Public Health Research Methods Research Articles

Estimating the Trafficked Population: Public-Health Research Methodologies May Be the Answer

ABSTRACTInevitably, there are a great number of methodological challenges and limitations to estimating the extent of human trafficking, which are largely due to definitional issues and the hidden nature of the trafficked population. To date, most national and global estimates of the problem have been discredited for using flawed, nontransparent, or nonexistent research methods; however, researchers have previously suggested that methodologies from public health, including those used to estimate hidden and transient populations, might also be useful to estimate the trafficked population. Specifically, research design, sampling strategies, and measures commonly used to estimate hidden populations in public-health research may hold promise for future human-trafficking studies, reducing bias and resulting in more narrow and precise range estimates of victims. This article presents examples of studies using public-health research methods to estimate various hidden and stigmatized populations (e.g., injection drug-users, homeless and runaway youth) and proposes a set of strategies that might be considered for future prevalence studies on human trafficking. Recent prevalence studies on human trafficking that have successfully implemented public-health research methods, such as Respondent-Driven Sampling and Venue-Based Sampling, are also discussed.

Book Review: Public health research methods

Book Review: Public health research methods

Interdisciplinary Synergy in the Teaching of Applied Community-Based Research Methods

The public health human power is one of the most diverse in race, ethnicity, gender, age, religion, and sexual orientation. Another area of diversity is the disciplinary background of its workers. Environmental, behavioral, biostatistical, health education, epidemiological, and health policy practitioners converge into the Master of Public Health (MPH) track offerings of our MPH program. The applied community-based participatory research class is a third semester course that is taken only after students have completed the core curriculum. We explain the design and organization of this course, to offer it as a model of interdisciplinary approaches, with experiential, learn-by-doing components that can be replicated and incorporated into public health research methods, as well as to share our own methodological crossovers with mixed methods and theoretical models in our public health research together. Semistructured interviews were applied to elicit feedback from MPH graduates who took the course, and describe the utility of the class. We learned that the MPH graduates found the class useful for short- and medium-term research outcomes.

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia.

BackgroundThe social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG.MethodsLed by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia.ResultsNew understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people’s willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas.ConclusionsOur recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue to expand to reflect the diverse worldviews of research participants. Researchers need to remain open to new possibilities for learning.

A Situated Practice of Ethics for Participatory Visual and Digital Methods in Public Health Research and Practice: A Focus on Digital Storytelling

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.

Training physician investigators in medicine and public health research.

We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health. We developed a rigorous curriculum in public health content and research methods and fostered linkages with research mentors and local public health agencies. Didactic training provided the foundation for fellows' mentored research initiatives, which addressed real-world challenges in advancing the health status of vulnerable urban populations. Two multidisciplinary cohorts (6 per cohort) completed this 2-year degree-granting program and engaged in diverse public health research initiatives on topics such as improving pediatric care outcomes through health literacy interventions, reducing hospital readmission rates among urban poor with multiple comorbidities, increasing cancer screening uptake, and broadening the reach of addiction screening and intervention. The majority of fellows (10/12) published their fellowship work and currently have a career focused in public health-related research or practice (9/12). A fellowship training program can prepare physician investigators for research careers that bridge the divide between medicine and public health.

Developing and promoting public health methods for integrative medicine: examples from the field in Australia

Integrative medicine (IM) research in China has largely focused on clinical and experimental research, which is critical to determining the efficacy of treatments and enhancing the standing of IM. Nevertheless, there is also a need to extend research activities to include methods and research perspectives from public health, which will provide a greater understanding of clinical practice and assist government and professional organizations to shape policies and directives in IM. In this article we outline the public health research methods we have used in relation to our program of research on complementary and alternative medicine use and area of residence/geography, to highlight the usefulness of these methods in IM.

Applying social science and public health methods to community-based pandemic planning

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 (‘swine flu’) outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

Health impact assessment of quality wine production in Hungary

Alcohol-related health outcomes show strikingly high incidence in Hungary. The effects of alcohol consumption are influenced not only by the quantity, but also the quality of drinks; therefore, wine production can have an important effect on public health outcomes. Nevertheless, the Hungarian wine sector faces several vital problems and challenges influenced by the country's accession to the European Union and by the need for restructuring. A comprehensive health impact assessment (HIA) based on the evaluation of the Hungarian legislation related to the wine sector has been carried out, aiming to assess the impact of the production of quality wine versus that of table wine, using a range of public health and epidemiological research methods and data as well as HIA guidelines. The study finds that the toxic effects of alcohol can be reduced with an increased supply of quality wine and with decreased overall consumption due to higher cost, although this might drive some people to seek illegal sources. Quality wine production allows for improved use of land, creates employment opportunities and increases the incomes of producers and local communities; however, capital-scarce producers unable to manage restructuring may lose their source of subsistence. The supply of quality wine can promote social relations, contribute to a healthy lifestyle and reduce criminality related to alcohol's influence and adulteration. In general, the production and supply of quality wine can have an overall positive impact on health. Nevertheless, because of the several possible negative effects expected without purposeful restructuring, recommendations for the maximization of favourable outcomes and suggestions for monitoring the success of the analysis have been provided.

