Contemporary Health Research Research Articles

Conducting mental health research with rural and regional older Australians: Reflections and recommendations.

This commentary aims to assist emerging leaders of mental health research with older rural Australians through (i) affirmation that others share the barriers, pitfalls and challenges being faced; (ii) reinforcing the rationale making this a pertinent area for research; and (iii) opening a dialogue for best practice to engage older rural Australians in mental health research. Supporting the mental health of older adults is a pertinent global challenge, none more so than in rural Australia where restricted access to services and supports are compounded by limited help-seeking behaviours and capacity to engage with support. Paradoxically, such limitations also extend to impact researchers' ability to engage rural older Australians in mental health research, particularly when combined with the stoicism and stigma that often envelopes mental health, and the contemporary challenges posed by the emergence of technology. Such challenges are however not often discussed, more-often sidelined in favour of reporting positive research outcomes, or seeing emerging researchers eschew such focus entirely. Through this paper, the authors utilised critical self-appraisal and iterative reflection to identify four recommendations for undertaking contemporary mental health research with rural older Australians, namely to: plan realistically through a collaborative, authentic and respectful approach; identify community champions and build/maintain trust; diversify thought, approaches and methodology; and cast the research net far, wide and often. By adopting recommendations, researchers can maximise accessibility to and possible participation in mental health research, providing foundations for older rural Australians' contributions to inform the development of policies and strategies to promote their health and well-being.

Characteristics of contemporary health research practice: A shift from ivory tower to collaborative power

Abstract The academic world is rapidly changing due to multiple influences, including COVID-19, technological advancement, tertiary competition, shifting government policies, and emerging research practices and priorities. Given this rapidly changing tertiary-education landscape, added importance is placed on the need for emerging research leaders to understand contemporary research practices which likely exceeds the skills displayed by their supervisors and mentors. Consequently, reflecting on 80+ years of collective post-PhD research experience, we identify and discuss six common characteristics of contemporary health research practice, with the aim of guiding and empowering higher degree by research students and emerging early career researchers as they develop their research identities and shape their approaches and values on the path to becoming research leaders in health. Indicative of today’s dynamic and exacting research environment, we propose that best practice contemporary health research should be: Diverse; Creative; Collaborative; Authentic; Respectful; and, Trusting. By understanding a diverse range of research approaches, and through working in collaborative and creative teams, diversity of thought, approach, and methods can become a cornerstone of practice. By blending this understanding with questions and research approaches that facilitate the pathway of translation uptake for the next-user, emerging research leaders can deliver authentic research with the requisite ingredients for impact.

DISCUSSING HEALTH WITHOUT ADULTS – YOUTH VOICES IN PEER-LED DISCUSSIONS ON TEENAGERS’ SUBREDDITS

Contemporary digital health research, policy and practice often engage young people in voicing their opinions with a participatory approach. Simultaneously, young people organise themselves on peer-led platforms like Reddit to talk about health without adults. Peer-led discussions on platforms like Reddit gives us access to a new perspective on how young people understand and experience health. This study investigates youth voices on health in teenagers’ subreddits on Reddit and responds to three research questions: how youth voices about health matters are represented in peer-led discussions; how the platform supports plural voices; and how the Bakhtinian dialogical account of voice can offer an alternative of non-unified, heterogeneous voices of young people to shortcomings of some participatory research, service, and policymaking. This study used unobtrusive digital ethnography and extant data collection methods to sample 50 posts related to physical, mental, and sexual health. Thematic analysis was conducted with grounded theory principles. Youth plural voices revealed different conceptualisations of health and diverse narratives about actors like parents, teachers, healthcare professionals and technologies involved in health experiences. Redditors engage in humorous and factual discussions equally and share both positive and negative health experiences. There is no unity in youth health meanings, but plurality and heterogeneity deserve more recognition and support. Analysing Reddit allows us to know what and how young people talk about health with their peers. Learning from the Reddit environment, adults may redefine their ideas of youth health to be more youth-centred and better align with young people’s needs.

