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Searching for Health Promotion Literature

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I  Introduction

Because health promotion is multidisciplinary, studies can appear in sociology, anthropology, psychology, medical, education, environmental, or public policy sources. To conduct a comprehensive search therefore requires searching several bibliographic databases. Another complication in searching for health promotion literature is that search terms for health promotion are often very general and are usually underdeveloped in the databases.

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II  Searching: Steps and Tips

Steps in database searching

1.    Define specifically what you are looking for. This is your search question.

2.    Generate a group of words or phrases from your search question. For each concept you want to search, identify a set of synonyms. These are your search terms.

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

4.    Refine your search terms by doing a few searches with them. Select articles that are relevant to your search question, and note the subject headings or descriptors that have been used to describe them. 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 further refine your search to be more specific to your topic or to fill in gaps. Check the help menu of the particular database you are using to determine the best way to achieve the precision you want.

7.    Download or print the results.

General searching tips

1.    Start with a few references that are relevant and check to see what subject headings or descriptors have been assigned by the database indexer. Build your own search strategy using these terms.

2.    If you use fewer terms, your search will be broader. Begin by searching broadly, and gradually narrowing (adding more terms) to your search string. At the beginning of your search, use your search terms in the subject field, the title field, and the abstract field.

3.    Keep a record of your search strategy. You may need to replicate it or describe it in a paper you are writing with the information you are searching. Use it as a resource to build other searches. You may want to build a list of search terms that you find helpful and work well for your area of practice.

4.    Pay special attention to review or meta-analysis articles or reports because they often provide useful overviews and 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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III  Bibliographic Databases

There are several bibliographic databases that should be used to perform a thorough search on most health promotion topics. The databases described in this article are available for free on the Internet. Often they are also accessible to authorized users through institutions that have site licenses. Databases available through institutions that pay licensing fees often provide a wider range of search and saving options, and may function faster than their free Internet counterparts. 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).

The tips provided for each database below are relevant to the free Internet version.

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

PubMed contains bibliographic citations (author, title, and journal references) and abstracts from over 5,000 journals published in over 80 countries. Journals cover the field of medicine, nursing, dentistry, the health care system, and the preclinical sciences. Currently there are over seventeen million records, most of which are in English, dating back to 1966. Journals indexed in PubMed are commonly found in university or college libraries, hospital libraries, and some large public libraries. Even if you cannot find the complete article, the abstract often provides valuable information.

Developed by the National Library of Medicine (USA), PubMed has been available for free on the Internet since 1997. Commercial MEDLINE databases, which use the PubMed records, have many features that make search and retrieval easier. These are explained well in the user's guides and other resources found in the database help menus.

To understand the differences between PubMed and MEDLINE, see http://www.nlm.nih.gov/pubs/factsheets/dif_med_pub.html.

The following features may prove to be extremely useful in your searches:

a)    Try applying limits such as language, a range of years, age group(s), gender or type of article (e.g., review or meta-analysis). This may help find a subset that is more relevant to your needs.

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.

b)    The subject headings that are assigned to the articles are part of the MeSH controlled vocabulary. More information about MeSH, which stands for Medical Subject Headings, is available at http://www.nlm.nih.gov/mesh/meshhome.html.

c)    The "Details" tab on the search page reveals how PubMed has interpreted your terms. If you wish, you may modify your search strategy at this point.

d)    The "Display" drop-down menu provides a range of formats in which results may be reviewed.

e)    The "Show" function offers a choice of criteria by which results may be sorted as well several options for handling your results. You may choose to view your search results as a text file, save them as a file on your computer, send them to a printer, or receive them by email. Note that if you have a pop-up blocker installed on your computer, you may need to turn it off to be able to save your results as a file.

f)    You can choose to have all records downloaded or select specific articles by clicking the check box by the citation. Having your results in electronic form may be useful in creating bibliographies later. Be sure to choose an output format that includes abstracts if you are going to want to look at them later.

g)    Results are presented in two categories under two tabs: all of the records retrieved as well as a subset of review articles.

Search Terms in MEDLINE

Here is sample list of MeSH search terms that you may find useful in searching PubMed for Health Promotion literature:
 
health promotion (good to use in combination with other terms), 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. A tutorial is available to users at http://www.nlm.nih.gov/bsd/pubmed_tutorial/m1001.html. To become a good searcher of PubMed, it is worth taking the time to complete the tutorial.

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

The HealthComm KEY database contains comprehensive summaries of more than 700 peer-reviewed research and evaluation studies focusing on health communication. While the site is copyright 2007, the main page indicates that it was last updated in October 2006.

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3.    Cochrane Library: http://www.cochrane.org/index.htm

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. The Cochrane Library, a collection of several databases, is the main output of the Cochrane Collaboration. Updated quarterly and distributed on an annual subscription basis on CD-ROM and through the Internet, the Cochrane Library is often accessible through institutions such as libraries and hospitals that provide access for authorized users. Abstracts are available for free on the Internet.

About 50 Collaborative Review Groups (CRGs) do the work of preparing and maintaining the reviews. CRGs are organized on topics of treatment of disease or health problems (e.g., Tobacco Addiction CRG, Infectious Diseases CRG) and are composed of researchers, health care professionals, and consumers.

Two databases from the Cochrane Library, The Cochrane Database of Systematic Reviews and The Database of Abstracts of Reviews of Effectiveness (DARE), may be of particular interest to health promoters.

The Cochrane Database of Systematic Reviews (abstracts only)
http://www.cochrane.org/reviews/index.htm provides regularly updated reviews on the effects of health care that are prepared and maintained by Collaborative Review Groups. Use the 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 paid subscription.

The Database of Abstracts of Reviews of Effectiveness (DARE,
http://www.york.ac.uk/inst/crd/darehp.htm) is assembled and maintained by the National Health Service Centre for Reviews and Dissemination (http://www.york.ac.uk/inst/crd/crddatabases.htm) 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 for free at http://www.york.ac.uk/inst/crd/crddatabases.htm. 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.

To represent dimensions of health care that span across CRGs, the Cochrane Collaboration has developed the Cochrane Fields. Of particular interest is the Cochrane Public Health and Health Promotion Field, a group that works with the CRGs to promote the conducting, dissemination, and use of systematic reviews of all health promotion and public health topics http://www.mrw.interscience.wiley.com/cochrane/clabout/articles/HEALTHP/frame.html).

The contact information for the current Public Health and Health Promotion Field administrator may be found at: http://www.cochrane.org/contact/mwgfield.htm#24.

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IV  Conclusion

The importance of evidence-based practice is likely to continue to grow. The wealth of literature available to us doesn't have to be overwhelming when we know where to look and to how to organize our searches.