Abstract
Background: Decision-makers in crisis zones are faced with the challenge of having to make health-related
decisions under limited time and resource constraints and in light of the many factors that can influence their
decisions, of which research evidence is just one. To address a key gap in the research literature about how best to
support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to
develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers
to evidence use in crisis zones.
Methods: We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic
approach to synthesise the results and develop the conceptual framework. We used a ‘compass’ question to create
a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of
Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional
papers to fill in conceptual gaps.
Results: We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual
gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined
through the lens of four systems – political, health, international humanitarian aid and health research. Within each
of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and
address the barriers to evidence use.
Conclusions: This study presents a new conceptual framework that outlines strategies that leverage the facilitators
and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature
pertaining to evidence-informed decision-making.