Bias assessment

The Mixed Methods Appraisal Tool (MMAT) was used by two independent reviewers to determine study quality with a third resolving discrepancies [49]. Quality was calculated using five domains scoring one point per domain achieved to a total of 5, with 5 equating to the highest study quality and 0 the lowest. Study designs were defined as qualitative, quantitative randomised controlled trial, quantitative non-randomised, quantitative descriptive, or mixed methods. Investigated domains for potential bias differed for each study design; however, all included analysis of participant selection, data collection, interpretation, and data reporting. No variation was made to study interpretation based on MMAT scores of 3 or more although study findings scoring 2 were assessed more critically. Studies scoring 0 or 1 were excluded.