Public Health Research Funding Research Articles

Current practice in the measurement and interpretation of intervention adherence in randomised controlled trials: A systematic review

BackgroundIdeally all participants in a randomised controlled trial (RCT) should fully receive their allocated intervention; however, this rarely occurs in practice. Intervention adherence affects Type II error so influences the interpretation of trial results and subsequent implementation. We aimed to describe current practice in the definition, measurement, and reporting of intervention adherence in non-pharmacological RCTs, and how this data is incorporated into a trial's interpretation and conclusions. MethodsWe conducted a systematic review of phase III RCTs published between January 2018 and June 2020 in the National Institute for Health Research Journals Library for the Health Technology Assessment, Programme Grants for Applied Research, and Public Health Research funding streams. ResultsOf 237 reports published, 76 met the eligibility criteria and were included. Most RCTs (n = 68, 89.5%) reported adherence, though use of terminology varied widely; nearly three quarters of these (n = 49, 72.1%) conducted a sensitivity analysis. Adherence measures varied between intervention types: behavioural change (n = 10, 43.5%), psychological therapy (n = 5, 83.3%) and physiotherapy/rehabilitation (n = 8, 66.7%) interventions predominately measured adherence based on session attendance. Whereas medical device and surgical interventions (n = 17, 73.9%) primarily record the number of participants receiving the allocated intervention, a third (n = 33, 67.3%) of studies reported a difference in findings between primary and sensitivity analyses. ConclusionsAlthough most trials report elements of adherence, terminology was inconsistent, and there was no systematic approach to its measurement, analyses, interpretation, or reporting. Given the importance of adherence within clinical trials, there is a pressing need for a standardised approach or framework.

Expanding Conflicts of Interest in Public Health Research

Expanding Conflicts of Interest in Public Health Research

An analysis of the strategic plan development processes of major public organisations funding health research in nine high-income countries worldwide

BackgroundThere have been claims that health research is not satisfactorily addressing healthcare challenges. A specific area of concern is the adequacy of the mechanisms used to plan investments in health research. However, the way organisations within countries devise research agendas has not been systematically reviewed. This study seeks to understand the legal basis, the actors and the processes involved in setting research agendas in major public health research funding organisations.MethodsWe reviewed information relating to the formulation of strategic plans by 11 public funders in nine high-income countries worldwide. Information was collected from official websites and strategic plan documents in English, French, Italian and Spanish between January 2019 and December 2019, by means of a conceptual framework and information abstraction form.ResultsWe found that the formulation of a strategic plan is a common and well-established practice in shaping research agendas across international settings. Most of the organisations studied are legally required to present a multi-year strategic plan. In some cases, legal provisions may set rules for actors and processes and may establish areas of research and/or types of research to be funded. Commonly, the decision-making process involves both internal and external stakeholders, with the latter being generally government officials and experts, and few examples of the participation of civil society. The process also varies across organisations depending on whether there is a formal requirement to align to strategic priorities developed by an overarching entity at national level. We also found that, while actors and their interactions were traceable, information, sources of information, criteria and the mechanisms/tools used to shape decisions were made less explicit.ConclusionsA complex picture emerges in which multiple interactive entities appear to shape research plans. Given the complexity of the influences of different parties and factors, the governance of the health research sector would benefit from a traceable and standardised knowledge-based process of health research strategic planning. This would provide an opportunity to demonstrate responsible budget stewardship and, more importantly, to make efforts to remain responsive to healthcare challenges, research gaps and opportunities.

Summer in Washington: How Hot Will It Get?

Summer in Washington: How Hot Will It Get?

