While health services leaders rely heavily on information gathered via environmental scans (ESs) to guide strategic decision-making, formal guidance on how to conduct these scans is notably absent. The purpose of this study was to determine the level of agreement on essential components of a definition and a methodological framework for ESs. The goals were to (1) advance our working definition to a concept definition for ESs and (2) develop a methodological framework to guide health service researchers conducting ESs.

We used a real-time, modified Delphi survey in a virtual platform setting to seek perspectives on statements related to ESs from individuals who were recruited based on having verifiable experience designing or conducting ESs in health services delivery research. Surveylet, an online software, was used to facilitate asynchronous data collection and to determine the level of agreement on the statements with an a priori threshold of 75% set for agreement on each statement.

21 panellists provided opinions on 59 statements related to a proposed ES definition and on 69 statements specific to components of a methodological framework for ESs.

Panellists from four countries participated in the survey representing 2 to ≥11 years of experience with ESs and having completed 1 to ≥7 ESs. Agreement was achieved in 28 of the 59 statements related to the ES definition and for 51 of 69 statements related to a methodological framework.

The agreement on many elements deemed essential for a definition of ES support development of a proposed concept definition of ES in health service delivery research. As well, the agreement on components deemed necessary for a methodological framework will help in future development of such a framework to guide stakeholders in the planning and implementation of ESs. These results provide a starting point for a common understanding of ESs in the field of health services delivery research.

Women with severe mental illness (SMI) face barriers to cervical cancer screening, leading to lower participation and poorer outcomes. This research aimed to develop and test an informed-choice tool to help women with SMI make informed decisions about screening attendance.

The tool was developed using a realist review of physical health interventions and a systematic review of informed-choice tools for people with SMI. A mixed-methods approach informed its development. Usability and acceptability were assessed through semistructured interviews and the think-aloud method with service users (n=18), clinicians (n=16) and key informants. A preliminary proof-of-concept (n=25) evaluated the impact on decisional conflict—the uncertainty around making value-sensitive choices.

Conducted in two National Health Service (NHS) Mental Health Trusts (urban and rural). Participants included women with SMI accessing secondary mental healthcare, clinicians and service user groups. A key informants’ group guided clinical content.

A cervical screening informed-choice leaflet and an accompanying video.

The tool was usable and acceptable, especially for women overdue or never screened. It may reduce decisional conflict and increase screening uptake, potentially improving survival. An National Institute for Health and Care Research (NIHR)-funded feasibility trial (Improving uptake of cervical screening in people with severe mental illness (OPTMISE)) is underway. The current UK government guidance on Support for people who find it hard to attend cervical screening due to having a mental health condition or having experienced trauma or abuse is based on this research.

Future research may involve further assessments of the real-world impact of the tool and its adaptation to other health-related decisions.