How can outdoor sports protect themselves against climate change-related health risks? - A prevention model based on an expert Delphi study.

OBJECTIVES: To systematically develop an adaptation model to reduce climate change-related health risks for outdoor athletes. DESIGN: Delphi Method study. METHODS: A classic asynchronous Delphi study was conducted with a total of three survey rounds. 24 experts from the eight largest outdoor sport associations by membership in the German Olympic Sports Confederation were included as well as 24 medical experts with expertise in sport medicine, internal medicine, allergology, dermatology, infectiology, or toxicology. Based on open-ended questions, panelists were asked to consider prevention measures for sport organizations and clubs. Free text responses were analyzed by qualitative content analysis according to Mayring. RESULTS: Experts recommended establishing the following eight fields of prevention measures: technical and structural measures; organizational measures; personalized measures; basic, advanced, and continuing education; concepts of action, warning concepts, and financial concepts; cooperation and coordination; campaigns; and evaluation measures. CONCLUSIONS: The pyramid model presented in this study systematizes possible sport-specific adaptation measures on climate change by empirical aggregation of knowledge from scientists, sport organizations, clubs, trainers, and professional athletes. To assess the effectiveness of these prevention measures, sport organizations may incorporate them not only into broader operations but also everyday training routines.

Definition and terminology of developmental language disorders-Interdisciplinary consensus across German-speaking countries.

In recent years, there have been intense international discussions about the definition and terminology of language disorders in childhood, such as those sparked by the publications of the CATALISE consortium. To address this ongoing debate, a Delphi study was conducted in German-speaking countries. This study consisted of three survey waves and involved over 400 experts from relevant disciplines. As a result, a far-reaching consensus was achieved on essential definition criteria and terminology, presented in 23 statements. The German term 'Sprachentwicklungsstörung' was endorsed to refer to children with significant deviations from typical language development that can negatively impact social interactions, educational progress, and/or social participation and do not occur together with a potentially contributing impairment. A significant deviation from typical language development was defined as a child's scores in standardized test procedures being ≥ 1.5 SD below the mean for children of the same age. The results of this Delphi study provide a proposal for a uniform use of terminology for language disorders in childhood in German-speaking countries.

[What is a public health intervention? Results of a Delphi process in German-speaking countries]. / Was wird unter einer Public-Health-Intervention verstanden? Ergebnisse eines Delphi-Prozesses im deutschsprachigen Raum.

BACKGROUND: Internationally, a variety of definitions for public health interventions (PHI) exist. In the German-speaking countries, however, a definition is still outstanding. Therefore, the aim of this study was to derive consensus criteria for the definition of PHI from the expert perspective of science and practice. METHODS: A Delphi survey with two online rounds was conducted from December 2022 to February 2023. Six criteria were formulated by a working group and posed for consensus: 1) the intention of the intervention, 2) potential conflicts of interest of the initiators of the intervention, 3) primary vs. secondary/tertiary prevention, 4) costs, 5) targeting, and 6) the reach of the intervention. In both Delphi rounds, experts from academia and practice were recruited through relevant networks and associations throughout the German-speaking world. The judgments were asked about standardized rating scales with the possibility of open justification. RESULTS: In the first Delphi round, n = 52 and in the second round n = 43 experts from research, care and administration/management in health care participated. Consensus was reached on four of the six criteria after the second Delphi round: the intention of the intervention, possible conflicts of interest of the initiators of the intervention, primary vs. secondary/tertiary prevention, and the scope of the intervention. From the perspective of the experts interviewed, these are the criteria that distinguish PHI. DISCUSSION AND CONCLUSION: Based on the consensus criteria, PHI can be defined more concretely. Thus, the results contribute to a better inter- and transdisciplinary understanding. Ideally, the criteria will make it easier to assign interventions to the public health sector in the future, even if a precise examination will be necessary in individual cases, among other things because the experts disagreed on the criteria of costs and how to address the target group.

Argument-based QUalitative Analysis strategy (AQUA) for analyzing free-text responses in health sciences Delphi studies.

Delphi methods are mostly used in the health sciences to reach agreement among experts on unclear issues. Generally, consensus is reached after several rounds of Delphi using standardized items. Additional open-ended questions offer respondents the opportunity to provide reasons for judgments. Although these free-text responses contribute substantially to the steering and result generation of the Delphi process, so far no analytical strategy has been established which takes into account the context and methodological principles of the Delphi procedure. Moreover, in already published Delphi studies the analysis of qualitative data is often not sufficiently disclosed.•We provide an overview of analytical strategies for free-text responses. We critically reflect on them with regard to their use and suitability in the context of Delphi procedures.•Following established qualitative methods of qualitative content analysis according to Mayring and thematic analysis according to Braun & Clarke, we developed the Argument-based QUalitative Analysis strategy (AQUA) for Delphi studies in the health sciences and presented it using a concrete project example.•This newly developed strategy can significantly support the rule-governed and intersubjective evaluation of free-text responses in Delphi processes, the integration of the results into the feedback design, and thereby also the quality of the results.

[The Delphi technique: Methodology, variants and usage examples]. / Das Delphi-Verfahren: Methodik, Varianten und Anwendungsbeispiele.

In the field of medicine and health sciences, Delphi methods are applied mainly in the exploratory or evaluative phases of a research process. Explicit and implicit knowledge of respected experts from research and practice is systematically synthesized. Originally developed as a method for structuring a group communication process, Delphi techniques have been established in the health sector as a consensus method. The findings are used to improve the evidence and acceptance of planned interventions or necessary standards or guidelines and to increase the probability of successful implementation in practice. However, different variants of Delphi methods have been developed in recent years, which are systematically contrasted and reflected in this paper with regard to key epistemological and methodological research activities. Based on this overview, researchers should be enabled to select the most suitable Delphi technique for their own research questions and research endeavors.

