{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:12:55Z","timestamp":1788502375867,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Research integrity (RI) is the cornerstone of trustworthy and reliable research conduct and findings across all domains, particularly in the sensitive field of healthcare research. Despite the existence of international and institutional frameworks, the development and implementation of RI policies remain inconsistent across healthcare research institutions. There are multilevel determinants like individual, organisational and system level barriers and facilitators of RI policies. Existing evidence regarding these determinants has not been systematically synthesised to inform policy and governance. This review aims to integrate qualitative and quantitative evidence on multilevel factors influencing RI policy development and implementation in healthcare research institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This systematic review will be conducted according to the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews of evidence. Qualitative, quantitative and mixed-methods records will be searched in MEDLINE (Ovid), Scopus, Cochrane CENTRAL, CINAHL (Ovid), Embase (Ovid), PsychINFO and Epistemonikos. Grey literature will be searched in ProQuest Dissertations and Theses Global (EBSCOhost), OAIster and Google Scholar. Methodological quality will be assessed using appropriate JBI critical appraisal tools.<\/jats:p>\n                    <jats:p>A convergent integrated approach will be employed. Depending on the nature of the extracted data, appropriate data transformation will be done to enable integration. Integrated findings will be synthesised thematically across individual, organisational and system levels. Confidence in the integrated findings will be assessed using an approach informed by Grading of Recommendations Assessment, Development and Evaluation (GRADE), GRADE-CERQual and JBI principles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study does not involve human participants. This is a secondary data analysis. Ethical approval is not required as this study involves analysis of published and publicly available data. Findings will be disseminated through publication in a peer-reviewed journal and presented at scientific conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration<\/jats:title>\n                    <jats:p>CRD420261279317.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117248","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:00:48Z","timestamp":1787227248000},"page":"e117248","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multilevel barriers and facilitators to the development and implementation of research integrity policies in healthcare research institutions: a Mixed-methods systematic review protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4815-5223","authenticated-orcid":false,"given":"Parvathy","family":"Balachandran","sequence":"first","affiliation":[{"name":"Amrita Vishwa Vidyapeetham, Amrita School of Dentistry, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1907-8708","authenticated-orcid":false,"given":"Chandrashekar","family":"Janakiram","sequence":"additional","affiliation":[{"name":"Amrita Vishwa Vidyapeetham, Amrita School of Dentistry, Kochi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7456-535X","authenticated-orcid":false,"given":"Anant","family":"Bhan","sequence":"additional","affiliation":[{"name":"Bhopal Hub, Sangath, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-2684","authenticated-orcid":false,"given":"Kavumpurathu Raman","family":"Thankappan","sequence":"additional","affiliation":[{"name":"Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini K","family":"Kumar","sequence":"additional","affiliation":[{"name":"Distinguished Scientist Chair, Ministry of AYUSH, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8123","authenticated-orcid":false,"given":"Jaideep C","family":"Menon","sequence":"additional","affiliation":[{"name":"Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"2026090322302609000_16.8.e117248.1","unstructured":"National Academies of Sciences, Engineering, and Medicine . 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