The International Network for Social Intervention Assessment (INSIA) is a partnership of organizations that produce, support, and use evidence synthesis in social care. It emerges as a pivotal entity that supports evidence-informed social care decision-making. The paper argues for the importance of the production and use of trustworthy evidence synthesis in social care to inform and guide policy and practice. We articulate INSIA's position in the global field of social intervention assessment, list the vision and aims of INSIA as a network for promoting and enabling the production and use of evidence synthesis in social care, and issue a call to action, inviting other organizations to join this work.

Background:Risk of bias (RoB) assessment is a highly skilled task that is time-consuming and subject to human error. RoB automation tools have previously used machine learning models built using relatively small task-specific training sets. Large language models (LLMs; e.g., ChatGPT) are complex models built using non-task-specific Internet-scale training sets. They demonstrate human-like abilities and might be able to support tasks like RoB assessment. Methods:Following a published peer-reviewed protocol, we randomly sampled 100 Cochrane reviews. New or updated reviews that evaluated medical interventions, included ≥ 1 eligible trial, and presented human consensus assessments using Cochrane RoB1 or RoB2 were eligible. We excluded reviews performed under emergency conditions (e.g., COVID-19), and those on public health or welfare. We randomly sampled one trial from each review. Trials using individual- or cluster-randomized designs were eligible. We extracted human consensus RoB assessments of the trials from the reviews, and methods texts from the trials. We used 25 review-trial pairs to develop a ChatGPT prompt to assess RoB using trial methods text. We used the prompt and the remaining 75 review-trial pairs to estimate human-ChatGPT agreement for "Overall RoB" (primary outcome) and "RoB due to the randomization process", and ChatGPT-ChatGPT (intrarater) agreement for "Overall RoB". We used ChatGPT-4o (February 2025) throughout. Results:The 75 reviews were sampled from 35 Cochrane review groups, and all used RoB1. The 75 trials spanned five decades, and all but one were published in English. Human-ChatGPT agreement for "Overall RoB" assessment was 50.7% (95% CI 39.3%-62.0%), substantially higher than expected by chance (p = 0.0015). Human-ChatGPT agreement for "RoB due to the randomization process" was 78.7% (95% CI 69.4%-88.0%; p < 0.001). ChatGPT-ChatGPT agreement was 74.7% (95% CI 64.8%-84.6%; p < 0.001). Conclusions:ChatGPT appears to have some ability to assess RoB and is unlikely to be guessing or "hallucinating". The estimated agreement for "Overall RoB" is well above estimates of agreement reported for some human reviewers, but below the highest estimates. LLM-based systems for assessing RoB may be able to help streamline and improve evidence synthesis production.

ABSTRACT Introduction Evidence syntheses are crucial in healthcare and elsewhere but are resource‐intensive, often taking years to produce. Artificial intelligence and machine learning (AI/ML) tools may improve production efficiency in certain review phases, but little is known about their impact on entire reviews. Methods We performed prespecified analyses of a convenience sample of eligible healthcare‐ or welfare‐related reviews commissioned at the Norwegian Institute of Public Health between August 1 2020 (first commission to use AI/ML) and January 31 2023 (administrative cut‐off). The main exposures were AI/ML use following an internal support team's recommendation versus no use. Ranking (e.g., priority screening), classification (e.g., study design), clustering (e.g., documents), and bibliometric analysis (e.g., OpenAlex) tools were included, but we did not include or exclude specific tools. Generative AI tools were not widely available during the study period. The outcomes were resources (person‐hours) and time from commission to completion (approval for delivery, including peer review; weeks). Analyses accounted for nonrandomized assignment and censored outcomes (reviews ongoing at cut‐off). Researchers classifying exposures were blinded to outcomes. The statistician was blinded to exposure. Results Among 39 reviews, 7 (18%) were health technology assessments versus systematic reviews, 19 (49%) focused on healthcare versus welfare, 18 (46%) planned meta‐analysis, and 3 (8%) were ongoing at cut‐off. AI/ML tools were used in 27 (69%) reviews. Reviews that used AI/ML as recommended used more resources (mean 667 vs. 291 person‐hours) but were completed slightly faster (27.6 vs. 28.2 weeks). These differences were not statistically significant (relative resource use 3.71; 95% CI: 0.36–37.95; p = 0.269; relative time‐to‐completion: 0.92; 95% CI: 0.53–1.58; p = 0.753). Conclusions Associations between AI/ML use and the outcomes remains uncertain. Multicenter studies or meta‐analyses may be needed to determine if these tools meaningfully reduce resource use and time to produce evidence syntheses.