A new approach to public health research funding

BackgroundThe National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre (NETSCC) is the UK's largest funder of public health research. NETSCC is exploring new methods to identify important areas of research to commission aiming for research that is high quality, serves stakeholders (including policy and decision makers), and is unconstrained by traditional programme boundaries. Here we describe such an approach that aims to explore a new approach to public health research funding. MethodsNETSCC develops commissioning briefs to prompt researchers to apply for funding. A new approach is being tested on a small number of key health challenges including tobacco. The new approach is to co-produce and co-create the commissioning brief involving a wide range of stakeholders. Topics are identified and prioritised systematically on the basis of the value of research; burden of disease; degree of uncertainty; and cost to society and the health system. Tobacco was chosen because it remains the UK's single greatest cause of preventable illness, avoidable death, and health inequalities, and there remain important unanswered questions. In-house expertise was used to scope the area and write an initial draft; this was sent to peer reviewers for feedback involving, in addition to the usual academics, evidence-users including directors of public health, local government councillors, and Action on Smoking and Health. The brief was taken to two national committees (Public Health England's Tobacco Control Plan Implementation Board and the Cancer Research UK Tobacco Advisory Board) and to the NETSCC's Programme Directors meeting. At each stage the brief was redrafted in response to comments received allowing continual development. FindingsThe wide range of peer reviewers and committees welcomed involvement in the process. Reviewers gave useful responses and the committees gave sufficient agenda time for engaged discussion. This approach is generalisable to other research calls and will aid the development of NETSCC commissioning. InterpretationNETSCC are developing a flexible and responsive process to address identified research needs. The final commissioning brief will ask for research in a range of areas relevant to end-users' needs in a rapidly changing field. Once advertised (in about November, 2018) its success will be measured by the number of applications and how many are fundable. FundingNone.

Priority-setting in public health research funding organisations: an exploratory qualitative study among five high-profile funders

BackgroundPriority-driven funding streams for population and public health are an important part of the health research landscape and contribute to orienting future scholarship in the field. While research priorities are often made public through targeted calls for research, less is known about how research funding organisations arrive at said priorities. Our objective was to explore how public health research funding organisations develop priorities for strategic extramural research funding programmes.MethodsContent analysis of published academic and grey literature and key informant interviews for five public and private funders of public health research in the United Kingdom, Australia, the United States and France were performed.ResultsWe found important distinctions in how funding organisations processed potential research priorities through four non-sequential phases, namely idea generation, idea analysis, idea socialisation and idea selection. Funders generally involved the public health research community and public health decision-makers in idea generation and socialisation, but other groups of stakeholders (e.g. the public, advocacy organisations) were not as frequently included.ConclusionsPriority-setting for strategic funding programmes in public health research involves consultation mainly with researchers in the early phase of the process. There is an opportunity for greater breadth of participation and more transparency in priority-setting mechanisms for strategic funding programmes in population and public health research.

Competitive funding and structures for public health research in European countries: Table 1

The European Union is giving increasing emphasis to research as a driver for innovation and economic development. The European collaborative study PHIRE (Public Health Innovation and Research in Europe) investigated the funding and structures of public health research at national level in European countries. Background materials were prepared for national public health associations of European countries to hold workshops or discussions with research and policy stakeholders on their public health research systems. The reports, supplemented from internet sources for 23 EU countries (four did not contribute), provided information for framework analysis. All countries have public funding and administrative structures for research, but structures for public health research are more varied. In most countries, competitive health research funding is controlled by the Ministry of Science, with little input from the Ministry of Health. In four countries, Ministries of Health provide competitive funding alongside Ministries of Science, and in two countries there is a single health research council. There is no comparative reporting of public health research funding, and little connection with European public health research programmes. Europe needs a comprehensive picture of national and regional systems of public health research, in order to critically assess them and better adapt to changes and challenges, and to achieve a European Research Area for public health.

‘We don’t see that in South Africa’

Of all neglected tropical diseases (NTDs), arguably the most neglected are helminthic infections, which comprise the top 5 of the top 10 NTDs in terms of disability-adjusted life years. Despite this, they are often assigned low priority in international public health research funding, and on a national scale, some helminth infections are considered to be non-endemic in particular countries or regions, hence little attention is paid to them. In this issue of the SAMJ, Black et al. describe a case series of geographically linked human fascioliasis, an infection about which most physicians are unaware. Indeed, the last recorded case of human fascioliasis originating in South Africa (SA) was reported more than 50 years ago and there have only been 3 published case reports in total.

