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Appendices

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Appendix 1: CERQual assessment template 

Finding1 

Overall assessment2 

Contributing studies3 

 

 

 

 

CERQual Assessment4 

Methodological limitations5 

Coherence6 

Relevance7 

Adequacy of data8 

 

 

 

 

 

Studies contributing to the review finding9 

Study ID 

Country  

Context 

Data collection methods 

Participants / Sample size 

Health topic 

Intervention type 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Methodological assessment of individual studies (Adapted CASP)10 

Study ID 

Was the context described? 

Was the sampling strategy appropriate and described? 

Was the data collection strategy appropriate and described?  

Was the data analysis appropriate and described?  

Were the findings supported by evidence?  

Is there evidence of researcher reflexivity? 

Have ethical issues been taken into consideration? 

Overall assessment of methodological limitations 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data contributing to this finding 

Study ID 

Data extracts11 

 

 

 

 

 

Guidance

For in depth guidance please refer to the GRADE-CERQual papers  

1 

Write the finding in this box. You may want to start with a general idea and then finalize the wording during the GRADE_CERQual process 

2 

In this box you will enter the overall assessment for the finding and the reasons for your assessment the options are: 

High confidence:  

It is highly likely that the review finding is a reasonable representation of the phenomenon of interest  

Moderate confidence:  

It is likely that the review finding is a reasonable representation of the phenomenon of interest  

Low confidence: 

 It is possible that the review finding is a reasonable representation of the phenomenon of interest  

Very low confidence: 

 It is not clear whether the review finding is a reasonable representation of the phenomenon of interest.  

3 

Here you can list the number of studies contributing to the finding or provide a list of Author/year 

4 

There are four possible assessments you can use in this section 

No or very minor concerns:  

No or very minor concerns regarding [methodological limitations / relevance / coherence / adequacy] that are unlikely to reduce confidence in the review finding  

Minor concerns:  

Minor concerns regarding [methodological limitations / relevance / coherence / adequacy] that may reduce confidence in the review finding [concerns to be described]  

Moderate concerns:  

Moderate concerns regarding [methodological limitations / relevance / coherence / adequacy] that will probably reduce confidence in the review finding [concerns to be described]  

Serious concerns:  

Serious concerns regarding [methodological limitations / relevance / coherence / adequacy] that are very likely to reduce confidence in the review finding [concerns to be described]  

5 

Methodological limitations: the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding. 

6 

Coherence: an assessment of how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises those data. By cogent, we mean well supported or compelling. 

7 

Relevance: the extent to which the body of evidence from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question. 

8 

Adequacy of data: an overall determination of the degree of richness and quantity of data supporting a review finding. 

9 

The subheadings here are suggestions. Each individual author should adjust them to meet their own needs 

10 

The adapted CASP checklist as recommended for use at NIPH 

11 

In this box insert all of the raw data extracts from each of the included studies that are relevant to the finding 

Appendix 2: Template for evidence profiles 

Finding: 

 

Assessment for each CERQual component 

Methodological limitations 

(concerns and explanation) 

Coherence 

(concerns and explanation) 

Relevance 

(concerns and explanation) 

Adequacy 

(concerns and explanation) 

Overall CERQual assessment 

Confidence 

(explanation) 

Contributing studies 

Study 

Context 

 

(provide a brief description of the relevant context of the study to the review objectives) 

 

 

*In this box you can explain any abbreviations used in the table 

Example of a completed evidence profile from Ames 2017:

Finding 1: Parents liked to receive information about vaccination before the baby was born for reasons such as fatigue and time limitations for reading about vaccination after delivery. 

