Priority Setting Exercise Research Articles

Health Research Priority Setting in Oman: Towards better utilization of the available resources

Objective: This concept paper aims to portray the steps and strategies followed in setting the health research priorities in Sultanate of Oman.
 Methods: This exercise was developed based on COHRED management process to priority setting for planning a high-quality health research priority setting exercise at national and sub national levels. Ranking for the diseases and risk factors in Oman was based on the estimates obtained from the Global Burden of Disease (GBD) 2016 study by the Institute for Health Metrics and Evaluation (IHME). The most important topics were generated from a panel of experts to tackle the above ranked problems, which was supported with a feasibility score to plan for conducting research.
 Results: A list of top 30 diseases and 10 risk factors based on DALYs estimates was ranked and listed. Sub-research topics were listed under each category. Feasibility scores were obtained from all the sub-national levels based on available human resources, infrastructure, financing, technology, legality, and ethical consideration. A plan for the next 15 years was developed for each sub national level based on the feasibility score.
 Conclusion: Prioritisation mechanisms are necessary to facilitate the current demand for increased harmonisation of health research to meet health services needs particularly in combination with translating the results into actions that improve overall population health. Due to the immense importance of health research in improving the health system and health services, the decision to prioritise health research was the first step in the direction to enhance health research and thereby enhance health service in Oman by the Centre of Studies & Research. This intervention will lead the health system to achieve better planning for effective utilization of available resources.

Involving Individuals with Developmental Language Disorder and their Parents/Carers in Research Priority Setting.

A protocol for involving individuals presenting with developmental language disorder (DLD) (iDLD) and their parents/carers (iDLDPC) in a research priority setting exercise is presented. iDLD have difficulties with communication skills, such as understanding language, word-finding and discourse. Such difficulties mean existing research priority setting protocols are difficult for iDLD to access, since they require sophisticated communication skills. Thus, a novel protocol for involving iDLD in these exercises is warranted. The same protocol is recommended for use with iDLDPC, to ensure accessibility. The protocol is presented in 4 steps. Step 1 describes a program of activities delivered by trained, specialist DLD speech and language therapists (SLTs) that prepares iDLD/iDLDPC for involvement. Step 2 outlines an approach to elicit iDLD/iDLDPC's opinions on research priorities. Steps 3 and 4 describe methods to analyze and integrate this data at multiple stages of the research priority setting process. 9 trained specialist DLD SLTs delivered steps 1 and 2. 17 iDLDs and 25 iDLDPCs consented to involvement. Opinions from all participants were elicited, and this data was used to influence the process and output of the exercise. An advantage of this protocol is its accommodation of the heterogeneity in support needs of iDLD/iDLDPC, through a menu of options, whilst also providing a structured framework. Due to the novelty of the protocol, the methods for data integration were developed by the research group. These are potential limitations of the protocol, and may bring the reliability and validity under scrutiny, which are yet to be tested. This protocol enables meaningful involvement of iDLD/iDLDPC inresearch priority setting and could be utilized for people with other kinds of speech, language or communication needs. Further research should evaluate the effectiveness of the protocol and whether it can be adapted for involvement of such populations in other research studies.

Priority-Setting for Cochrane Review Updates With Clinicians and Consumers [36J

INTRODUCTION: The US Satellite of the Cochrane Pregnancy & Childbirth Group was launched in March 2019. One of the goals of the US-PCG was to engage both clinicians and consumers in a priority-setting exercise that aimed to (1) identify which systematic reviews to update and (2) reveal any gaps in current knowledge that require a new review. METHODS: A series of editorial team evaluations narrowed a list of over 600 relevant review titles down to 97, all of which were in 7 topic categories. A Qualtrics survey was used. Respondents self-identified as a clinician/researcher or consumer and then were asked to rank 10 titles into a “highest priority” area and could rank another 20 in a “medium priority” area. This survey was disseminated through various channels, including ACOG, March of Dimes, Cochrane, and social media networks. RESULTS: 63 participated in our survey, with 45 clinicians and 18 consumers. Of the 7 categories, maternal medical problems and complications (MMPC) was the topic of most interest overall (79.4%). MMPC was chosen most by clinicians but was tied with psychosocial factors in postpartum care (PFPC) for consumers. Antiplatelet agents for preventing preeclampsia was the only title in the top 3 priority by both clinicians and consumers, but multiple titles overlapped in the top 10 priority. CONCLUSION: Clinicians and consumers were able to select priority titles for updating reviews with the groups often sharing some consensus. Stakeholder consensus on review topics will be further refined using Delphi methods to a final priority list by the end of 2019.