Advancing application of satellite remote sensing technologies for linking atmospheric and built environment to health.

The intricate interplay between human well-being and the surrounding environment underscores contemporary discourse. Within this paradigm, comprehensive environmental monitoring holds the key to unraveling the intricate connections linking population health to environmental exposures. The advent of satellite remote sensing monitoring (SRSM) has revolutionized traditional monitoring constraints, particularly limited spatial coverage and resolution. This innovation finds profound utility in quantifying land covers and air pollution data, casting new light on epidemiological and geographical investigations. This dynamic application reveals the intricate web connecting public health, environmental pollution, and the built environment. This comprehensive review navigates the evolving trajectory of SRSM technology, casting light on its role in addressing environmental and geographic health issues. The discussion hones in on how SRSM has recently magnified our understanding of the relationship between air pollutant exposure and population health. Additionally, this discourse delves into public health challenges stemming from shifts in urban morphology. Utilizing the strategic keywords "SRSM," "air pollutant health risk," and "built environment," an exhaustive search unfolded across prestigious databases including the China National Knowledge Network (CNKI), PubMed and Web of Science. The Citespace tool further unveiled interconnections among resultant articles and research trends. Synthesizing insights from a myriad of articles spanning 1988 to 2023, our findings unveil how SRMS bridges gaps in ground-based monitoring through continuous spatial observations, empowering global air quality surveillance. High-resolution SRSM advances data precision, capturing multiple built environment impact factors. Its application to epidemiological health exposure holds promise as a pioneering tool for contemporary health research. This review underscores SRSM's pivotal role in enriching geographic health studies, particularly in atmospheric pollution domains. The study illuminates how SRSM overcomes spatial resolution and data loss hurdles, enriching environmental monitoring tools and datasets. The path forward envisions the integration of cutting-edge remote sensing technologies, novel explorations of urban-public health associations, and an enriched assessment of built environment characteristics on public well-being.

Aligning global health policy and research with sustainable development: A strategic market approach

AbstractAttaining Sustainable Development Goal 3 (SDG 3: Health and Well‐Being) faces a dual challenge of diminishing returns of established intervention designs, and a threat to future gains from complex inter‐connected global health challenges like antimicrobial resistance and global biodiversity loss. The growing movement of context‐sensitive approaches could help realise yet untapped potential for intervention designs, but contemporary global health policy and research still remain dominated by a model of individual market style choices. This paper therefore aims to support the development of global health planning processes that are more grounded and integrative across the SDGs. Reiterating calls for disruptive policy change is unlikely to impact the modus operandi of global health policy and research. This paper therefore builds on a logic that already finds widespread and intuitive application in their underlying planning processes: ‘the market’. However, it challenges the dominant supply‐and‐demand approach to healthcare markets and redefines them from a strategic marketing perspective. Translated to the interface of populations and health systems, the strategic market is a site for solving problems that are defined by people with multidimensional health needs. This framework offers four guiding questions to define the strategic market and six premises as a simple intellectual starting point and checklist for more grounded and inter‐sectorial action across the SDGs. The analysis of data from one of the largest behavioural survey data sets, covering 6683 villagers across China, India, Lao PDR and Thailand, demonstrates the relevance of the premises empirically.

Concretization, please: A commentary on Turcotte, Holmes, and Murray.

Concretization, please: A commentary on Turcotte, Holmes, and Murray.

“We should be at the table together from the beginning”: perspectives on partnership from stakeholders at four research institutions in sub-Saharan Africa