Risk of bias (RoB) assessment is an essential part of systematic reviews that requires reading and understanding each eligible trial and RoB tools. RoB assessment is subject to human error and is time-consuming. Machine learning-based tools have been developed to automate RoB assessment using simple models trained on limited corpuses. ChatGPT is a conversational agent based on a large language model (LLM) that was trained on an internet-scale corpus and has demonstrated human-like abilities in multiple areas including healthcare. LLMs might be able to support systematic reviewing tasks such as assessing RoB. We aim to assess interrater agreement in overall (rather than domain-level) RoB assessment between human reviewers and ChatGPT, in randomized controlled trials of interventions within medical interventions. We will randomly select 100 individually- or cluster-randomized, parallel, two-arm trials of medical interventions from recent Cochrane systematic reviews that have been assessed using the RoB1 or RoB2 family of tools. We will exclude reviews and trials that were performed under emergency conditions (e.g., COVID-19), as well as public health and welfare interventions. We will use 25 of the trials and human RoB assessments to engineer a ChatGPT prompt for assessing overall RoB, based on trial methods text. We will obtain ChatGPT assessments of RoB for the remaining 75 trials and human assessments. We will then estimate interrater agreement using Cohen’s κ. The primary outcome for this study is overall human-ChatGPT interrater agreement. We will report observed agreement with an exact 95

OBJECTIVES: This study aimed to assess 12-month outcomes on return to work (RTW) and cost-effectiveness in adults on sick leave due to musculoskeletal disorders who were randomized to either usual case management (UC), UC+motivational interviewing (MI) or UC+stratified vocational advice intervention (SVAI). METHODS: The study was conducted in the Norwegian Labor and Welfare Administration (NAV). Workers on sick leave due to musculoskeletal disorders for ≥50% of their contracted work hours for ≥7 consecutive weeks were included. Trained caseworkers delivered MI in two face-to-face sessions, and physiotherapists provided SVAI and identified RTW obstacles. The main outcomes were sick leave days over 12 months and cost-effectiveness, cost-utility and cost-benefit. RESULTS: The trial included 509 workers with a mean age of 48 years. There were statistically significant differences between UC+MI versus UC [-15.6 days, 95% confidence interval (CI) -31.0– -0.2], and UC+SVAI versus UC (-17.6 days, 95% CI -33.0– -2.2). Compared to UC, odds ratios (OR) for receiving wage replacement benefits each month were lower for UC+MI (OR=0.73, 95% CI 0.64–0.84), and UC+SVAI (OR 0.74, 95% CI 0.64–0.84). The probabilities of cost-effectiveness were high for adding either MI or SVAI to UC (ceiling ratio 0.90), and the net benefit for MI was €5225 (95% CI -592–10 985) and for SVAI €7214 ((95% CI 1548–12 851) per person. CONCLUSIONS: Adding MI or SVAI to UC significantly improved RTW outcomes and was cost-effective among people on sickness absence due to musculoskeletal disorders.

We examined changes in HIV testing and medical care among men who have sex with men (MSM) in Russia. Data come from the 2010 and 2017 waves of the European MSM Internet Survey. From 2010 to 2017 there was an increase in the proportion who had ever received an HIV test (+ 11.2