Understanding the implications of the Sustainable Development Goals for health policy and systems research: results of a research priority setting exercise

BackgroundGiven the paradigmatic shift represented by the Sustainable Development Goals (SDGs) as compared to the Millennium Development Goals - in particular their broad and interconnected nature - a new set of health policy and systems research (HPSR) priorities are needed to inform strategies to address these interconnected goals.ObjectivesTo identify high priority HPSR questions linked to the achievement of the Sustainable Development Goals.MethodsWe focused on three themes that we considered to be central to achieving the health related SDGs: (i) Protecting and promoting access to health services through systems of social protection (ii) Strengthening multisectoral collaborations for health and (iii) Developing more participatory and accountable institutions. We conducted 54 semi-structured interviews and two focus group discussions to investigate policy-maker perspectives on evidence needs. We also conducted an overview of literature reviews in each theme. Information from these sub-studies was extracted into a matrix of possible research questions and developed into three domain-specific lists of 30–36 potential priority questions. Topic experts from the global research community then refined and ranked the proposed questions through an online platform. A final webinar on each theme sought feedback on findings.ResultsPolicy-makers continue to demand HPSR for many well-established issues such as health financing, human resources for health, and service delivery. In terms of service delivery, policy-makers wanted to know how best to strengthen primary health care and community-based systems. In the themes of social protection and multisectoral collaboration, prioritized questions had a strong emphasis on issues of practical implementation. For participatory and accountable institutions, the two priority questions focused on political factors affecting the adoption of accountability measures, as well as health worker reactions to such measures.ConclusionsTo achieve the SDGs, there is a continuing need for research in some already well established areas of HPSR as well as key areas highlighted by decision-makers. Identifying appropriate conceptual frameworks as well as typologies of examples may be a prerequisite for answering some of the substantive policymaker questions. In addition, implementation research engaging non-traditional stakeholders outside of the health sector will be critical.

An assessment of the representation of ecosystems in global protected areas using new maps of World Climate Regions and World Ecosystems

Representation of ecosystems in protected area networks and conservation strategies is a core principle of global conservation priority setting approaches and a commitment in Aichi Target 11 of the Convention on Biological Diversity. The 2030 Sustainable Development Goals (SDGs) explicitly call for the conservation of terrestrial, freshwater, and marine ecosystems. Accurate ecosystem distribution maps are required to assess representation of ecosystems in protected areas, but standardized, high spatial resolution, and globally comprehensive ecosystem maps have heretofore been lacking. While macroscale global ecoregions maps have been used in global conservation priority setting exercises, they do not identify distinct localized ecosystems at the occurrence (patch) level, and instead describe large ecologically meaningful areas within which additional conservation planning and management are necessary. We describe a new set of maps of globally consistent climate regions and ecosystems at a much finer spatial resolution (250 m) than existing ecological regionalizations. We then describe a global gap analysis of the representation of these ecosystems in protected areas. The new map of terrestrial World Ecosystems was derived from the objective development and integration of 1) global temperature domains, 2) global moisture domains, 3) global landforms, and 4) 2015 global vegetation and land use. These new terrestrial World Ecosystems do not include either freshwater or marine ecosystems, but analog products for the freshwater and marine domains are in development. A total of 431 World Ecosystems were identified, and of these a total of 278 units were natural or semi-natural vegetation/environment combinations, including different kinds of forestlands, shrublands, grasslands, bare areas, and ice/snow regions. The remaining classes were different kinds of croplands and settlements. Of the 278 natural and semi-natural classes, 9 were not represented in global protected areas with a strict biodiversity conservation management objective (IUCN management categories I-IV), and an additional 206 were less than 8.5% protected (half way to the 17% Aichi Target 11 goal). Forty four classes were between 8.5% and 17% protected (more than half way towards the Aichi 17% target), and only 19 classes exceeded the 17% Aichi target. However, when all protected areas (IUCN management categories I-VI plus protected areas with no IUCN designation) were included in a separate global gap analysis, representation of ecosystems increases substantially, with a third of the ecosystems exceeding the 17% Aichi target, and another third between 8.5% and 17%. The overall protection (representation) of global ecosystems in protected areas is considerably less when assessed using only strictly conserved protected areas, and more if all protected areas are included in the analysis. Protected area effectiveness should be included in further evaluations of global ecosystem protection. The ecosystems with the highest representation in protected areas were often bare or sparsely vegetated and found in inhospitable environments (e.g. cold mountains, deserts), and the eight most protected ecosystems were all snow and ice ecosystems. In addition to the global gap analysis of World Ecosystems in protected areas, we report on the representation results for the ecosystems in each biogeographic realm (Neotropical, Nearctic, Afrotropical, Palearctic, Indomalayan, Australasian, and Oceania).