Collaboration required to secure public health research funding

Collaboration required to secure public health research funding

Public health research funding: independence is important

Public health research funding: independence is important

What influences the transfer of research into health policy and practice? Observations from England and Australia

To explore the role of evidence in the public health policy-making process, and show how the way in which public health problems are defined and measured influences policy outcomes. The policy responses of the Blair Labour Government in the UK and the Howard Coalition Government in Australia to persistent health inequalities over the last decade are examined as a case study. Soon after being elected, the Blair Government commissioned an independent inquiry into health inequalities, signalling the priority it gave to addressing this longstanding challenge. It chose to take a 'whole-of-government' approach, combining actions that addressed both personal risk factors and the social determinants of health. This approach reflects the long-established tradition in England of routinely measuring disparities in health outcomes and correlating them with socio-economic status and underlying social determinants of health. Over the same period, the Howard Government also outlined its 'whole-of-government' approach to addressing the most extreme and persistent health inequalities between indigenous and non-indigenous Australians. In contrast, its approach focused primarily on modifying risk factors and improving service provision. This approach reflects the different historical circumstances in Australia and a different tradition in the collection of health data, focused more on health service access and personal risk factors. This case study offers some insight into the ways in which the production and presentation of evidence can influence and shape governmental responses to public health problems. The usefulness of available evidence is dependent upon the type of data that is produced routinely by government, as well as more deliberate decisions concerning public health research funding. Researchers can maximize the influence of research evidence on the policy process by engaging in the policy-making process, presenting research in ways that fit with the political context of the day, and, where necessary, using research evidence in public health advocacy in order to influence political priorities more directly.

Outcomes from NHMRC public health research project grants awarded in 1993.

In 1987, the Public Health Research and Development Committee (PHRDC) was established by the NHMRC as one mechanism to fund public health research in Australia. In 1993, it awarded 32 new and 31 continuing project grants. Given increasing interest in research accountability in Australia, we designed an audit to determine outcomes from this investment. We also explored grant recipients' views about sources of research funding and strategies to enhance research dissemination. Self-administered survey, July 1999. We obtained a 69% response fraction. The majority of projects already had been completed with peer-reviewed articles the most common outputs. More than half (58%) of respondents 'strongly agreed' or 'agreed' that their research had influenced policy to improve public health and 69% that it had influenced practice. Study design was significantly associated with peer-reviewed output, whether self-reported (p=0.002) or corroborated by us (p=0.004). With respect to research funding, significantly more agreed that the NHMRC should enhance program grants for public health research than mechanisms through the Strategic Research Development Committee (p=0.013). The most highly rated strategy to enhance dissemination was greater demand for research results among policy makers. A pleasing proportion of projects funded by PHRDC in 1993 generated peer-reviewed publications and provided research training. Recipients perceive their research has influenced policy and practice. Recipients' views about strategies to increase funding for public health research are consistent with current reforms within the NHMRC. Policy makers emerge as a key target for training in research transfer.

Dental Public Health Research Funding Sources

Dental Public Health Research Funding Sources

Functional hypoglycemia and the hyperventilation syndrome: a clinical study.