BACKGROUND:Employment provides economic security, a social network, and is important for self-identity. A review published by van der Noordt and colleagues in 2014 showed that employment was beneficial for depression and general mental health. However, an updated synthesis including research published in the last decade is lacking. In the planned review, we aim to update, critically assess, and synthesise the current evidence of the association between paid employment (excluding precarious employment) and common mental health outcomes (depression, anxiety, and psychological distress) among the working age population in the labour force. METHODS:We will follow recommended guidelines for conducting and reporting systematic reviews. Four electronic databases (MEDLINE, Embase, APA PsycINFO, and Web of Science) will be searched from 2012, using appropriate MeSH terms and text words related to our inclusion criteria. We will screen the records against predefined eligibility criteria, first by title and abstract using the priority screening function in EPPI-Reviewer, before proceeding to full-text screening. Only studies investigating the longitudinal relationship between employment and common mental health outcomes will be included. We will search for grey literature in OpenAlex and conduct backward and forward citation searches of included studies. The methodological quality of the included studies will be assessed using the Cochrane risk-of-bias tool (RoB 2), Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I), or the Newcastle-Ottawa scale (NOS). We will conduct a narrative review and, if possible following pre-set criteria, conduct random-effects meta-analyses to estimate the pooled effect of employment on depression, anxiety, and psychological distress, across the included studies. DISCUSSION:An updated review of the association between non-precarious employment and mental health outcomes is needed. In the planned review, we will assess the quality of the included studies and synthesise the results across studies to make them easily accessible to policy makers and researchers. The results from the review can be used to aid in policy decisions and guide future research priorities. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42023405919.

Becoming a parent is a vulnerable life transition and may affect parents’ mental health. Depressive symptoms may occur in fathers, as well as mothers, during pregnancy and the postpartum period. The health service is expected to have a family perspective, aiming to support both parents. Despite this goal, mothers traditionally receive more support than fathers. Home visiting programs may provide enhanced guidance for new fathers and increased mental health support. The aim of this study was therefore to assess possible differences in level of depressive symptom in fathers receiving the New Families home visiting program compared with those receiving standard care from the Norwegian Child Health Service. A prospective nonrandomized controlled study with a parallel group design was performed. The Edinburg Postnatal Depression Scale (EPDS) was used to measure depressive symptoms in fathers ( N = 197) at 28 weeks of their partners’ pregnancy (T1), at 6 weeks (T2), and 3 months postpartum (T3), in the intervention and the control group. The results indicate a prevalence of depressive symptoms (EPDS score ≥ 10) in Norwegian fathers of 3.1% at T1, 3.9% at T2, and 2.2% at T3 for the full sample. No significant EPDS score differences were found between the intervention and the control group at six weeks and three months postpartum. This suggests that the intervention had no clear impact on depressive symptoms during this time-period.

Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclusion, chemsex had to be the main focus, and studies had to specify GHB/GBL, stimulant (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine use with sex as a variable. From 7055 titles/abstracts, 108 studies were included, mostly cross-sectional, and from Western countries. About one-third of studies recruited exclusively from clinical settings. A majority of these recruited from sexually transmitted infection (STI) clinics. The included quantitative studies analyzed possible associations between chemsex and STI health (40%), mental health (15%), drug health (12%), sexological health (10%), and post-diagnostic HIV health (7%). Most studies included GHB/GBL and crystal meth in their operationalization of chemsex. Definitions and operationalizations of chemsex vary greatly in the literature, and researchers of chemsex among MSM should consider ways in which this variation impacts the validity of their results. More studies are needed among MSM in non-high income and non-Western countries, and examination of possible links between chemsex and post-diagnostic HIV health, sexological health, and mental health.

Peer support for people living with HIV has gained increasing traction and is considered a way to take an active role in self-management. The existing research examining peer support interventions has reported promising evidence of the benefits of peer support. The purpose of our scoping review was to describe research on peer support for people living with HIV. We included 53 studies and sorted them into analytic categories and conducted descriptive analyses. The studies that were published between November/December 2000 and May 2021, had a range of study designs and heterogeneous priority groups, and included 20,657 participants from 16 countries. We identified 43 evaluations of the effect of peer support and 10 evaluations of implementation, process, feasibility, cost of peer support. We also categorized peer support by key functions, finding that the most common key functions were linkage to clinical care and community resources and assistance in daily management, with only one study directly related to chronic care. There is growing research interest in peer support for people living with HIV, particularly in high-income countries and related to the evaluation of effects. The revealed gaps of prioritized functions of peer support have implications for further research. Further focus on interventions addressing secondary prevention related to noncommunicable diseases as part of a care package is recommended to meet people's needs and preferences and increase self-management related to a chronic lifelong condition.

