A mixed methods approach to research synthesis developed by researchers at the EPPI-Centre is described here. Three distinct stages of the review process support the integration of two epistemologically diverse traditions. The first stage is a traditional systematic review of effectiveness (with or without meta-analysis); the second a synthesis of qualitative research which addresses questions of intervention need, implementation, acceptability, and appropriateness; and, finally a cross-study synthesis which brings the findings of both earlier syntheses together. The mixed methods approach is illustrated in a case example of a systematic review of dietary and physical activity interventions for weight management in pregnancy. This review found that important factors that influence maternal weight gain were not addressed by the intervention studies, such as: the difficulty women encounter when seeking to use gym facilities when pregnant and the conflict between lay health beliefs held by the wider family and healthy eating messages.
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