Assessment for each CERQual component 

Methodological limitations 

Minor concerns regarding methodological limitations due to poor reporting from 1 study on sampling and data collection methods 

Coherence 

No or very minor concerns regarding coherence 

Relevance 

Moderate concerns regarding relevance due to partial relevance as studies were from limited settings 

Adequacy 

Moderate concerns regarding adequacy due to 3 contributing studies with thin data 

Overall CERQual assessment 

Low confidence 

Due to minor concerns about methodological limitations and moderate concerns about adequacy and relevance 

Contributing studies 

Study 

Context 

Benin 2006 

Connecticut USA; postpartum mothers; unspecified vaccines with a focus on hepatitis B 

Tickner 2007 

Southern England; parents with babies aged 4-13 weeks; a focus on MMR and the 5-in-1 vaccine 

Miller 2008 

Rural Alberta Canada; mothers with varying vaccination choices; unspecified vaccines 

Barbieri 2015 

Southeast Sao Paulo, Brazil; highly educated parents in urban areas; EPI vaccines 

Saada 2015 

Northern California, USA; parents who were on time, late or missing vaccinations of children aged 12-36 months; members of Kaiser Permanente; unspecified vaccines 

EPI: Extended Programme on Immunization; MMR: measles, mumps and rubella vaccine 

Appendix 3: Template for summary of qualitative findings tables 

Finding 

Overall CERQual assessment 

Explanation for assessment 

Contributing studies 

1 

(Enter finding here) 

(Enter confidence level here) 

(Enter your explanation for the confidence assessment here) 

(list or reference the contributing studies here) 

2 

 

 

 

 

3 

 

 

 

 

4 

 

 

 

 

5 

 

 

 

 

 

Example of a completed evidence profile from Ames 2018:

Finding 

Overall CERQual assessment 

Explanation for assessment 

Contributing studies 

1 

Participants reported varying degrees of access to network services including cell networks (for calls and SMS) and internet. In addition, some had poor access to electricity to charge their phones. These factors were reported to be barrier to using the mHealth programs. 

High confidence 

Due to minor concerns regarding methodological limitations 

Akinfaderin-Agarau 2012; Cornelius 2009; Flax 2017; Hirsch-Moverman 2017;  

Jalloh-Vos 2014; Mbuagbaw 2012; Mbuagbaw 2014; Smilie 2014 

2 

Participants reported varying degrees of access to mobile phones. For instance, some had no phone, some had lost or broken their phone, some could not afford to purchase airtime, some changed their number or sim card, or for some access to the phone was controlled by another person.  These factors were reported to be barrier to using the mHealth programs.  

Moderate confidence 

Due to minor concerns regarding methodological limitations and relevance 

Akinfaderin-Agarau 2012; Entsieh 2015; Flax 2017; Hirsch-Moverman 2017; Jalloh-Vos 2014; Jennings 2013; Menacho 2013; Missal 2016; Rana 2015; Smilie 2014; 

3 

Some participants, particularly women and adolescents, who had to share or borrow a phone or had their access to phones controlled or restricted by another person, complained that this made it difficult to keep messages and conversations private or to receive their messages at all.  These factors were reported to be barrier to using the mHealth programs. 

Moderate confidence 

Due to minor concerns regarding methodological limitations, coherence, adequacy and relevance 

Akinfaderin-Agarau 2012; Flax 2017; Jalloh-Vos 2014;  

Rana 2015 

4 

Some participants who were dealing with health conditions that are often seen as stigmatised or very personal  (for example HIV, family planning and abortion care) worried that their confidential health information would be disclosed or their identity traced due to their participation in a mHealth program. People’s perceptions of information delivery channels (SMS, IVR, Voice call) were influenced by how confidential they felt the delivery channels were.   

High confidence 

Due to minor concerns regarding methodological limitations 

Akinfaderin-Agarau 2012; Calderon 2017; Cates 2015; Curioso 2009; Evans 2016; French 2016; Goldenberg 2015; Greaney 2014; Jalloh-Vos 2014; Jennings 2013; Mbuagbaw 2012; Mbuagbaw 2014; Mitchell 2016; Menacho 2013; Nachega 2016; Odeny 2014; Perry 2012; Rana 2015; Rodrigues 2017; Smith 2017; Willoughby 2017 

 

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