BackgroundGlobal health research partnerships have been scrutinised for how they operate and criticised for perpetuating inequities. Guidance to inform fair partnership practice has proliferated and the movement to decolonise global health has added momentum for change. In light of this evolving context, we sought in this study to document contemporary experiences of partnership from the perspective of stakeholders in four sub-Saharan African research institutions.MethodsWe conducted qualitative interviews with 20 stakeholders at research institutions in four countries in anglophone eastern and southern Africa. Interview questions were informed by published guidance on equitable research partnerships. Data was analysed through an iterative process of inductive and deductive coding, supported by NVivo software.ResultsEarly-career, mid-career and senior researchers and research administrators from four sub-Saharan African research institutions described wide-ranging experiences of partnership with high-income country collaborators. Existing guidelines for partnership provided good coverage of issues that participants described as being the key determinants of a healthy partnership, including mutual respect, role clarity and early involvement of all partners. However, there was almost no mention of guidelines being used to inform partnership practice. Participants considered the key benefits of partnership to be capacity strengthening and access to research funding. Meanwhile, participants continued to experience a range of well-documented inequities, including exclusion from agenda setting, study design, data analysis and authorship; and relationships that were exploitative and dominated by high-income country partners’ interests. Participants also reported emerging issues where their institution had been the prime recipient of funds. These included high-income country partners being unwilling to accept a subordinate role and failing to comply with reporting requirements.ConclusionsInsights from stakeholders in four sub-Saharan African research institutions suggest that contemporary global health research partnerships generate considerable benefits but continue to exhibit longstanding inequities and reveal emerging tensions. Our findings suggest that long-term support targeted towards institutions and national research systems remains essential to fulfil the potential of research led from sub-Saharan Africa. High-income country stakeholders need to find new roles in partnerships and stakeholders from sub-Saharan Africa must continue to tackle challenges presented by the resource-constrained contexts in which they commonly operate.

Vagueness and variety in person-centred care

Person-centred care is a cornerstone of contemporary health policy, research and practice. However, many researchers and practitioners worry that it lacks a ‘clear definition and method of measurement,’ and that this creates problems for the implementation of person-centred care and limits understanding of its benefits. In this paper we urge caution about this concern and resist calls for a clear, settled definition and measurement approach. We develop a philosophical and conceptual analysis which is grounded in the body of literature concerning the theory and practice of person-centred care. We consider a range of influential definitional frameworks of person-centred care, highlighting their differences and showing that they do not correspond to a clearly circumscribed and consistent underlying concept. We argue that a degree of indeterminacy and vagueness should not be seen as a problem with the concept of person-centred care; these are features of a rich and contested concept which exists prior to and outside of practical and technical operational definitions and applications. We defend the value of operating with multiple accounts of person-centred care, arguing that what counts as being person-centred can vary across different care contexts, in relation to different patient groups, and as a reflection of different, defensible ethical perspectives. Although the idea of a single, agreed definition is attractive and may seem to be a practical or even necessary step towards meaningful and coordinated action, we argue that this is only the case in a qualified sense. Comprehensive attempts to narrow down the concept in this way should be resisted, as they risk undermining what it is that makes person-centredness a valuable concept in healthcare.

Are you ready for Patient Engagement in Health Care?

Active patient engagement (PE) is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout public health and the research process. However, guidance for PE in research does not exist, the evidence base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. An explicit statement of values seeks to align all stakeholders on the purpose, practice, and credibility of PE activities. An innovative, flexible, and transparent research environment is valued as essential to developing a trustworthy evidence base with which to underpin future guidance for good PE practice. The recent focus on PE acknowledges that patients have an important role to play in their own health care. This includes reading, understanding and acting on health information (health literacy), working together with clinicians to select appropriate treatments or management options (shared decision-making), and providing feedback on health-care processes and outcomes (quality improvement). This review explores the values that should underpin PE in contemporary public health research to help inform future good practice guidance.

Vagueness and variety in person-centred care.

