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Searching for Health Promotion Literature



The purpose of this bulletin is to provide some tools and tips that will help in searching for health promotion literature in journals and reports. It is often challenging to find health promotion studies because of the multidisciplinary nature of the field. Health promotion studies can appear in a wide range of sociology, anthropology, psychology, medical, education, environmental or public policy journals. This requires searching multiple bibliographic databases in order to approach being comprehensive. I commonly use 6 databases in order to complete a search on one topic. Searching for health promotion literature is also difficult because the search terms relevant to health promotion are often very general and are usually underdeveloped in these databases.





B. SEARCHING: STEPS AND TIPS



Steps in database searching:



1) Define what it is you want to know. This is your search question.



2) Generate a group of words or phrases that are related to your search question. These are your search terms.



3) Determine how comprehensively and widely you want to search and select a database or databases that covers those areas. Note what areas or journals are not included in these databases so that you know the limits of your search.



4) Do a few searches using your search terms. Select articles that are relevant to your search question and note their subject headings. You may want to add these words or phrases to your search terms.



5) Perform your searches.



6) Evaluate your results. You may need to refine your search in order to be more on topic or to fill in gaps.



7) Download or print the results.



General searching tips:



1) Start with a few references that are relevant and check how they are indexed (what subject terms are assigned) in the database. Build your own search strategy using these terms.



2) Start broad and then later narrow your search. Do not begin by limiting your search terms just to the subject field but also search in the title and abstract fields.



3) Keep a record of your search strategy in case you have to replicate it or use it as a resource to build other searches. Keep a record of search terms that you use frequently.



4) Pay special attention to review or meta-analysis articles or reports because they often provide useful overviews and also extensive bibliographies.



5) Take the time to read the searching tips for the database. These tips can often save you time and effort and make your searches more precise. Of particular importance are the ways to limit search results (years, languages, population groups, etc), combine search terms (for example Boolean operators such as and, or, not) and save and download searches.



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C. BIBLIOGRAPHIC DATABASES



There are several bibliographic databases that should be used in order to perform a thorough search on most health promotion topics. The databases described here are available for free on the Internet and are often also available to authorized users, for example students, staff or faculty, through institutions that have site licences. One example of this is accessing MEDLINE at a university computer terminal or through the Internet at home with a password. Accessing databases through institutions that pay a site licence often gives you a wider range of search and saving options and may be quicker than using the free Internet interface. The tips provided for each database below are relevant to the free Internet version. If you are accessing the database through an institution there should be supporting documents or help screens available through the database (or ask a librarian for assistance.)



1) MEDLINE http://www.ncbi.nlm.nih.gov/entrez/query.fcgi



MEDLINE contains bibliographic citations (author, title, and journal references) and abstracts from over 3,900 journals published in 70 countries. Journals cover the field of medicine, nursing, dentistry, the health care system, and the preclinical sciences. Currently there are over 9 million records, the majority of which are in English, dating back to 1966. Journals that are indexed in MEDLINE can commonly be found in university or college libraries, hospital libraries and in some large public libraries. Even if you cannot find the complete article, the abstract can often be enough for your purposes.



Since 1997, MEDLINE has been available for free on the Internet using the Pubmed interface at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi. Pubmed is a free, Web-based database of health literature developed by the National Library of Medicine (USA).



Databases that run behind PubMed, such as MEDLINE, have a lot of features that are worth learning about and are explained well in the user's guide and other resources that are on the site. I have found the following features extremely useful in my searches:



a. Applying limits to results such as language, year range, age group, gender and sometimes limiting results to review or meta-analysis articles.



b. After finding an article of interest it is easy to retrieve others with similar subject headings by selecting the "related articles" button to the left of the citation. This feature does not replace doing a complete search.



c. The subject headings that are assigned to the articles are part of the MeSH controlled vocabulary. More information about MeSH is available at: http://www.nlm.nih.gov/mesh/meshhome.html



d. The "analyze search" function will suggest alternative subject headings in order to expand or limit a search.



e. One of the options on the results screen is to "Download to Disk" which means the results will be formatted to your specifications and then FTPed or transferred to the hard drive of your computer via the Internet. You can choose to have all records downloaded or only those you have selected. Having your results in electronic form may be useful in creating bibliographies later. Be sure to include abstracts if you are going to want to look at them later. If you are using bibliographic reference software, such as Endnote or Reference Manager, select tagged format.



Search Terms in MEDLINE



Here is a sample of MeSH search terms that you may find useful in searching MEDLINE for Health Promotion literature:

Health promotion (a good term to combine others with), Health education, Patient education, Health behavior, Preventive medicine, Community health planning, Primary prevention, Community networks, Social support, Mass media , Research design, Questionnaires, Evaluation studies, Program evaluation, Consumer participation, Smoking, Smoking cessation, Alcoholism, Diet, Exercise, Risk factors, Mass media

* Remember that terms use American spelling.



2) HealthComm KEY http://www.cdc.gov/od/oc/hcomm



The database contains comprehensive summaries of more than 200 articles about health communication research and practice. Articles selected for the database were published between 1986 and 1996 and describe U.S. based public health interventions that have communication as a major component.



3) Cochrane Collaboration http://cochrane.mcmaster.ca/



The Cochrane Collaboration is an international not-for-profit organization that prepares, maintains and promotes the accessibility of systematic reviews of the effects of healthcare interventions. About fifty Collaborative Review Groups (CRGs) do the work of preparing and maintaining the reviews. CRGs are organized around treatment of disease or health problems (e.g. Tobacco Addiction CRG, Infectious Diseases CRG) and are comprised of researchers, health care professionals and consumers. To represent dimensions of health care that span across CRGs, Cochrane Fields have been developed. Of particular interest is the Cochrane Health Promotion Field, a group that works with the CRGs to promote the conduct, dissemination and utilization of systematic reviews of all health promotion and public health topics. The contact person for the Health Promotion Field is the field administrator, Sheila McNair (mcnairs@fhs.mcmaster.ca).



The Cochrane Library, which consists of several databases, is the main output of the Collaboration. It is updated quarterly and distributed on an annual subscription basis on disk, CD-ROM and via the Internet. The Cochrane Library is available in full text by subscription or through institutions such as libraries and hospitals that provide access for authorized users.



Two databases of the Cochrane Library may be of particular interest to Health Promoters. If you do not have full text access through subscription or an institution you can still search for abstracts through the Internet.



i) The Cochrane Database of Systematic Reviews (abstracts only)

http://www.cochrane.org/reviews/index.htm



These regularly updated reviews on the effects of health care are prepared and maintained by Collaborative Review Groups. Use the new site search engine, or browse by group. Many OHPE readers will find the Cochrane Tobacco Addiction Group particularly interesting. The full text of these reviews is only available through subscription to the Cochrane Library.



ii) The Database of Abstracts of Reviews of Effectiveness (DARE)

http://www.york.ac.uk/inst/crd/darehp.htm



This database is assembled and maintained by the NHS Centre for Reviews and Dissemination in York, England. It contains critical assessments of systematic reviews that have been published in journals or as reports. The web version of this database is searchable by author, title and subject heading. When you locate a review of interest you can then get it directly from the journal it was published in or by contacting the source organization.