Reporting guidelines for Delphi techniques in health sciences: A methodological review.

BACKGROUND: Delphi techniques are conducted across different subfields in the health sciences. The reporting practices of studies using Delphi techniques vary, and current reporting guidelines for Delphi techniques focus on individual subfields of the health sciences or on different aspects of research and are therefore of limited applicability. The aim of this article was to identify similarities, differences, and possible shortcomings of existing Delphi reporting guidelines and to draft an initial proposal for a comprehensively applicable reporting guideline. METHODS: A systematic literature search for reporting guidelines on Delphi studies was performed in existing data resources based on databases in the health sciences (Scopus, MEDLINE, CINAHL, Epistemonikos) including publications from 2016 to 2021. In June 2021, we conducted an additional search in PubMed and included further studies by contacting experts of the scientific Delphi expert network (DeWiss). Title and abstract screening of articles was performed, followed by a full-text screening of the articles included. We qualitatively and quantitatively evaluated, compared and contrasted the reporting guidelines identified using content analysis and discussed the results among the members of the Delphi expert network. RESULTS: We retrieved ten health science articles with reporting guidelines for Delphi studies. In analyzing them, we identified nine main categories (Justification, Expert panel, Questionnaire, Survey design, Process regulation, Analyses, Results, Discussion, Methods reflection & Ethics). The current reporting guidelines vary significantly, with only the aspect of consensus appearing in all of them. Frequency distributions show that most of the subcategories are only addressed in individual articles (e.g., meeting of participants, proceeding with the survey method, transfer of the results, validation, prevention of bias) and that epistemological foundations of the Delphi technique are rarely mentioned or reflected on. We drafted an initial proposal for Delphi reporting guidelines for the health science sector. DISCUSSION: A well-justified position concerning epistemological foundations of Delphi studies is necessary to make the quality of the process assessable and, along with the reporting of the process, to classify and compare study results. This will increase the acceptance of both the method in the health science sector and the results in medical practice. A Delphi reporting guideline must, above all, take into account the diversity of variants, subfield-related objectives and application areas, and their modifications of the Delphi technique in order to be comprehensively applicable in the health sciences. CONCLUSION: The results of our methodological review do not provide a final reporting guideline. The newly developed proposal is intended to encourage discussion and agreement in further analyses.

Coming to consensus: the Delphi technique.

Delphi techniques are used in health care and nursing to systematically bring together explicit and implicit knowledge from experts with a research or practical background, often with the goal of reaching a group consensus. Consensus standards and findings are important for promoting the exchange of information and ideas on an interdisciplinary and transdisciplinary basis, and for guaranteeing comparable procedures in diagnostic and therapeutic approaches. Yet, the development of consensus standards using Delphi techniques is challenging because it is dependent on the willingness of experts to participate and the statistical definition of consensus.

Delphi Technique in Health Sciences: A Map.

Objectives: In health sciences, the Delphi technique is primarily used by researchers when the available knowledge is incomplete or subject to uncertainty and other methods that provide higher levels of evidence cannot be used. The aim is to collect expert-based judgments and often to use them to identify consensus. In this map, we provide an overview of the fields of application for Delphi techniques in health sciences in this map and discuss the processes used and the quality of the findings. We use systematic reviews of Delphi techniques for the map, summarize their findings and examine them from a methodological perspective. Methods: Twelve systematic reviews of Delphi techniques from different sectors of the health sciences were identified and systematically analyzed. Results: The 12 systematic reviews show, that Delphi studies are typically carried out in two to three rounds with a deliberately selected panel of experts. A large number of modifications to the Delphi technique have now been developed. Significant weaknesses exist in the quality of the reporting. Conclusion: Based on the results, there is a need for clarification with regard to the methodological approaches of Delphi techniques, also with respect to any modification. Criteria for evaluating the quality of their execution and reporting also appear to be necessary. However, it should be noted that we cannot make any statements about the quality of execution of the Delphi studies but rather our results are exclusively based on the reported findings of the systematic reviews.

[Mixed-methods studies in the field of health promotion. Results of a systematic review of German publications]. / Mixed-Methods-Studien in der Gesundheitsförderung. Ergebnisse eines systematischen Reviews deutschsprachiger Publikationen.

Research in the field of health promotion generates evidence-based knowledge and has the potential to increase the acceptance, impact and long-term effectiveness of interventions. Typically, a distinction is made between qualitative and quantitative approaches. Yet, with complex and multidimensional re-search questions in the field of health promotion a combination of the two approaches has proven useful. Using mixed-methods designs promises, among other things, to compensate for weaknesses of the individual methods, to improve the scope of the results, and to provide a comprehensive insight into the topic. In this systematic review of two German journals we examine the role of the mixed-methods approach in the field of health promotion and how it can be translated into specific research projects. The review's results show that mixed-methods designs are implemented in various contexts. In most studies, the quantitative research strand plays the central role. The use of the mixed-methods designs in health promotion can be further discussed, especially taking into account technical innovations in the field of data collection or with regard to the interpretative potential of qualitative research. The presentation of the review is based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) by the Equator Network.

[Mixed methods studies in the health sciences. A critical map]. / Mixed-Methods-Studien in den Gesundheitswissenschaften. Ein kritischer Überblick.

Mixed methods studies (MMS) play an increasingly important role in the health sciences. Its potential lies in the acquisition of causal conditions and in the intersubjective understanding of diverse and new phenomena. The holistic and multi-perspective analysis strategy of MMS also allows a subject-oriented and an evidence-based approach to clinical practice. The article reviews the use of MMS in the health sciences on the basis of various reviews, and it highlights current methodological developments and research gaps.