Table 1 Summary of key findings from framework analysis

Use of systematic reviews in decision-making

• Systematic reviews used to some extent in commissioning and policy-making.

• Other evidence used alongside or instead of reviews, with grey literature from specific organisations highly valued.

• Use of systematic reviews varies between individuals, job roles and LAs.

Finding and selecting reviews

• PHPs have search and appraisal skills but time is a barrier.

• Literature often found through quick searches or other routes and quality assessed informally.

• Diverging views on the value of non-systematic reviews, with factors other than methodology more important for some PHPs.

Barriers to use

• Limited number of reviews on some key topics in LA public health, narrow focus of reviews and restricted access to full texts are all key barriers.

• Other barriers include generalisability to place and LA context and the involvement of politicians in decision-making.

Improving the usefulness of systematic reviews

• Suggestions included providing executive summaries, recommendations for practice and economic evidence.

Role of PHPs in advocating for evidence use

• Senior PHPs perceive themselves as having role advocating for use of evidence in wider LA.

• Commitment to evidence use linked to professional identity.

• Evidence used in range of ways to influence or persuade, including symbolic use and more nuanced ways.

Engagement with research outside decision-making

• PHPs frequently engage with research, often through a personal commitment to maintaining knowledge and professional development.

Value of systematic reviews in LA context

• Systematic reviews highly valued in principle but limits to value and impact in LAs.

• Decision-making is complex and there are contesting interpretations of evidence, with local and anecdotal evidence valued.