Setting priorities in child health research in India for 2016-2025: a CHNRI exercise undertaken by the Indian Council for Medical Research and INCLEN Trust.

BackgroundMillennium Development Goal 4 (MDGs) mobilised countries to reduce child mortality by two thirds the 1990 rate in 2015. While India did not reach MDG 4, it considerably reduced child mortality in the MDG-era. Efficient and targeted interventions and adequate monitoring are necessary to further progress in improvements to child health. Looking forward to the Sustainable Development Goal (SDG)-era, the Indian Council of Medical Research and The INCLEN Trust International conducted a national research priority setting exercise for maternal, child, newborn health, and maternal and child nutrition. Here, results are reported for child health.MethodsThe Child Health and Nutrition Research Initiative (CHNRI) method for research priority setting was employed. Research ideas were crowd-sourced from a network of child health experts from across India; these were refined and consolidated into research options (ROs) which were scored against five weighted criteria to arrive weighted Research Priority Scores (wRPS). National and regional priority lists were prepared.Results90 experts contributed 596 ideas that were consolidated into 101 research options (ROs). These were scored by 233 experts nationwide. National wRPS for ROs ranged between 0.92 and 0.51. The majority of the top research priorities related to development of cost-effective interventions and their implementation, and impact evaluations, improving data quality; and monitoring of existing programs, or improving the management of morbidities. The research priorities varied between regions, the Economic Action Group and North-Eastern states prioritised questions relating to delivering interventions at community- or household-level, whereas the North-Eastern states and Union Territories prioritised research questions involving managing and measuring malaria, and the Southern and Western states prioritised research questions involving pharmacovigilance of vaccines, impact of newly introduced vaccines, and delivery of vaccines to hard-to-reach populations.ConclusionsResearch priorities varied geographically, according the stage of development of the area and mostly pertained to implementation sciences, which was expected given diversity in epidemiological profiles. Priority setting should help guide investment decisions by national and international agencies, therefore encouraging researchers to focus on priority areas. The ICMR has launched a grants programme for implementation research on maternal and child health to pursue research priorities identified by this exercise.

Quality, safety and performance management in primary health care: from scoping review to research priority setting and implementation plan in the Eastern Mediterranean Region.

IntroductionStrong primary health care (PHC) leads to better health outcomes, improves health equity and accelerates progress towards universal health coverage (UHC). The Astana Declaration on PHC emphasised the importance of quality care to achieve UHC. A comprehensive understanding of the quality paradigm of PHC is critical, yet it remains elusive in countries of the Eastern Mediterranean Region (EMR). This study used a multistep approach to generate a policy-relevant research agenda for strengthening quality, safety and performance management in PHC in the EMR.MethodsA multistep approach was adopted, encompassing the following steps: scoping review and generation of evidence and gap maps, validation and ranking exercises, and development of an approach for research implementation. We followed Joanna Briggs Institute guidelines for conducting scoping reviews and a method review of the literature to build the evidence and gap maps. For the validation and ranking exercises, we purposively sampled 55 high-level policy-makers and stakeholders from selected EMR countries. We used explicit multicriteria for ranking the research questions emerging from the gap maps. The approach for research implementation was adapted from the literature and subsequently tailored to address the top ranked research question.ResultsThe evidence and gap maps revealed limited production of research evidence in the area of quality, safety and performance management in PHC by country and by topic. The priority setting exercises generated a ranked list of 34 policy-relevant research questions addressing quality, safety and performance management in PHC in the EMR. The proposed research implementation plan involves collaborative knowledge generation with policy-makers along with knowledge translation and impact assessment.ConclusionStudy findings can help inform and direct future plans to generate, disseminate and use research evidence to enhance quality, safety and performance management in PHC in EMR and beyond. Study methodology can help bridge the gap between research and policy-making.

