specific page for recruitment [ 2 , 51 , 76 , 78 , 82 , 91 , 94 , 107 , 112 , 113 ] and the use of secure landing sites or study webpages for data collection [ 35 , 43 , 48 , 50 , 58 , 75 , 106 , 118 ]. In addition to the strategies proposed by health researchers, there were 4 reports identified in the included studies that outlined guidelines and recommendations for social media recruitment ( Table 5 ).

Recommendations for best practices on social media recruitment.

Principal Findings

Although we intentionally excluded 13 reviews from this study, 7 (54%) of them are discussed here against the findings of our review. The results from our review show an increased interest in using social media for research recruitment by researchers from different health disciplines in which social media strategies have fulfilled researchers’ recruitment needs. Considering the wide range of publications, the scope of this literature review, and the social media applications examined in this review, it can be concluded that the use of social media is on the rise, as evidenced by the increase in the number of publications in the past few years. The different research methods identified in the included studies suggest increased use of social media for a variety of research methods. Notably, a few of the included studies recruited participants for clinical studies, with most recruiting participants for cross-sectional studies. Despite social media’s reach within a broad geographic location, health researchers are still challenged with participant recruitment for clinical trials. This suggests that social media may be best suited for recruiting participants for noninterventional studies. Researchers recruiting for clinical trials may have to diversify their recruitment strategies to reach their recruitment goals until a comprehensive strategy to navigate social media platforms is established. This finding is similar to that of the review by Topolovec-Vranic and Natarajan [ 127 ], which found that only a few studies used social media to recruit participants for interventional studies as opposed to observational studies. Although the Topolovec-Vranic and Natarajan review [ 127 ] used a smaller number of studies to draw this conclusion, their findings are still significant, considering this review.

Researchers from different health disciplines, including nursing, medicine, public health, mental health, and pharmacy, have used social media for recruitment and have published their findings in a variety of journals. Some of these journals are discipline specific or interdisciplinary. This suggests different avenues for health researchers to publish their work. Within the nursing discipline, nurses are increasingly using social media for the recruitment of research studies, as published in multiple nursing and nonnursing journals. However, there are opportunities to continue promoting the use of social media among nurses for research and educational purposes.

On the basis of this review, researchers used different social media applications to advertise and recruit potential research participants. The preferred social media applications were Facebook, Instagram, Snapchat, LinkedIn, Twitter, Grindr, Reddit, Tumblr, WhatsApp, Craigslist, YouTube, and blogs to be used either solely to recruit or in conjunction with other recruitment strategies to achieve recruitment and study goals. Owing to its popularity among users and global penetration, Facebook was the most widely used application among researchers. Different social media applications enabled researchers to recruit participants with different demographics and characteristics. For instance, Facebook was used to recruit younger participants [ 77 , 113 ] and older individuals [ 67 ], whereas other researchers recruited young people through Tumblr [ 61 ]. This finding is similar to that of Arigo et al [ 128 ], who identified web-based platforms such as social networking sites (Facebook, Twitter, Instagram, Tumblr, and LinkedIn) as some of the common platforms that health researchers use to recruit research participants, including a diverse population for their research studies. In addition, researchers used multiple approaches and strategies to recruit participants. An approximately equal number of participants were recruited through social media alone or social media in conjunction with other strategies. This finding agrees with the general literature on the increasing acceptance of digital platforms for recruitment and with some health researchers using social media and traditional methods [ 129 ] for recruitment. In addition to the findings in this review, reviews conducted by some researchers [ 15 , 127 , 130 - 134 ], although focusing on only one social media application or using the term “social networking sites” broadly in their research, exclusively and comprehensively reported on a wide range of different social media applications used in research recruitment.

The different social media platforms used to target the different groups of populations such as the general population, hard-to-reach populations, and specialized populations, depended on the research aim. The hard-to-reach populations included people with addictions, sensitive health issues, ethnic groups, and poor and stigmatized populations [ 135 ]. Social media was found to be effective in reaching and recruiting hard-to-reach potential participants who were otherwise unreceptive to traditional recruitment methods because of their conditions and representations within their communities and society [ 50 ]. Researchers must weigh all available options to determine the best approach to proceed when recruiting from these populations.

The age group distribution of the research participants included in this review spanned different age categories. As shown in Table 1 , the most targeted population from an age perspective was young adults. According to Kemp [ 10 ], the engagement of social media platforms among youth stands at 58% between the ages of 16 and 24 years. This is not surprising because of the acceptability of social media among youth who are considered technology savvy and their tendency to use social media regularly. As such, targeting such an age group for research studies can lead to increased participation. An observation of interest in this review is the low involvement of children and adolescents aged <18 years and older adults. Only 2% (2/96) of studies [ 18 , 120 ] involved adolescents between the ages of 13 and 14 years. As researchers require parental consent among the children and the adolescent group, research studies involving these groups are relatively limited. This finding is similar to that of Amon et al [ 130 ], who suggested that instead of focusing on adolescents who require parental consent, targeting parents or guardians of the intended group could help waive parental consent.