Person-centred care is a cornerstone of contemporary health policy, research and practice. However, many researchers and practitioners worry that it lacks a 'clear definition and method of measurement,' and that this creates problems for the implementation of person-centred care and limits understanding of its benefits. In this paper we urge caution about this concern and resist calls for a clear, settled definition and measurement approach. We develop a philosophical and conceptual analysis which is grounded in the body of literature concerning the theory and practice of person-centred care. We consider a range of influential definitional frameworks of person-centred care, highlighting their differences and showing that they do not correspond to a clearly circumscribed and consistent underlying concept. We argue that a degree of indeterminacy and vagueness should not be seen as a problem with the concept of person-centred care; these are features of a rich and contested concept which exists prior to and outside of practical and technical operational definitions and applications. We defend the value of operating with multiple accounts of person-centred care, arguing that what counts as being person-centred can vary across different care contexts, in relation to different patient groups, and as a reflection of different, defensible ethical perspectives. Although the idea of a single, agreed definition is attractive and may seem to be a practical or even necessary step towards meaningful and coordinated action, we argue that this is only the case in a qualified sense. Comprehensive attempts to narrow down the concept in this way should be resisted, as they risk undermining what it is that makes person-centredness a valuable concept in healthcare.

The Unique and the Universal: Analyzing the Interplay Between Regulatory Frameworks, Researchers and Research Participants in Data Making

Contemporary health research is becoming increasingly data intensive with a dependency on more data, of different types, and on more people. Multiple measures are therefore taken to ensure a variety of data, for example by re-appropriating data collected for purposes other than research. In genetic research, there is a general aim of more personalized diagnostics and treatments. Personalization in many ways depends on access to a universal data pool to gain statistical strength when identifying rare variants affecting unique individuals. If the aim of identifying the unique depends on access to the universal, how are we then to understand the dialectic between these two concepts? Further, if data-intensive research thrives on repurposing data, how does the repurposing affect the interests of the people from whom the data derive? In this article, we explore these questions by comparing two Danish initiatives aimed at making more data available for research through repurposing: one from a screening program of newborns at the beginning of life; and the other through an educational program collecting bodies after death. They both involve reinventing the original collection practices and they illustrate how regulatory frameworks, researchers and research participants reason differently about what can be considered as unique and as universal, as well as the risks and benefits involved in participating in data-intensive research.

Transcending the Male-Female Binary in Biomedical Research: Constellations, Heterogeneity, and Mechanism When Considering Sex and Gender.

Accounting for the influences of sex- and gender-related factors on health is one of the most interesting and important challenges in contemporary health research. In biomedical research, models, experimental designs, and statistical analyses create particular challenges in attempting to incorporate the complex, dynamic, and context-dependent constructs of sex and gender. Here, we offer conceptual elaborations of the constructs of sex and gender and discuss their application in biomedical research, including a more mechanism-oriented and context-driven approach to experimental design integrating sex and gender. We highlight how practices of data visualization, statistical analysis, and rhetoric can be valuable tools in expanding the operationalization of sex and gender biomedical science and reducing reliance on a male–female binary approach.

Stakeholders facilitating hope and empowerment amidst social suffering: A qualitative documentary analysis exploring lives of homeless women with mental illness.

Globally homeless mentally ill (HMI) individuals are considered one of the most vulnerable populations. An individual-centric, psychopathology-oriented focus of the existing mental health-care system limits the understanding of the HMI individuals through the disability lens overlooking their strengths and resilience that enable them to survive extremely hostile environments. Contemporary mental health research has embraced a paradigm shift that allows researchers to look beyond the predominant medical model to give precedence to a socio-culturally contexted and experientially firm understanding of human behaviour. Through the theoretical lens of social suffering, this article attempts to understand the lived experiences of the HMI women, the perspective of their caregivers and the standpoint of service providers in the context of homelessness and mental illness. A documentary analysis as a qualitative research methodology has been used to reflect upon the concerns mentioned above. Following Figueroa's approach to the analysis of audio-visual texts, the documentary Lapata Zindagi, directed by Radhika Lata Murthy, has woven the stories of four HMI women and their caregivers have been analysed. The two-phased analysis involved constructivist grounded theory procedures. The methodological steps, rigour and the resulting categories (experience of social suffering associated with homelessness among HMI women, denial of care and rights within patriarchy, helplessness associated with the burden of caregiving and roles of NGO and community in building hope and empowerment) have been discussed through the lens of social suffering and how stakeholders might facilitate hope and empowerment amidst it. The article highlights the dire and urgent need to integrate mental health into primary health care and community-based intervention and move beyond clinical recovery to nurture 'hope' to enable recovery and empowerment for such marginalised populations.

