Methodological Quality of Included Studies
The Mixed Methods Appraisal Tool (MMAT)44 used to assess included quantitative, qualitative, and mixed-methods studies. There was a meaningful variation in the methodological quality of the included articles, with scores ranging from 25% to100%; the score of each type of study is judged within its methodological scope as presented in Table 2. Also, the distribution of study design with study quality is presented in Table 3. The majority of studies (n=18, 50%) were methodologically adequate (>75%), noting that design and research perform were generally appropriate. Thirteen studies (36.1%) in score 75%, four studies (11.1%) in score 50%, and one study (2.8%) in score 25%.