For older adults, the usability of social media platforms presents a challenge, such as platform design and content, as these platforms are tailored to the interests of the younger population [ 136 ]. Owing to the complex design, nature, and privacy-related concerns associated with social media platforms, older adults are more comfortable and familiar with traditional forms of recruitment than social-mediated platforms [ 137 ]. Other barriers encountered by older adults include intrapersonal, interpersonal, functional, and structural elements that hinder the use of social media platforms [ 138 ]. Although social media presents a challenge for recruitment in the older population, researchers can continue to explore traditional methods in such populations to offer an equal chance of participation in research studies. The trade-off between using traditional methods and social media for recruiting research participants is a complicated issue, requiring health researchers to weigh options and the benefits and risks to the participant and the research study, as well as more creative ways of engaging low participating groups.

There is a debate on the cost-effectiveness of social media in the literature. Some studies found the social media method to be cost-effective, whereas other studies disagree with this assertion [ 18 , 58 ]. In this review, the cost of other recruitment strategies compared with social media recruitment strategies was presented as part of this review to assist researchers in making an informed decision ( Tables 3 and ​ and4). 4 ). In addition, in this review, the factors that influenced the cost associated with recruitment varied from one study to the next. Some researchers reported advertising, recruitment, and other administrative costs as the total cost, whereas others reported only aspects of social media advertisement and recruitment as the total cost. Owing to the inconsistency in cost reporting, having a standardized cost reporting system to maintain consistency would help to effectively determine whether social media recruitment is cost-effective. On the basis of the analysis of the cost-effectiveness of both social media and other recruitment strategies, this review found that social media was viewed by researchers as a cost-effective strategy. Although 28% (27/96) of studies in this review reported on the cost of social media compared with other recruitment methods, not all researchers found social media as a cost-effective method. Nonetheless, given that a large proportion of these studies found social media to be cost-effective, this review supports this conclusion. Compared with the previously published reviews by Reagan et al [ 15 ] and Topolovec-Vranic and Natarajan [ 127 ], this review provides additional insights and includes a broader range of studies. This review captured additional literature not included in the review by Reagan et al [ 15 ], which relied only on 18 articles, of which only 10 articles reported on cost. In the review by Topolovec-Vranic and Natarajan [ 127 ], the authors included 30 studies, of which 5 reported on cost-effectiveness, and 7 did not find social media to be a cost-effective method. The findings also revealed that the cost of recruitment for hard-to-reach populations differs from that for the general population. Jurascheck et al [ 58 ] found that recruiting through Facebook advertisements for the African American population was costly; however, advertisements were effective in directing eligible participants to the website. Hence, researchers hoping to recruit research participants through social media must consider these factors to make decisive choices on the most suitable method for recruitment.

Best Practices for the Use of Social Media in Recruitment of Research Participants

Researchers are increasingly tapping into the available opportunities to use social media platforms for their research studies. However, there is a need for best practices to guide this process. To adequately explore and navigate social media platforms successfully for recruitment, adhering to best practices, including those of ethical considerations (informed consent, privacy, confidentiality, and transparency) that protect the researcher and participants, is of utmost importance [ 26 , 118 , 122 ]. In the review by Amon et al [ 130 ], the authors found that participants recruited on web-based platforms were subjected to the same ethical standards as though they were responding to a traditional recruitment method. In that regard, Gelinas et al [ 26 ] were of the view that REBs should standardize social media techniques by clarifying their similarity to traditional recruitment. Furthermore, the findings from the review also establish the need to take additional steps to make available informed consent through other means, where the potential participants are well informed with detailed information about the research study before participation. To curb and curtail the complexities and complicated nature of informed consent, the findings from this review support the recommendations suggested by Herbell and Zauszniewski [ 94 ] and Stokes et al [ 105 ] in their studies to make an information sheet in a downloadable version available for participants and send web-based consent forms to potential participants after meeting the eligibility criteria. To maintain the confidentiality of both researchers and participants, Shaver et al [ 71 ] suggested using anonymous surveys and directing interested participants through a survey link to a landing page for study information. Researchers are discouraged from directly recruiting participants on social media platforms but instead using the social media platform to advertise, as the confidentiality and privacy of participants’ data cannot be guaranteed. To further ensure the provision of privacy, Bender et al [ 121 ] used privacy-enhancing measures aligned with the principles of Privacy by Design by disabling the comment feature, developing privacy notices for social media campaigns, sending disclaimers about the privacy risks of social media pages, and building privacy protection into the recruitment strategy. Although the tenets of the foundational principles were incorporated to avoid privacy-related issues, Bender et al [ 121 ] were of the view that the principles of transparency and user-centric options of Privacy by Design provide inadequate guidance on how to design privacy notices using these key principles.