Article1 May 1955FUNCTIONAL HYPOGLYCEMIA AND THE HYPERVENTILATION SYNDROME: A CLINICAL STUDYW. L. JACK EDWARDS, M.D., WILLIAM F. LUMMUS, M.D.W. L. JACK EDWARDS, M.D.Search for more papers by this author, WILLIAM F. LUMMUS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-42-5-1031 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIntroductionSpontaneous hypoglycemia was first described by Seale Harris1 in 1924, under the name of "hyperinsulinism." More recently, Conn2 has classified the hypoglycemias, naming "functional hyperinsulinism" as including those forms of hypoglycemia not associated with anatomic lesions. The majority of patients in this group have associated anxiety states, with spontaneous hypoglycemic attacks at least one to two hours after meals. The term now commonly used for this disorder is "functional hypoglycemia."This report is concerned with patients having functional hypoglycemia in a series of 866 referred ambulatory patients. Since the hyperventilation syndrome was found to occur concomitantly in more than...Bibliography1. Harris S: Hyperinsulinism and dysinsulinism, J. A. M. A. 83: 729, 1924. CrossrefGoogle Scholar2. Conn JW: The spontaneous hypoglycemias: importance of etiology in determining treatment, J. A. M. A. 115: 1669, 1940. CrossrefGoogle Scholar3. De Costa JM: An irritable heart: a clinical study of a functional cardiac disorder and its consequences, Am. J. M. Sc. 61: 17, 1871. Google Scholar4. Wood P: De Costa's syndrome, Brit. M. J. 1: 767, 805 and 845, 1941. CrossrefMedlineGoogle Scholar5. Friedman MF: Functional cardiovascular disease, 1947, Williams and Wilkins, Baltimore, p. 35. Google Scholar6. Rice RL: Symptom patterns of the hyperventilation syndrome, Am. J. Med. 8: 691, 1950. CrossrefMedlineGoogle Scholar7. ConnConn JWES: Metabolism in organic hyperinsulinism; quantitative studies of variations in rate of combustion of carbohydrate produced by alterations in diet, Arch. Int. Med. 68: 876, 1941. CrossrefGoogle Scholar8. HarrisonFinks TRRM: Glucose deficiency as a factor in the production of symptoms referable to the cardiovascular system, Am. Heart J. 26: 147, 1943. CrossrefGoogle Scholar9. Conn JW: The diagnosis and management of spontaneous hypoglycemia, J. A. M. A. 134: 130, 1947. CrossrefMedlineGoogle Scholar10. NevesFariaFujioka DPCVT: Hyperglicemia e hipoglicemia conseqüentes ā intoxicāo aguda e crônica pelo ālcool etīlico, Rev. Hosp. clín. 5: 115, 1950. Google Scholar11. ConnNewburghJohnsonSheldon JWLHMWJM: Study of the deranged carbohydrate metabolism in chronic infectious hepatitis, Arch. Int. Med. 62: 765, 1938. CrossrefGoogle Scholar12. Kety SS: Circulation and metabolism of the human brain in health and disease, Am. J. Med. 8: 205, 1950. CrossrefMedlineGoogle Scholar13. Conn JW: The advantage of a high protein diet in the treatment of spontaneous hypoglycemia, J. Clin. Investigation 15: 673, 1936. CrossrefMedlineGoogle Scholar14. ThornQuinbyClinton GWJTM: A comparison of the metabolic effects of isocaloric meals of varying composition with special reference to the prevention of postprandial hypoglycemia symptoms, Ann. Int. Med. 18: 913, 1943. LinkGoogle Scholar15. Cannon WB: Mechanism of emotional disturbance of bodily functions, New England J. Med. 198: 877, 1928. CrossrefGoogle Scholar16. RennieHoward TAJE: Hypoglycemia and tension depression, Psychosom. Med. 4: 273, 1942. CrossrefGoogle Scholar17. MalmoSchaguss RBC: Reaction to stress in anxiety and early schizophrenia, Psychosom. Med. 11: 9, 1949. CrossrefMedlineGoogle Scholar18. SoskinMirskyZimmermanHeller SIALMRC: Normal dextrose tolerance curves in the absence of insulin, in the hypophysectomized depancreatized dog, Am. J. Physiol. 114: 648, 1936. CrossrefGoogle Scholar19. LazurusVolk SSBW: Studies on hypoglycemia responsiveness, Metabolism 2: 500, 1954. Google Scholar20. AndersonLong EJA: Hormonal influences on the secretion of insulin, Recent Prog. in Hor. Research 2: 209, 1948. MedlineGoogle Scholar21. Combat stress: front-line view, The Johns Hopkins Magazine 5: 8 (Feb.) 1954. Google Scholar22. DavisWallace HWM: Factors affecting the electroencephalographic changes induced by hyperventilation, Am. J. Physiol. 113: 258, 1941. Google Scholar23. EngelFerrisLogan GLEBM: Hyperventilation: analysis of clinical symptomatology, Ann. Int. Med. 27: 683, 1947. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Birmingham, Alabama*Received for publication September 7, 1954.From the Department of Medicine, Medical College of Alabama, Birmingham, Ala.†Aided by a grant from the Life Insurance Medical Research Fund.‡Work done during the tenure of a National Heart Institute Traineeship, National Institutes of Health, U. S. Public Health Service. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNutritional Approaches to Behavior ModificationHypoglycemia and convulsions in children following alcohol ingestion 1 May 1955Volume 42, Issue 5Page: 1031-1040KeywordsAnxietyHeartHyperinsulinemiaHypoglycemiaHypoglycemicsLesionsMedical servicesPrevention, policy, and public healthResearch funding ePublished: 1 December 2008 Issue Published: 1 May 1955 PDF downloadLoading ...