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4.
Health Res Policy Syst ; 17(1): 68, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324187

RESUMO

BACKGROUND: Although enhanced priority-setting for investments in health research for development is essential to tackling inequalities in global health, there is a lack of consensus on an optimal priority-setting process. In light of the current surge in tuberculosis (TB) research investment, we use TB as a case study. METHODS: We investigated two critical aspects of a research prioritisation process, namely the criteria that should be used to rank alternative research options and which stakeholders should be involved in priority-setting. We conducted semi-structured interviews with 24 key informants purposively selected from four distinct groups - academia, funding bodies, international policy or technical agencies, and national disease control programmes. Interview transcripts were analysed verbatim using a framework approach. We also performed a systematic analysis of seven diverse TB research prioritisation processes. RESULTS: There was consensus that well-defined and transparent criteria for assessing research options need to be agreed at the outset of any prioritisation process. It was recommended that criteria should select for research that is likely to have the greatest public health impact in affected countries rather than research that mainly fills scientific knowledge gaps. Some interviewees expressed strong views about the need - and reluctance - to make politically challenging decisions that place some research areas at a lower priority for funding. The importance of taking input from stakeholders from countries with high disease burden was emphasised; such stakeholders were notably absent from the majority of prioritisation processes we analysed. CONCLUSIONS: This study indicated two critical areas for improvement of research prioritisation processes such that inequalities in health are better addressed - the need to deprioritise some research areas to generate a specific and meaningful list for investment, and greater involvement of experts working in high disease-burden countries.


Assuntos
Pesquisa Biomédica/organização & administração , Prioridades em Saúde/organização & administração , Tuberculose/epidemiologia , Pesquisa Biomédica/economia , Saúde Global , Pesquisa sobre Serviços de Saúde/organização & administração , Humanos , Internacionalidade , Entrevistas como Assunto , Política , Apoio à Pesquisa como Assunto/organização & administração , Universidades/organização & administração
5.
Health Res Policy Syst ; 17(1): 67, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319867

RESUMO

BACKGROUND: Healthcare research funders may undertake various roles to facilitate implementation of research findings. Their ability to enact such roles depends on several factors, knowledge of implementation being one essential requirement. However, previous studies do not assess the type or level of knowledge about implementation that research funders possess. This paper therefore presents findings from a qualitative, inductive study of the implementation knowledge of research funders. Three aspects of this knowledge are explored, namely how research funders define implementation, their level of self-assessed implementation knowledge and the factors influencing their self-assessment of implementation knowledge. METHODS: Research funders (n = 18) were purposefully selected from a sample of research funding organisations in Sweden (n = 10). In-depth semi-structured interviews were conducted, recorded and transcribed verbatim. An inductive method using a systematic coding procedure was employed to derive the findings. RESULTS: The research funders defined implementation as either an outcome or a process, with the majority believing that implementation of healthcare research results demands a process, although its complexity varied in the research funders' view. They perceived their own level of implementation knowledge as either limited or substantial, with a majority regarding it as limited. Clinical research experience, clinical experience and task relevance were singled out as the clearest factors affecting the self-assessment of their own implementation knowledge. CONCLUSIONS: This study, the first to focus on implementation knowledge of research funders, demonstrates that they are a category of policy-makers who may possess knowledge, based on their previous professional experience, that is comparable to some important findings from implementation research. Consequently, the findings not only pinpoint the relevance of professional experience, but also reveal a lack of awareness and knowledge of the results of implementation research among research funders in charge of healthcare research.


Assuntos
Pesquisa sobre Serviços de Saúde/organização & administração , Conhecimento , Apoio à Pesquisa como Assunto/organização & administração , Pesquisa Médica Translacional/organização & administração , Difusão de Inovações , Pesquisa sobre Serviços de Saúde/economia , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Suécia
12.
JAMA Netw Open ; 2(1): e187498, 2019 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-30681715