In addition, some factors were identified to influence advertisements, such as advertisement targets, crafting of multiple advertisement campaigns with different wordings and themes, rotating and alternating advertisements, payment model, duration of the advertisement, and location of the advertisement on the social media platform. To favorably achieve the results of recruiting an increasing number of participants for research, researchers advertising on social media must strategically reach out to their participants. On the basis of the findings of this review, using an appealing image and simple and consistent language through both the text caption and image [ 69 ] influences and attracts participants to the study. Some social media platforms’ advertising policies provide details on advertisement content, including the choice of words and counts and the duration of an advertisement on their platforms. The advertisement policies differ from platform to platform. Researchers must research any platform they wish to engage in, understand the policies, and adhere to them. In addition, working with REBs on social recruitment messages and strategies helps avoid ineffective strategies and enhance ethical conduct. Incorporating prescreening questions before allowing participants to enter details for study participation reduces the rate of ineligible participants and maximizes the reach and sample representativeness. Researchers can use these applications simultaneously because of the feasibility of incorporating social media platforms such as Instagram, Snapchat, and Facebook into a study without difficulty [ 47 ].

Implications

The findings from the review show the increasing accessibility and multifunctionality of social media platforms that could be leveraged to further support health science research. In fact, one of the benefits of social media for conducting research recruitment has been amplified during the COVID-19 pandemic because of the limitations to in-person recruitment, thus sustaining the continuity of research.

Generally, social media platforms provide avenues for a practical approach to reaching diverse, extensive, and targeted audiences [ 139 ] or populations, particularly those that are hard to reach. Further research may be needed to understand the barriers to and facilitators of older adults’ engagement with social media platform recruitment.

Although different approaches to recruitment, advertisement, cost determination, and efficiency reporting can challenge novice researchers planning to use social media, there are ways of mitigating some of these challenges. For example, with the availability of funds and resources, researchers can benefit from hiring specialized companies or third-party service organizations to assist with the marketing and development of social media recruitment strategies and other innovative recruitment approaches targeting potential research participants. It is also recommended that these strategies be discussed and coordinated with the researcher’s academic institution’s REB to ensure no risks to participants.

The lack of explicit regulations by REBs to guide researchers continues to prevent the full exploration of social media platforms to support health science research. As such, stakeholders and collaborative efforts from research-based organizations, academia, researchers, think tanks, and student groups must partner to develop guidelines that reflect the use of social media in research studies. The different guidelines developed and published by researchers and academic institutions can provide a context for what is available. Therefore, based on our review, we propose a tentative description or guideline to guide researchers based on what we have synthesized from the literature included in this review ( Multimedia Appendix 6 ). Ultimately, this guide could serve as a starting point to inform stakeholders in the development of a standardized protocol to guide health science researchers in the use of various social media platforms for research participant recruitment.

Finally, there are opportunities to advance health science education regarding social media use in general and its use for the recruitment of research participants. As students become technologically savvy, incorporating social media into their learning process will allow them to effectively engage with the platform. Schools can also provide guidelines on social media platforms on their websites to enhance learning about their applications in research processes. In addition, teaching students about best practices that support professional social media use and including social media applications as part of ethics training programs are also recommended.

Strengths and Limitations

The findings of this review offer a broad perspective on the use of social media platforms for participant recruitment by health researchers. A large number of studies were included for analysis in this review. The timelines for the included studies span >20 years and provide sufficient time to capture all studies published during the popularity of social media. This study comprehensively synthesized available literature from all health science disciplines. However, the review was limited to studies reported only in English.

The purpose of this integrative review was to explore the literature on recruiting participants for research studies through social media application tools and identify best practices to assist researchers in conducting research participant recruitment via social media tools. This integrative review expanded on the review by Reagan et al [ 15 ], which focused primarily on Facebook, by including other social media applications used by health researchers to recruit research participants, such as Facebook, Craigslist, Instagram, LinkedIn, Reddit, Tumblr, Twitter, and YouTube. Overall, the findings showed that social media is a suitable, viable, and cost-effective channel for recruiting research participants, despite some challenges associated with its use. Health researchers are increasingly embracing various social media platforms in their research to recruit participants from various age groups and diverse backgrounds; however, there is less use of social media to recruit older adults. Adhering to best practices when targeting various populations through social media advertisements is vitally important to protect participants’ and researchers’ rights and increase participation. REBs must proactively provide protocols and best practice guidelines that researchers can apply during the advertisement and recruitment of research participants.

Acknowledgments

The authors acknowledge the assistance of Janice Kung, Laura Hamonic, and Allison Sivak of the University of Alberta Health Sciences Library for their support during the literature search.

Abbreviations

Multimedia appendix 1, multimedia appendix 2, multimedia appendix 3, multimedia appendix 4, multimedia appendix 5, multimedia appendix 6.

Conflicts of Interest: None declared.

Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review

Affiliations.

• 1 Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.
• 2 Metropolia University of Applied Sciences, Helsinki, Finland.
• 3 Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
• 4 INVEST Research Flagship, University of Turku, Turku, Finland.
• 5 Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland.
• PMID: 38706160
• DOI: 10.1111/inm.13343

Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.

Keywords: consumer involvement; experience; framework; mental health; social interaction.

© 2024 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.

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