Peer support for people living with HIV has gained increasing traction and is considered a way to take an active role in self-management. The existing research examining peer support interventions has reported promising evidence of the benefits of peer support. The purpose of our scoping review was to describe research on peer support for people living with HIV. We included 53 studies and sorted them into analytic categories and conducted descriptive analyses. The studies that were published between November/December 2000 and May 2021, had a range of study designs and heterogeneous priority groups, and included 20,657 participants from 16 countries. We identified 43 evaluations of the effect of peer support and 10 evaluations of implementation, process, feasibility, cost of peer support. We also categorized peer support by key functions, finding that the most common key functions were linkage to clinical care and community resources and assistance in daily management, with only one study directly related to chronic care. There is growing research interest in peer support for people living with HIV, particularly in high-income countries and related to the evaluation of effects. The revealed gaps of prioritized functions of peer support have implications for further research. Further focus on interventions addressing secondary prevention related to noncommunicable diseases as part of a care package is recommended to meet people’s needs and preferences and increase self-management related to a chronic lifelong condition. Keywords people living with HIV , chronic disease , peer support , medication adherence , antiretroviral therapy

Becoming a parent for the first time is a major transition, and parental self-efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first-time parents' experiences related to PSE in the transition to parenthood in the first-year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task-specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture-factors in society and the healthcare services; parents-processes within the parents; tasks-different parental tasks; support-parents' perceived support from professionals, peers, friends, family, and partner; and child-the child's well-being and feedback. This scoping review describes qualitative studies on first-time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate.

To examine the impact of migration and acculturation of Turkish men who have sex with men (MSM) to Germany, using data from the European MSM Internet Survey (EMIS-2010), on measures of acculturation including circumcision status, internalized homonegativity (IH), HIV/STI knowledge, sexual orientation, outness, HIV-testing, and sexual behaviors. We compared four groups of MSM: MSM born and residing in Germany who had completed the questionnaire in German (n = 38,915), MSM born and residing in Germany, with a father or mother born in Turkey (n = 97), MSM residing in Germany who were born in Turkey or whose parents were born in Turkey (n = 262), and MSM who were born and residing in Turkey and who completed the questionnaire in Turkish (n = 1,717). Data showed that there were significant dose–response curves between level of migration and several outcome variables. As exposure to Germany increased, MSM had lower IH, higher HIV/STI knowledge, increased outness, and were less likely to be circumcised. There were similar significant findings with regard to sexual HIV risk behavior (condomless anal intercourse with partners of unknown (or sero-discordant) HIV status). Data were consistent with acculturation over generations in immigrant groups in MSM migrating from Turkey to Germany. Integration includes both cultural aspects (circumcision) and integration into a more homopositive gay environment (IH, outness, increased HIV/STI knowledge), and sexual HIV risk behavior. Migration and associated acculturation may constitute a risk change for HIV/STI and mental health issues associated with IH and outness.

BACKGROUND:Machine learning (ML) tools exist that can reduce or replace human activities in repetitive or complex tasks. Yet, ML is underutilized within evidence synthesis, despite the steadily growing rate of primary study publication and the need to periodically update reviews to reflect new evidence. Underutilization may be partially explained by a paucity of evidence on how ML tools can reduce resource use and time-to-completion of reviews. METHODS:This protocol describes how we will answer two research questions using a retrospective study design: Is there a difference in resources used to produce reviews using recommended ML versus not using ML, and is there a difference in time-to-completion? We will also compare recommended ML use to non-recommended ML use that merely adds ML use to existing procedures. We will retrospectively include all reviews conducted at our institute from 1 August 2020, corresponding to the commission of the first review in our institute that used ML. CONCLUSION:The results of this study will allow us to quantitatively estimate the effect of ML adoption on resource use and time-to-completion, providing our organization and others with better information to make high-level organizational decisions about ML.

