Development of a synthesis model from the results of the evidence review, expert consultation, and supplementary analytical work
Once the review teams had submitted their final synthesis papers [24–26], two of the authors [JN and DF] completed a thorough content analysis of each with the intention of consolidating the diversity of conceptual thinking and findings toward the development of a single, cohesive, representative draft generic logic model. The three synthesis papers did not adequately address, however, how community systems can influence CHW performance. Consequently, the same two authors [JN and DF] consulted several key papers from the literature on building community capacity [27–29]. This cursory review produced a working outline on community systems, which all the authors examined for its relevance to CHW performance. The authors incorporated the information from this outline into a second draft of the generic logic model and continued to meet to refine the full model through discussion and further clustering and aggregating of information, which led to a series of additional iterations until the authors reached a consensus.
Ethical approval was not required as this study was based on reviewing published and unpublished literature and consulting with experts. A comprehensive description of all phases of the structured evidence review process, including its strengths and limitations, has been reported elsewhere [7].