STEP 6 – FOCUSED PRACTICE QUESTION REPORT GUIDE
(v. October 2015)
Notes about style and format:
The target audience is decision makers.
Include information on a need-to-know basis (this is not an academic paper).
Write in sentences, in plain language, as you would speak.
Check grammar and punctuation.
Explain definitions of health conditions and statistical tests in plain language.
Follow a 1:10 format: one (optional) page of key messages, and an up-to-10-page full
report.
Use the report template provided. Notes on using the template follow.
Link to report template:
[insert link]
Link to examples of completed focused practice question reports:
http://www.peelregion.ca/health/library/literature-reviews.asp
Title
Create a major title, followed by the minor title “A Focused Practice Question” on a
separate line.
Use the fewest words and the plainest language for the major title that gets the precise
meaning across in a two-line maximum (about eight words in Arial 24-pt font).
Begin the major title with an action verb if possible. For example, “Making Immunization
Decisions for School-aged Children,” “Communicating Urgent Environmental Risks.”
Style Notes
Use title case: Capitalize significant words.
No punctuation is needed at the end of either title.
Key Messages (optional)
One page, in numbered list format. Write this section last.
Provide, in plain language, up to six statements that are the “bottom line.” These are
derived from the evidence itself.
Full Report
Up to 10 pages in total, consisting of the sections that follow:
1. Issue & Context
Up to one-half page (6 sentences). Include only what is relevant for your issue.
Outline, in plain language, a statement of the practice question. Ask yourself, and
answer in this section, why this question is important to address, and why has it come
about at this point in time?
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Include available data about the incidence and prevalence of the health issue in
Peel. In addition, if available, include any relevant provincial or national data.
Include any information that compares the incidence and prevalence data with those
of other relevant jurisdictions.
Provide definitions for conditions if they would not be widely understood by the target
audience.
Describe any political situations or issues of relevance in the Peel context.
Describe any community situations or issues of relevance in Peel, including
important partnerships that could be affected by any practice or policy change
implemented as a result of the review.
Describe any practice issues for Peel Public Health and other public health
organizations that may be directly and/or indirectly affected by this review.
Outline the financial and resource implications of any practice or policy change
implemented as a result of the review, if they might be significant.
Be sure, when quoting references, to use the primary source or reference and not a
secondary reference (e.g., where an agency has quoted a primary reference).
Make sure each initial reference to a source explicitly names the source (see
References section below).
2. Literature Review Question
Up to two sentences.
Include the plain language question and the question in PICO (population,
intervention, comparison and outcome) format, as appropriate .
3. Literature Search
Four to five sentences.
List all sources searched (e.g., websites, databases, reference lists, journals, experts
contacted), the date the search was conducted (i.e., month, year), and any search limits
(e.g., dates, language, type of paper).
Append the search strategy in Appendix B.
4. Relevance Assessment
Four to five sentences.
Describe the process used to assess relevance (e.g., number of assessors, method
to resolve any discrepancies).
List the relevance criteria used to determine which papers to include in the review.
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
Inclusion criteria are those factors used to determine that a paper should be
appraised for quality (e.g., the paper is a systematic review, aligns with the
elements of the PICO question).
 Exclusion criteria are other factors which eliminated papers from critical
appraisal (e.g., duplicate, not within date range, not English language). These
should be new criteria, not just the negative of the inclusion criteria.
List the relevance criteria using two bullets, one each summarizing the inclusion and
exclusion criteria. Example:
“The studies were assessed based on the following criteria:
 Inclusion criteria: English language; published in the last five years;
tobacco prevention included as an outcome; includes late teens,
young adults and adults in target population
 Exclusion criteria: Duplicates; focused on children”
Adapted from: Effective Interventions to Prevent Males in their Late Teens and
Early Twenties from Progressing to Regular Smoking. Ho and Fitzgibbon, 2014.
5. Results of the Search
Two to four sentences.
Describe the total number of papers of each type identified in the final version of the
implemented search.
Describe how many articles of each type were found to meet the relevance criteria.
Append the search results flowchart in Appendix C.
6. Critical Appraisal
Four to six sentences.
Describe the process used to appraise quality (e.g., the tool used to assess quality,
how many reviewers independently completed the assessments and the method to
resolve any disagreement in assessment among reviewers).
Describe how many papers of each type were assessed to be of weak, moderate or
strong quality.
Include a summary statement stating the final number of papers included in the
review. The final papers included do not need to be named in this section.
Include a statement about any papers that were excluded based on a weak quality
score.
7. Description of Included Studies
Up to five sentences for each included paper.
Describe the included papers (usually guidelines or systematic reviews), including:
title, author, year of publication, paper type (e.g., guideline, systematic review), number
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of studies included (if the paper is a synthesis), or number of reviews used to produce it
(if the paper is a guideline), and quality rating from the critical appraisal.
Describe the settings, population, interventions (describe the studied interventions in
enough detail so that the interventions could be reproduced), any comparisons, and the
outcomes studied if available. (Do not describe the results or findings here, just describe
what the authors studied.)
Append the details (which also include the main findings for each paper) in data
extraction tables in Appendix D.
Link to examples of data extraction tables:
http://www.peelregion.ca/health/library
Style Notes
To present each paper, use an abbreviated version of the full reference as a secondlevel subheading. The heading should contain abbreviated authors, year, full title of the
paper and reference list number (see example below).
Include, for each study, the type of study and its assessed quality rating in the first
line of the description (see example below).
Example:
LaRocca et al. (2012): The effectiveness of knowledge translation
strategies used in public health (4)
The objective of this systematic review, rated as strong, was to “address
which knowledge translation (KT) strategies are most effective among
practitioners, managers and policy makers to promote the use of research
evidence in public health settings.” Five primary studies were included in …
Adapted from: Effective Knowledge Translation Tactics for Increasing the Use
of Health Status and Surveillance Data. Kujbida and Stratton, 2014.
8. Synthesis of Findings
Three to four sentences for each conclusion (depending on number of references
supporting each conclusion).
Interpret the findings of the included papers as follows:
o Provide an overall summarizing statement for each conclusion (by outcome or
intervention, depending on how you decide to present the findings) and include the
population studied. Use PICO when stating your results. Example:
“There was no effect shown among 7- to14-year-old school children [population]
of curriculum-based interventions [intervention] compared to educational
interventions [comparison intervention] on screen time [outcome].”
o Following the overall statement, describe the relevant findings that support the
conclusion. Include the source of these findings using Vancouver style.
o Where effects were found, report the magnitude or size of the effect, with applicable
statistics for each intervention. Where applicable, interpret the effect size. Example:
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At 15-60 months post vaccination, participants who received the HPV vaccine
(population) were 64% less likely to develop any cervical lesions (outcome)
compared to those not vaccinated (comparison population) (OR 0.36, 95% CI
0.29 to 0.45).
Style Notes
Present each finding as a bullet with the overall summarizing statement in bold font,
followed by the supporting information in regular font. Example:

As the average volume of alcohol consumption increases, the lifetime risk
of alcohol-related disease increases. For younger men (<45 years old), there
is a linear relationship between the volume of alcohol consumed and all-cause
mortality (RR=1.09 at >10g/day). However, for both men and women over age
45, a J-shaped relationship emerges, with …
Adapted from: Alcohol impacts health: A rapid review of the evidence, Kaptein,
Wan, Amorim, Smith and Bromby, 2013.
9. Limitations and Gaps
Two to five sentences.
Describe any information about the amount, quality or focus of the literature that is
relevant to the topic or conclusions.
10. Relevance to Practice
Two to five sentences.
Based on the evidence, outline any practice changes that will be made.
11. References
Include all references quoted in your paper in your reference list in the order in which
they appear. For help using write and cite, contact the library.
Use Vancouver style to reference sources. In brief, this requires
1) naming the source in the text the first time it’s used,
2) assigning a number to each source,
3) placing a list of numbered references at the end of the body of the report as
endnotes, and
4) using these reference numbers when citing the source thereafter.
For example, the passage below clearly sets out the initial references to three sources
cited (underlining for illustration purposes only):
Peer support was cited in the Mandatory Health Programs and Service
Guidelines (1997) as a strategy to promote and support breastfeeding (1). The
current Ontario Public Health Standards (2008) do not require peer support for
breastfeeding (2). Providing peer support is one criterion for Baby Friendly
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designation by the Breastfeeding Committee for Canada (3), which was achieved
by Peel Public Health in 2009.
Adapted from: Effect of Peer Support on Breastfeeding Initiation, Duration and
Exclusivity: Evidence for Public Health Decision Making. Walker, DeVouge,
Chang and Notten, 2012.
Link to information about using the Vancouver style:
[https://www.york.ac.uk/integrity/downloads/17060_Vancouver%20style-web.pdf].
12. Appendices
Use simply “See Appendix X” at the end of the appropriate section. (The title of the
appendix or a description of its contents aren’t necessary.)
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About the Focused Practice Question Report Template
The template for Focused Practice Question reports assigns specific styles to fulfill
specific functions. The basic approach is outlined below:

All style names for the focused practice question format are preceded by FPQ.

The base font is Arial, 12-pt, regular.

Paragraph text is fully justified and not indented.

Paragraph text is double-spaced. Additional paragraph spacing is automatically
added before each new paragraph or subheading.

Headings and bulleted lists are left-justified (use ragged right margin).

Titles, headings and table entries may use a different font size or appearance;
these elements are built into the styles for those items.

Three levels of sub-headings have been constructed and are followed
automatically by normal text.

Two levels of bullets have been constructed and are followed automatically by
the same level of bullet. No additional paragraph spacing occurs between bullets,
or between the lead-in and initial bullet.

Tables use Arial, 10-pt, regular as the base font. Table text, column titles and row
titles each have specific styles assigned. Rows or columns can be added to a
table as needed, and the font size can be reduced only if absolutely necessary in
the 20-page body of the report. [Data extraction tables in the appendices can use
smaller fonts.]

A two-page Style Aid immediately follows the title page. Its text illustrates the
styles available. It should be deleted before a draft is circulated.
Using the Template
Save a copy of the report template under the file name you want to use for your focused
practice question.
Keep the Style Aid as part of your draft so you can refer to it as needed.
Type directly into the template, typing over the dummy text in each section which is
automatically in the correct style.
When you need to apply a different style (for example, to switch from normal text to a
bulleted list), you can 1) apply the styles in the Styles menu, or 2) use the Style Aid and
the format painter feature in Word.
1. Apply the styles listed on the Styles menu, located on the Home tab.
a. Highlight the text you want to apply a new style to (for example, to turn a
line of normal text into a first-level bullet, highlight the line of normal text).
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b. On the Styles menu, click on the arrow at the bottom of the Styles ruler
(right side of box containing the styles). This will expand the box and show
all of the styles available.
c. Click on the style you want to apply (for example, FPQ Bullet1). The style
will be automatically applied to the text you highlighted earlier.
2. Use the Style Aid and the format painter feature in Word.
a. Find the format painter represented by the paintbrush icon located on the
Home tab (left side of tab).
b. Position the cursor on existing text that contains the desired style you
want to apply to your new text, either in the Style Aid or elsewhere in your
document (for example, position the cursor on the first-level bullet in the
Style Aid, or on a pre-existing first-level bullet in your document).
c. Click the paintbrush icon on the Home tab to turn it on. (Clicking the
paintbrush once allows one application of the desired style; clicking it
twice allows unlimited applications of the desired style until you turn it off.)
d. Use the cursor to highlight the text you want to paint with the desired style.
The highlighted text will immediately change to the desired style.
e. If you double-clicked the paintbrush icon (to apply the same style to
several items), you’ll need to click on it again when you’re finished to turn
it off.
f. To make this easier, you can split the screen and keep the Style Aid
handy above the split while you work on the text below.
i. To split the screen: Position your cursor on the Style Aid where
you’d like the screen to split to give you sufficient working area
below it. On the View tab, click on “Split.”
ii. You can work in either area of the split screen, scrolling up and
down. This allows you to position your cursor on Style Aid items
easily and apply the styles in the working area of the screen below
without flipping through the document.
iii. To remove the split: On the View tab, click “Remove Split.”
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