Background Partner notification (PN) after a sexually transmitted infection (STI) diagnosis is being promoted as a means to interrupt transmission chains. We investigated whether Internalised Homonegativity (IH) is associated with PN among men having sex with men (MSM). Methods PN, defined as notifying at least one partner after diagnosis of syphilis and gonorrhoea, was queried in two internet-based self-completion surveys conducted between Oct 2017 and May 2018 in 68 countries in Europe, Latin America, Canada, and the Philippines. IH is defined by a man’s level of agreement or disagreement with negative social beliefs about male homosexuality. Covariates included in a multivariate regression model with a random intercept at country level were age, HIV diagnosis, partnership status, sexual self-efficacy, HIV serostatus communication during last sex with a non-steady partner, place where this partner was met, and PN-related socio-historical background of the country of residence. We grouped countries in three areas: North- and Central-Western European countries plus Canada, former socialist countries, and Latin-American/Mediterranean countries plus the Philippines. In each of the three areas individuals were assigned to 4 subgroups based on IH quartiles and PN rates were determined for each subgroup. Results PN rates were calculated for 49 countries (excluding countries with less than 10 diagnoses). Mean proportions of MSM notifying their partners were 68.1% and 72.9% after syphilis and gonorrhoea diagnoses, respectively. PN rates were lower in Latin American countries and the Philippines compared to European countries. Within Europe, a North–South divide with lower PN rates in Mediterranean countries was observed. In each of the three regions we mostly observed a stepwise increase of PN rates with decreasing IH. Regression analysis showed lower IH scores associated with higher PN rates. Higher perceived self-efficacy, living in a partnership, and HIV status communication were positively associated with PN. Men who had met their last partner in a gay social venue were more likely to have notified their partners of a syphilis diagnosis compared to men who had met this partner online. Men with diagnosed HIV were less likely to report PN. Conclusions We could demonstrate that IH was associated with PN among MSM across all countries included in our analysis. Reducing cultural homophobia and ensuring inclusive policies may contribute to STI prevention and control.

Background Although the life expectancy of people living with HIV has increased, they are still often disconnected from society through stigma and discrimination. Peer support has been found to increase social support. Given the limited research on peer support from the providers' perspective, this study explored how peer supporters experience their roles and contributions in outpatient clinics (OPCs). Additionally, healthcare professionals' perceptions of working with peer supporters in OPCs were examined. Methods This qualitative study included purposively selected peer supporters (n = 10) and healthcare professionals (n = 5) from five OPCs in Norway in 2020. In-depth interviews and focus group discussions were conducted in Norwegian or English, using interview guides. Interview transcripts were analysed in NVivo 12 using reflexive and collaborative thematic analysis. Results The results show that peer supporters experience mutual support through emotional and honest interactions. Further, the peer supporters found it essential to negotiate with the service users about their preconception of HIV, confront their views through dialogue, and replicate positive experiences by being credible role models. The participants expressed that integrating peer support in the OPCs' usual care processes increased the prospect of equitable services. Quality of peer support and role clarity were identified as critical components. The results demonstrate that emotional and honest conversations promote support between peers and that peer supporters identify a need for a reframed understanding of HIV by modelling plausible alternative interpretations and coping experiences. Conclusions This study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care.

Background Although human immunodeficiency virus (HIV) has become a manageable condition with increasing life expectancy, people living with HIV (PLHIV) are still often isolated from society due to stigma and discrimination. Peer support provides one avenue for increased social support. Given the limited research on peer support from the perspective of PLHIV, this study explored their experiences of peer support organised by healthcare professionals in an outpatient clinical setting. Methods The study used a qualitative, descriptive research design for an in-depth understanding of peer support provided to PLHIV in the context of outpatient clinics. Healthcare professionals contributed to the recruitment of 16 participants. We conducted in-depth interviews about participants' experiences of peer support, and performed a directed content analysis of the data. Further, we sorted the data into pre-determined categories. Results The pre-determined categories constituted attachment, social integration, an opportunity for nurturance, reassurance of worth, reliable alliance, and guidance. The identified themes were: gained emotional support, disclosure behaviour allowed garnering of emotional support, non-disclosure promoted the need to meet a peer, experienced a sense of belonging, activated an opportunity for mutual support, means to re-establish belief in one's own worth, perceived a positive affirmation of disease management, facilitated dialogue about disease management, the outpatient clinic as a safe place, and a setting for flexible, individualised support. Conclusions This study highlights the peer support experiences of PLHIV in the context of outpatient clinics. The participants' experiences align with previous findings, showing that peer support contributes to mutual emotional support between peers. This is particularly important in cultures of non-disclosure where PLHIV experience intersectional stigma. Additionally, our results show outpatient clinics to be supportive surroundings for facilitating peer support, ensuring confidentiality in peer support outreach. Therefore, peer support contributes positively to individualising outpatient clinic services to meet the changing needs of PLHIV.