The National Institute for Health Research Critical Care Research Priority Setting Survey 2018.

Defining research priorities in intensive care is key to determining appropriate allocation of funding. Several topics were identified from the 2014 James Lind Alliance priority setting exercise conducted with the Intensive Care Society. The James Lind Alliance process included significant (and vital) patient/public contribution, but excluded professionals without a bedside role. As a result it may have failed to identify potential early-stage translational research topics, which are more likely identified by medical and/or academic members of relevant specialist basic science groups. The objective of the present project was to complement the James Lind Alliance project by generating an updated list of research priorities by facilitating academic research input. A survey was conducted by the National Institute for Health Research (NIHR) to identify the key research priorities from intensive care clinicians, including allied health professionals and academics, along with any evolving themes arising from translational research. Feasibility of all identified topics were then discussed and allocated to themes by a joint clinical academics/NIHR focus group. The survey was completed by 94 intensive care clinicians (including subspecialists), academics and allied health professions. In total, 203 research questions were identified, with the top five themes focusing on: appropriate case selection (e.g. who and when to treat; 24%), ventilation (7%), sepsis (6%), delirium (5%) and rehabilitation (5%). Utilising a methodology distinct from that employed by the James Lind Alliance process, from a broad spectrum of intensive care clinicians/scientists, enabled identification of a variety of priority research areas. These topics can now inform not only the investigator-led research agenda, but will also be considered in due course by the NIHR for potential future funding calls.

What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project

ObjectivesTo identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population.DesignMixed-methods priority setting exercises framed by the dialogue model, using the...

Operationalizing the Development of the National Unified Health Research Agenda 2017-2022

Introduction. The National Unified Health Research Agenda is a major document whose creation by the Philippine National Health Research Systems is mandated by Philippine Law. Multiple frameworks, methods, and approaches for the development of a health research agenda exists. Available literature on research priority setting have mostly focused on its methods, results, or implementation. There are limited studies on the operations management of conducting a national health research priority-setting exercise.
 Objectives. This paper aims to describe the operational components utilized to develop the NUHRA 2017-2022 and provide lessons learned for future research priority setting endeavors. Methods. This paper identified and categorized the operational components to develop the NUHRA 2017-2022 using the Enabler Criterion of the European Foundation for Quality Management’s (EFQM) Excellence Model.
 Results. Operationalizing the development of a national health research agenda requires the harmonization of multiple components. Having region-based staff involved in the production of a regional situational analysis improved its context and accuracy. The workload for each cluster team must be considered and anticipated by the management. Stakeholder engagement requires political, diplomatic, advocacy, marketing, management, and technical skills. The process requires building relationships with various institutions. In a largescale project, management processes must be in place to effectively track and monitor its progress.
 Conclusion. Operations and management are usually a neglected area in research and development projects. In a bottoms-up research priority-setting approach, iteration and flexibility is needed which requires a lot of management skills and insight. Duration of the project, planning, resources available, and quality of outputs have a strong interconnected relationship.