Black bodies and Bioethics: Debunking Mythologies of Benevolence and Beneficence in Contemporary Indigenous Health Research in Colonial Australia.

We seek to bring Black bodies and lives into full view within the enterprise of Indigenous health research to interrogate the unquestioned good that is taken to characterize contemporary Indigenous health research. We articulate a Black bioethics that is not premised upon a false logic of beneficence, rather we think through a Black bioethics premised upon an unconditional love for the Black body. We achieve this by examining the accounts of two Black mothers, fictional and factual rendering visible the racial violence Black bodies have been subjected to. We call for a Black bioethics that reimagines the Black body as beautiful and belonging-to both someone and somewhere.

Intersectionality of Resilience: A Strengths-Based Case Study Approach With Indigenous Youth in an Urban Canadian Context.

By bringing together two important areas of contemporary health research-resilience among Indigenous youth and intersectionality theory-this study advances an intersectionality of resilience framework that exposes intersecting forms of oppression within inner city urban contexts, while also critically reframing intersectionality to include strength-based perspectives of overlapping individual, social, and structural resilience-promoting processes. Drawing on Indigenous methodologies, a "two-eyed seeing" approach, and Stake's case study methodology involving multiple data sources (i.e., four sharing circles, 38 conversational interviews, four rounds of photovoice, and naturalistic interactions that occurred with 28 youth over an entire year), this qualitative study outlines three intersecting processes that facilitate youth resilience and wellness in various ways: (a) strengthening cultural identity and family connections; (b) engagement in social groups and service to self and community; and (c) practices of the arts and a positive outlook. In the end, implications for research, clinical practice, and health or community interventions are also discussed.

One Indigenous Academic’s Evolution: A Personal Narrative of Native Health Research and Competing Ways of Knowing

Indigenous health research should reflect the needs and benefits of the participants and their community as well as academic and practitioner interests. The research relationship can be viewed as co-constructed by researchers, participants, and communities, but this nature often goes unrecognized because it is confined by the limits of Western epistemology. Dominant Western knowledge systems assume an objective reality or truth that does not support multiple or subjective realities, especially knowledge in which culture or context is important, such as in Indigenous ways of knowing. Alternatives and critiques of the current academic system of research could come from Native conceptualizations and philosophies, such as Indigenous ways of knowing and Indigenous protocols, which are increasingly becoming more prominent both Native and non-Native societies. This paper contains a narrative account by an Indigenous researcher of her personal experience of the significant events of her doctoral research, which examined the narratives of Native Canadian counselors’ understanding of traditional and contemporary mental health and healing. As a result of this narrative, it is understood that research with Indigenous communities requires a different paradigm than has been historically offered by academic researchers. Research methodologies employed in Native contexts must come from Indigenous values and philosophies for a number of important reasons and with consequences that impact both the practice of research itself and the general validity of research results. In conclusion, Indigenous ways of knowing can form a new basis for understanding contemporary health research with Indigenous peoples and contribute to the evolution of Indigenous academics and research methodologies in both Western academic and Native community contexts.

If We Show Them Will They Come? Attitudes of Native American Youth Towards Higher Education

Indigenous health research should reflect the needs and benefits of the participants and their community as well as academic and practitioner interests. The research relationship can be viewed as co-constructed by researchers, participants, and communities, but this nature often goes unrecognized because it is confined by the limits of Western epistemology. Dominant Western knowledge systems assume an objective reality or truth that does not support multiple or subjective realities, especially knowledge in which culture or context is important, such as in Indigenous ways of knowing. Alternatives and critiques of the current academic system of research could come from Native conceptualizations and philosophies, such as Indigenous ways of knowing and Indigenous protocols, which are increasingly becoming more prominent both Native and non-Native societies. This paper contains a narrative account by an Indigenous researcher of her personal experience of the significant events of her doctoral research, which examined the narratives of Native Canadian counselors’ understanding of traditional and contemporary mental health and healing. As a result of this narrative, it is understood that research with Indigenous communities requires a different paradigm than has been historically offered by academic researchers. Research methodologies employed in Native contexts must come from Indigenous values and philosophies for a number of important reasons and with consequences that impact both the practice of research itself and the general validity of research results. In conclusion, Indigenous ways of knowing can form a new basis for understanding contemporary health research with Indigenous peoples and contribute to the evolution of Indigenous academics and research methodologies in both Western academic and Native community contexts.