Health Care Issues Among Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Populations in the United States: Introduction

ABSTRACT This supplemental issue of the Journal of Homosexuality presents research that explores a variety of health care issues encountered by lesbian, gay, bisexual, transgender and intersex (LGBTI) population groups in the United States over the 10-year period from 1993 to 2002. Topics include access to health care, utilization of care, training of medical and mental health providers, and the appropriate preparation of clinical offices and waiting areas. Authors used a variety of community-based public health research methods, including participant and provider surveys and retrospective chart reviews of patients, to develop this body of research, providing a recent-historical perspective on the complex health care and health-related needs of sexual and gender minorities. Particularly for transgender and intersex populations, the state of research describing their health care needs is in its infancy, and much remains to be done to design effective medical and mental health programs and interventions.

Spatial statistical methods in health.

The study of the geographical distribution of disease incidence and its relationship to potential risk factors (referred to here as "geographical epidemiology") has provided, and continues to provide, rich ground for the application and development of statistical methods and models. In recent years increasingly powerful and versatile statistical tools have been developed in this application area. This paper discusses the general classes of problem in geographical epidemiology and reviews the key statistical methods now being employed in each of the application areas identified. The paper does not attempt to exhaustively cover all possible methods and models, but extensive references are provided to further details and to additional approaches. The overall aim is to provide a picture of the "current state of the art" in the use of spatial statistical methods in epidemiological and public health research. Following the review of methods, the main software environments which are available to implement such methods are discussed. The paper concludes with some brief general reflections on the epidemiological and public health implications of the use of spatial statistical methods in health and on associated benefits and problems.

Qualitative Health Research and Health Promotion at the Local Level

The Municipal Health Service for Rotterdam area in the Netherlands has developed a health research strategy with special focus on qualitative methods. This article describes one of the first and most instructive cases in which this strategy has been applied: a local health study in "Feijenoord." The research in Feijenoord was carried out between 1989 and 1990 making it possible to look both at the short-term and long-term effects. Quantitative data were used to describe the neighborhood health situation. Qualitative data were used to expand on this description. The qualitative information was obtained from residents and workers in health care and welfare using focused interviews and nominal group interviews. The results and effects of the research presented were influential. The research started a train of activity that could not have been predicted, and of which the Municipal Health Service had little control at first. An important effect in the short-term was that, as bringer of unpleasant news, the Municipal Health Service was unfavorably regarded. In the long-term, the Municipal Health Service participated significantly in the activities set up within the health framework. After evaluating these effects it was possible to formulate the conditions for an effective use of qualitative methods in public health research.

Problems of focus group methods in cross‐cultural research: a case study of beliefs about sudden infant death syndrome

Over the past decade there has been increasing interest in using focus group methods in public health research. Focus group discussions have become particularly popular, in part because they are commonly perceived to be a less time‐consuming and less expensive way of collecting qualitative data than the more traditional ethnographic methods. However, little attention has been given to methodological issues when the locus group method is applied in cross‐cultural settings. This paper discusses a number of these concerns, illustrated through the use of the focus groups to explore mothers' beliefs about sudden infant death syndrome (SIDS) in an ethnically diverse sample in Victoria. We found that some methodological difficulties were related to cultural factors. This has led us to use caution when considering the use of focused group discussions as a research method in cross‐cultural contexts. We urge public health researchers to take a critical look at the appropriateness of focus groups before applying this method in cross‐cultural public health research. (Aust J Public Health 1995; 19: 257–63)

Training researchers in cancer prevention and control: a description and evaluation of NCI's Cancer Prevention Fellowship Program.

NCI's Cancer Prevention Fellowship Program recently initiated a continuing evaluation of the fellows' demographics, fellows' accomplishments in the program, fellow and preceptor expectations and satisfaction, program strengths and weaknesses, current employment for former fellows, and ex-fellows' perceptions of program training. Evaluation shows that the program attracts quality applicants (including minorities and females) nationwide from many disciplines. The program successfully educates about cancer prevention and provides a positive preceptor experience with publication opportunities. Areas for improvement are data access, stipend, office space, job assistance, and networking. Recommendations for other programs include committed enthusiastic staff; adequate budget, space, and support; a formal learning experience in public health fundamentals, research methods, and cancer prevention; individual mentored research within a productive scientific program; aggressive recruitment; competitive admissions policy; defined objectives for fellows; and ongoing formal program evaluation.