Effect of Personality, Power, and Emotion on Developing the 2017-2022 Philippine Health Research Agenda: A Case Study

Background. Social dynamics, specifically personalities, power dynamics, and emotions, have been shown to influence the methods, outputs, and quality of multi-stakeholder processes, especially the development of a national health research agenda.
 Objective and Methods. Using a case analysis approach utilizing related conceptual frameworks, the paper determined how personalities, power dynamics, and emotions affected the research priority-setting exercise, identified lessons learned, and recommended how to effectively manage these social dynamics in consultations. Data gathering methods were participant observation and process documentation, results of which were codified and analyzed.
 Results. Dominant personalities, stakeholders with power, and stakeholders that openly expressed dissatisfaction were most likely to attempt to change the methods and final outputs of the consultation, with varying level of success. Other dominant personalities used their power constructively for a smooth flow of generating and agreeing on ideas.
 Conclusion. In this case, social dynamics was shown to heavily influence the decision-making process, thus underlining its importance in organizing multisectoral representation. Effectively managing social dynamics may thus have to consider building trust and respect between participants, mediating discussions, reaching a mutually beneficial solution, and establishing and implementing mutually agreed house rules. The significant role of facilitators in developing a climate for truly inclusive participation must also be recognized.

Making an IMPACT: A priority setting consultation exercise to improve outcomes in patients with locally advanced, recurrent and metastatic colorectal cancer

AimThe IMPACT (Improving the Management of Patients with Advanced Colorectal Tumours) initiative was established by the Association of Coloproctology of Great Britain and Ireland in 2017 as a consortium of surgeons (colorectal, hepatobiliary, thoracic), oncologists, radiologists, pathologists, palliative care physicians, patients, carers and charity stakeholders who will work together to improve outcomes in patients with advanced and metastatic colorectal cancer. To establish this initiative, better information is required to establish how further intervention is focused. This paper details the approaches used, and outcomes generated, from a priority setting exercise to inform the design of the IMPACT initiative. MethodsA mixed method approach was employed to set the priorities of patients, clinicians and other key stakeholders in the delivery of optimal care. This consisted of two patient centered consultation events and a questionnaire. ResultsA total of 128 participants took part in the consultation exercise; 15 patients, 5 carers/family members, 5 charity representatives and 113 healthcare professionals. Nine key themes for focus were identified, these were: current service provision, specialist services, communication, education, access to care, definitions and standardisation, research and audit, outcome measures, and funding of specialist care. ConclusionThese future priorities will be developed with collaborative engagement in a systematic manner to produce an overall cohesive programme which will deliver a sustainable and efficient clinical and academic service to improving the management of patients with advanced colorectal tumours.

Developing population health research priorities in Asian city state: Results from a multi-step participatory community engagement.

ObjectivesTo identify a broad range of research priorities to inform the studies seeking to improve population health outcomes based on the engagement of diverse stakeholders.MethodsA multi-step, participatory and mixed-methods approach was adopted to solicit and structure the investigative themes from diverse stakeholders. The priority setting exercise involved four key phases: (1) feedback from community leadership; (2) interim ranking survey and focus group discussions during the population health symposium; (3) individual in-depth interviews with stakeholders in the community; and (4) synthesis of the research priorities from the multistep process.ResultsDiverse stakeholders in Singapore, comprising community partnership leaders, health care and social service providers, users of population health services, patients and caregivers, participated in the research priority setting exercise. Initial 14 priorities were identified from six community leadership feedback, 42 survey responses, two focus groups (n = 16) and 95 in-depth interviews. The final integrated research agenda identified six priorities: empower residents and patients to take charge of their health; improve care transition and management through relationship building and communication; enhance health-social care interface; improve respite care services for long-term caregivers; develop primary care as a driving force for care integration; and capacity building for service providers. Selected research questions in each priority area were also generated to develop novel models of care, foster collaboration, implement optimal services and enhance understanding of the end users’ care needs.ConclusionsThis study illuminates that greater community engagement in research priority setting for population health can facilitate the formulation of evidence-based research agendas that matter to the care providers and service users in the community. The outcomes derived from this exercise will help focus researchers’ efforts through which meaningful gains can be made for population health.

Cochrane Rehabilitation: 2018 annual report

During its second year of existence, Cochrane Rehabilitation worked hard to accomplish new and old goals. The Review Committee completed the massive task of identifying and "tagging" all rehabilitation reviews in the Cochrane library. The Publication Committee signed agreements with several international journals and started the publication of Cochrane Corners. The Education Committee performed educational activities such as workshops in International Meetings. The Methodology Committee has completed a two days Cochrane Rehabilitation Methodological Meeting in Paris of which the results will soon be published. The Communication Committee reaches almost 5,000 rehabilitation professionals through social media, and is working on the translation of contents in Italian, Spanish, French, Dutch, Croatian and Japanese. Memoranda of Understanding have been signed with several National and International Rehabilitation Scientific Societies, Universities, Hospitals, Research Centres and other organizations. The be4rehab (best evidence for rehabilitation) project has been started with the World Health Organisation (WHO) to extract from Cochrane reviews and clinical guidelines the best currently available evidence to produce the WHO Minimum Package of Rehabilitation Interventions. The Cochrane Rehabilitation ebook is under development as well as a priority setting exercise with 39 countries from all continents.

