Table 4 Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist

1

Aim

State the research question the synthesis addresses.

See Abstract and Background

2

Synthesis methodology

Identify the synthesis methodology or theoretical framework which underpins the synthesis, and describe the rationale for choice of methodology (e.g. meta-ethnography, thematic synthesis, critical interpretive synthesis, grounded theory synthesis, realist synthesis, meta-aggregation, meta-study, framework synthesis).

Thematic synthesis

3

Approach to searching

Indicate whether the search was pre-planned (comprehensive search strategies to seek all available studies) or iterative (to seek all available concepts until they theoretical saturation is achieved).

Pre-planned, as identified in Table 1 and Methods

4

Inclusion criteria

Specify the inclusion/exclusion criteria (e.g. in terms of population, language, year limits, type of publication, study type).

Detailed under the heading entitled, “Eligibility criteria” in Methods

5

Data sources

Describe the information sources used (e.g. electronic databases (MEDLINE, EMBASE, CINAHL, psycINFO, Econlit), grey literature databases (digital thesis, policy reports), relevant organisational websites, experts, information specialists, generic web searches (Google Scholar) hand searching, reference lists) and when the searches conducted; provide the rationale for using the data sources.

Pubmed, Embase, Education Source, Academic Search Complete, and Web of Science (Core Collection), plus reference list searches and the authors’ own knowledge of manuscripts. See Methods

6

Electronic Search strategy

Describe the literature search (e.g. provide electronic search strategies with population terms, clinical or health topic terms, experiential or social phenomena related terms, filters for qualitative research, and search limits).

See Table 1

7

Study screening methods

Describe the process of study screening and sifting (e.g. title, abstract and full text review, number of independent reviewers who screened studies).

See Methods and Figure

8

Study characteristics

Present the characteristics of the included studies (e.g. year of publication, country, population, number of participants, data collection, methodology, analysis, research questions).

See Table 2

9

Study selection results

Identify the number of studies screened and provide reasons for study exclusion (e, g, for comprehensive searching, provide numbers of studies screened and reasons for exclusion indicated in a figure/flowchart; for iterative searching describe reasons for study exclusion and inclusion based on modifications t the research question and/or contribution to theory development).

See Methods and Figure

10

Rationale for appraisal

Describe the rationale and approach used to appraise the included studies or selected findings (e.g. assessment of conduct (validity and robustness), assessment of reporting (transparency), assessment of content and utility of the findings).

See Methods and Table 2 for our appraisal of the studies’ methods and scope. Content was appraised as a part of the screening process, as detailed in the heading titled, “study selection.”

11

Appraisal items

State the tools, frameworks and criteria used to appraise the studies or selected findings (e.g. Existing tools: CASP, QARI, COREQ, Mays and Pope [25]; reviewer developed tools; describe the domains assessed: research team, study design, data analysis and interpretations, reporting).

Domains assessed included the study design (qualitative vs. mixed-methods), study size (n), interviewees, and content. See Methods and Table 2 for further details.

12

Appraisal process

Indicate whether the appraisal was conducted independently by more than one reviewer and if consensus was required.

Appraisal of the methodology, interviewees, and study size was conducted by a single reviewer, and appraisal of content was conducted by two reviewers independently as part of the screening process. See Methods for further details.

13

Appraisal results

Present results of the quality assessment and indicate which articles, if any, were weighted/excluded based on the assessment and give the rationale.

No studies were excluded based on results of the appraisal, and the appraisal of ‘n’ and the qualitative nature of most of the studies are commented on in Methods and Discussion.

14

Data extraction

Indicate which sections of the primary studies were analysed and how were the data extracted from the primary studies? (e.g. all text under the headings “results /conclusions” were extracted electronically and entered into a computer software).

The sections of the studies analyzed were abstracts, results, discussion, and conclusion. See Methods heading, “Data Extraction and Analysis.”

15

Software

State the computer software used, if any.

NVivo

16

Number of reviewers

Identify who was involved in coding and analysis.

This is detailed in Methods

17

Coding

Describe the process for coding of data (e.g. line by line coding to search for concepts).

See Methods: coding was line by line.

18

Study comparison

Describe how were comparisons made within and across studies (e.g. subsequent studies were coded into pre-existing concepts, and new concepts were created when deemed necessary).

Line-by-line codes were coded into pre-existing concepts and new concepts were created if deemed necessary.

19

Derivation of themes

Explain whether the process of deriving the themes or constructs was inductive or deductive.

We derived the codes and major themes inductively, with no a priori codes.

20

Quotations

Provide quotations from the primary studies to illustrate themes/constructs, and identify whether the quotations were participant quotations of the author’s interpretation.

Provided in Results

21

Synthesis output

Present rich, compelling and useful results that go beyond a summary of the primary studies (e.g. new interpretation, models of evidence, conceptual models, analytical framework, development of a new theory or construct).

See Discussion.