Novel Approaches to Air Pollution Exposure and Clinical Outcomes Assessment in Environmental Health Studies

An accurate assessment of pollutants’ exposure and precise evaluation of the clinical outcomes pose two major challenges to the contemporary environmental health research. The common methods for exposure assessment are based on residential addresses and are prone to many biases. Pollution levels are defined based on monitoring stations that are sparsely distributed and frequently distanced far from residential addresses. In addition, the degree of an association between outdoor and indoor air pollution levels is not fully elucidated, making the exposure assessment all the more inaccurate. Clinical outcomes’ assessment, on the other hand, mostly relies on the access to medical records from hospital admissions and outpatients’ visits in clinics. This method differentiates by health care seeking behavior and is therefore, problematic in evaluation of an onset, duration, and severity of an outcome. In the current paper, we review a number of novel solutions aimed to mitigate the aforementioned biases. First, a hybrid satellite-based modeling approach provides daily continuous spatiotemporal estimations with improved spatial resolution of 1 × 1 km2 and 200 × 200 m2 grid, and thus allows a more accurate exposure assessment. Utilizing low-cost air pollution sensors allowing a direct measurement of indoor air pollution levels can further validate these models. Furthermore, the real temporal-spatial activity can be assessed by GPS tracking devices within the individuals’ smartphones. A widespread use of smart devices can help with obtaining objective measurements of some of the clinical outcomes such as vital signs and glucose levels. Finally, human biomonitoring can be efficiently done at a population level, providing accurate estimates of in-vivo absorbed pollutants and allowing for the evaluation of body responses, by biomarkers examination. We suggest that the adoption of these novel methods will change the research paradigm heavily relying on ecological methodology and support development of the new clinical practices preventing adverse environmental effects on human health.

Mental health, big data and research ethics: Parity of esteem in mental health research from a UK perspective

Central to ethical debates in contemporary mental health research are the rhetoric of parity of esteem, challenges underpinned by the social construct of vulnerability and the tendency to homogenise the population diagnosed with mental health conditions. Such ethical dimensions are further complicated by the contemporary endeavour to work with ‘big data’ which has led to ambitious claims for discovery and knowledge. Research in mental health is challenging due to the perceived constraints of ethical principles such as the protection of autonomy, consent, risk and harms. This article discusses how ethical considerations need to be reconceptualised when using big data sets. The argument is foregrounded with an appraisal of the prevailing political discourse of parity of esteem demonstrating that ongoing disparities in services and research should also be considered when inquiry uses big data.

Challenging Diversity: Steering Effects of Buzzwords in Projectified Health Care

This article discusses the effects of two trends in contemporary biomedicine that have so far been largely addressed separately: the steering of fields through programmatic “buzzwords” and the projectified nature of contemporary health research, care, and promotion. Drawing on a case study of an Austrian diversity-sensitive health promotion project related to obesity prevention, we show how the articulation of these trends—governance by buzzwords and projectification—often leads to not unproblematic and often paradoxical outcomes. Buzzwords such as “diversity” become especially important in an innovation-driven environment encouraging a promissory rhetoric. At the same time, the project form shapes and restricts how buzzwords (as typically vague terms that need to be fleshed out) are articulated and translated into a specific project design. In our case study of an obesity prevention program, the need to translate diversity into a “doable” project encouraged the identification of seemingly clearly delineated target groups and thus promoted a rather narrow understanding of diversity, which stands in tension with much more fluid and context-sensitive ways of performing “diversity.” We show how actors grapple with these paradoxes. This restricts the full power a buzzword such as diversity could achieve in terms of social justice.