Supporting ageing well research: Findings from a research priority setting exercise.

This paper describes a workshop process conducted to guide funding priorities for the Ageing Well National Science Challenge in New Zealand (NZ). Based on the Checklist for Health Research Priority Setting, stakeholders networking workshops were conducted in five main cities in NZ (n=133 attendees). Each workshop involved an introductory presentation; small group work exploring the a priori areas of: mind health, social well-being, health services and age-friendly environments; capturing key ideas on flip charts; feedback; and discussion of documented content. Suggested strategies to address these issues incorporated reduction in segregated "villages," delivery of integrated care and provision of age-friendly transport. Proposed examples of monitoring impact included increased tertiary participation by older people and presence of more housing options. Actively engaging older adults and community stakeholders in setting research priorities provided a unique opportunity to understand the key areas older adults think important for future research.

Identifying research priorities for psychosocial support programs in humanitarian settings.

Given the range and reach of psychosocial support (PSS) interventions in humanitarian settings, within the continuum of mental health and psychosocial support services, evaluation of their impact is critical. Understanding stakeholders' perspectives on which PSS interventions of unknown effectiveness warrant rigorous evaluation is essential to identify research priorities. This project aimed to facilitate a process with stakeholders to reach consensus on PSS interventions that are of high priority for further research based on existing evidence and stakeholders' opinions. Interviews with 109 stakeholders working on PSS programming in humanitarian settings served as the foundation for two in-person regional meetings and four webinars. Nominal Group Technique (NGT) was used to develop a priority PSS program list. The top five priorities from each meeting were combined for a final online survey distributed globally. Seventy participants across six meetings contributed to the prioritization process. Eighty-seven individuals completed the final online survey. 'Community based PSS' was the top-ranked research priority, followed by PSS integrated into basic services, providing PSS to caregivers to improve child wellbeing, PSS-focused gender-based violence programming, and classroom-based PSS interventions. NGT and online surveys were effective methods to engage stakeholders in a priority setting exercise to development a research agenda. Information from this stage of the project will be combined with findings from a concurrent systematic review to form the base of a second phase of work, which will include the development and implementation of a research strategy to strengthen the evidence base for those prioritized interventions.

Scoping review of priority setting of research topics for musculoskeletal conditions

ObjectiveDescribe research methods used in priority-setting exercises for musculoskeletal conditions and synthesise the priorities identified.DesignScoping review.Setting and populationStudies that elicited the research priorities of patients/consumers, clinicians, researchers, policy-makers and/or funders...

Airway management research: a systematic review.

Recent controversy regarding the ethics of conducting airway research in patients led to disagreements concerning the value and frequency of manikin-based investigation. However, no formal examination of the methodology of airway research has been undertaken. We, therefore, performed a systematic bibliometric review of airway management research to describe the conduct, quantify the subjects (patient vs. manikin vs. other), assess the reported outcomes and map global trends. We retrieved 1505 relevant studies published between 2006 and 2017, together recruiting 359,648 subjects, of which 341,233 were patients, the remaining being volunteers or subjects managing manikins, human cadavers, animals or bench models. There were 701 randomised controlled clinical trials (46.6%), 83 non-randomised experimental clinical trials (5.5%), 298 observational studies (19.8%) and 423 non-patient studies (28.1%). A total of 1082 studies (71.9%) were patient studies and 322 were manikin studies (21.4%). The total annual number of airway management studies increased over time, as did the annual number of patient studies, but there was no significant increase in the annual number of manikin studies over time. Of the patient studies, subject baseline characteristics were most likely to be ASA status 1-2 (n = 531, 49.1%), populations were most often elective surgical patients (n = 918, 84.8%) and the most common interventions studied were tracheal intubation (n = 820, 54.4%) or supraglottic airway device insertion (n = 257, 17.1%). There was a total of 77 different primary outcomes used in the included studies, the most commonly reported being success rate and procedure time. By understanding how and what has been previously studied these data can be used to form the basis for future priority setting exercises, core outcome set development, and could inform strategy on the future directions of airway management research.