RESUMO

Importance: Incomplete information about existing research is an underlying cause of research waste. National and international initiatives and requirements have been launched to address this issue. Objectives: To characterize current clinical trial transparency policies among the largest noncommercial US funders and examine whether the policies are concordant with international funders. Design, Setting, and Participants: This retrospective review of public information used methods developed for documenting funder policies internationally; 2 researchers searched each funder's website and Google between May and November 2018 to locate trial transparency policies for 10 top US funders. Key informants at each funding organization were contacted by email and given 3 or more weeks to review and confirm or correct the findings. Nonresponders were contacted 2 or more additional times. Descriptive statistics were calculated to summarize the findings. The study was conducted using publicly available policy information with findings confirmed by funder representatives where possible. Participants included top 10 noncommercial US health research funders with the highest reported investment in health research (2013 dollars) who fund clinical trials. Data analysis was conducted from November 6, 2018, to November 23, 2018. Exposures: Availability of policies addressing each of the 3 key trial transparency domains as specified by the World Health Organization in 2017. Main Outcomes and Measures: Independent assessment by 2 investigators of availability (yes or no) of a policy addressing registration for trials, sharing of summary results, and individual participant data sharing activities; requirements (yes, no, or supportive statement) of these policies in terms of completeness, timeliness, public access, and provision of additional technical or financial support to meet data sharing requirements; description (yes or no) of internal monitoring for policy adherence. Results: All 10 funders acknowledged the outreach. One funder who indicated that less than 1% of their research funding goes to clinical trials was removed. Six (67%) of the remaining 9 top US funders have a publicly available written policy for all 3 major trial transparency domains. The most comprehensive trial transparency practice among US funders addresses summary results sharing as follows: 8 of 9 US funders (89%) have a policy, 5 of 9 US funders (56%) require reporting of summary results within 1 year, and 6 of 9 US funders (67%) monitor compliance with their summary results sharing policy. For clinical trial registration, 7 of 9 US funders (78%) have a policy and 5 of 9 US funders (56%) require registration and monitor trial registration to measure adherence to the policy. Conclusions and Relevance: In this study, overall the proportion of US funders with policies and practices to support trial transparency in this sample was similar or compared favorably with the larger international sample of noncommercial funders recently reported.


Assuntos
Acesso à Informação , Ensaios Clínicos como Assunto/organização & administração , Disseminação de Informação , Política Organizacional , Apoio à Pesquisa como Assunto/organização & administração , Pesquisa Biomédica/economia , Ensaios Clínicos como Assunto/economia , Humanos , Estudos Retrospectivos , Estados Unidos
16.
J Public Health (Oxf) ; 40(suppl_2): ii12-ii15, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30551132

RESUMO

Background: The IDRC 'Strengthening Equity through Applied Research Capacity building in eHealth' (SEARCH) funded seven research projects in Bangladesh, Burkina Faso, Ethiopia, Kenya, Lebanon, Peru and Vietnam that sought to answer questions or test solutions related to the use of Internet or mobile phone technology in strengthening health systems. The evaluation accompanied these projects over two years to answer, among others, the question how cross-grant learning interactions influenced project outcomes. Methods: The evaluation team conducted repeated interviews and on-line questionnaire surveys with the research teams and analysed the information exchanges among researchers on a SharePoint site established by IDRC. Results: The expectations of the SEARCH program in terms of cross-project learning were only partially realized. The diversity of themes, language barriers and differences in context were cited as main reasons. Non-facilitated active cross-grant networking was only observed between two teams working in English on thematically similar issues. However, networking among all projects was active during two program workshops organized by IDRC. Conclusions: Networking among research teams can increase the quality and the applicability of health systems research and potentially promote knowledge translation. Spontaneous networking across language barriers is, however, difficult. Effective global research networks require dedicated human and financial resources to keep them vibrant and alive. Keywords: e-health, refugees.


Assuntos
Pesquisa sobre Serviços de Saúde/métodos , Telemedicina , Telefone Celular , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Países em Desenvolvimento , Pesquisa sobre Serviços de Saúde/organização & administração , Humanos , Relações Interinstitucionais , Cooperação Internacional , Internet , Entrevistas como Assunto , Avaliação de Programas e Projetos de Saúde , Apoio à Pesquisa como Assunto/métodos , Apoio à Pesquisa como Assunto/organização & administração , Telemedicina/métodos
18.
Am J Public Health ; 108(12): 1613-1616, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30359103

RESUMO

American Indian and Alaska Native (AI/AN) communities harbor understandable mistrust of research. Outside researchers have historically controlled processes, promulgating conclusions and recommended policies with virtually no input from the communities studied. Reservation-based communities can apply sovereignty rights conferred by the federal government to change this research trajectory. Many tribes now require review and approval before allowing research activities to occur, in part through the development of regulatory codes and oversight measures. Tribal oversight ensures that research is directed toward questions of importance to the community and that results are returned in ways that optimize problem solving. Unfortunately, tribal governance protections do not always extend to AI/ANs residing in urban environments. Although they represent the majority of AI/ANs, urban Indians face an ongoing struggle for visibility and access to health care. It is against this backdrop that urban Indians suffer disproportionate health problems. Improved efforts to ensure responsible research with urban Indian populations requires attention to community engagement, research oversight, and capacity building. We consider strategies to offset these limitations and develop a foundation for responsible research with urban Indians.


Assuntos
Grupo com Ancestrais Nativos do Continente Americano , Saúde Pública , Pesquisa/organização & administração , População Urbana , Nativos do Alasca , Fortalecimento Institucional/organização & administração , Participação da Comunidade , Pesquisa Participativa Baseada na Comunidade/organização & administração , Competência Cultural , Comitês de Ética em Pesquisa/organização & administração , Disparidades nos Níveis de Saúde , Humanos , Índios Norte-Americanos , Inuítes , Pesquisa/economia , Pesquisa/normas , Apoio à Pesquisa como Assunto/organização & administração , Estados Unidos , United States Indian Health Service
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