Stakeholder involvement in health research priority setting in low income countries: the case of Zambia

SummaryWhile there is increasing recognition of the importance of stakeholder involvement in health research priority setting there is a paucity of literature reporting on stakeholder involvement in health research priority setting in low income countries. This paper fills this gap by identifying and discussing the roles and legitimacy of different stakeholders (including the public and patients) involved in the health research priority setting process in Zambia; identifying the barriers to public participation and proposing improvement strategies.We interviewed 28 policy makers and practitioners who had participated in the national level health research priority setting in Zambia. Reported participants in health research priority setting included research users, researchers, research funders and the community/ public. Research funders were thought to have undue influence while the public and patients were not effectively involved. This could be due to the public’s lack of education, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation of people from rural areas, women and young professionals was also limited.While there is a commitment to broad stakeholder involvement in health research priority setting, there’s limited public/patient involvement. Public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated and incentives availed to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts.Background Stakeholder involvement in health research priority setting contributes to the legitimacy and acceptability of the priorities. Hence legitimate priority setting should involve a broad representation of stakeholders including the public. While there is a growing body of literature on health research prioritization in low income countries, there is a paucity of literature reporting on stakeholder involvement in the process. The objectives of this paper are to; 1) identify the stakeholders who were involved in the health research priority setting process in Zambia; 2) discuss the roles and perceived legitimacy of the stakeholders and analyze the degree to which patients/ public was involved; 3) To discuss some of the barriers to stakeholder participation in Zambia and similar contexts and to propose improvement strategies.Methods This was a qualitative study involving 28 in-depth interviews with stakeholders who had participated in the national level health research priority setting exercises in Zambia. An interview guide was used. Audio recorded interviews were transcribed and analyzed using INVIVO 10. Analysis of the Stakeholders’ theme involved identifying the different dimensions of stakeholder involvement as discussed in the interviews.Results Identified stakeholders included; research users, researchers, research funders and the community/ public. We found that health research priority setting involved research users, researchers, research funders and the community/ public. However, research funders were thought to have undue influence while the public and patients were not effectively involved. While the respondents recognized the advantages of involving the public and patients, they were not effectively involved. This could be due to the public’s limited understanding of the technicalities of priority setting, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation from rural areas, women, and young professionals was also limited.Conclusions While there is a commitment to broad stakeholder involvement in health research priority setting, the public is left out. Efforts such as public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated through their direct involvement in the prioritization process and incentives to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts.

Identifying top 10 primary care research priorities from international stakeholders using a modified Delphi method.

BackgroundHigh quality primary care is fundamental to achieving health for all. Research priority setting is a key facilitator of improving how research activity responds to concrete needs. There has never before been an attempt to identify international primary care research priorities, in order to guide resource allocation and to enhance global primary care. This study aimed to identify a list of top 10 primary care research priorities, as identified by members of the public, health professionals working in primary care, researchers, and policymakers.MethodsWe adapted the James Lind Alliance Priority Setting Partnership process, to conduct multiple rounds of stakeholder recruitment and prioritization. The study included an online survey conducted in three languages, followed by an in-person priority setting exercise involving primary care stakeholders from 13 countries.FindingsParticipants identified a list of top 10 international primary care research priorities. These were focused on diverse topics such as enhancing use of information and communication technology, and improving integration of indigenous communities’ knowledge in the design of primary care services. The main limitations of the study related to challenges in engaging an adequate diversity and number of appropriate stakeholders, particularly members of the public, in aggregating the diverse set of responses into coherent categories representative of the participants’ perspectives and in adequately representing the diversity of submitted responses while ensuring research priorities on the final list are sufficiently actionable to guide resource allocation.ConclusionsThe top 10 identified research priorities have the potential to guide research resource allocation, supporting funding agencies and initiatives to promote global primary care research and practice.