Two-round Delphi Survey Research Articles

Construction of an evaluation index system for undergraduate nursing teachers’ curriculum humanistic competence: a Delphi study in China

BackgroundThe curriculum humanistic competence of nursing teachers is important to cultivate the humanistic qualities of undergraduate nursing students. However, there are no evaluation tools for the curriculum humanistic competence of undergraduate nursing teachers in China.ObjectiveTo develop an index system to evaluate the curriculum humanistic competence of undergraduate nursing teachers.DesignThis research conducted a Delphi study.ParticipantsSemi-structured interviews were held with 19 experts, and Delphi rounds were conducted with 18 experts.SettingsThis study was conducted in 12 universities and 4 Grade A tertiary hospitals in China.MethodsA literature review and semi-structured interviews were conducted to develop an initial framework. A two-round Delphi survey was employed to build the index system for undergraduate nursing teachers’ curriculum humanistic competence.ResultsAfter two rounds of consultation, the index system included 5 first-level indicators, 11 second-level indicators and 41 third-level indicators. The Cr for two rounds of consultation were 0.929 and 0.923, and Kendall’s W was 0.152(P<0.001).ConclusionsThe index system for the evaluation of undergraduate nursing teachers’ curriculum humanistic competence offers guidelines for undergraduate nursing teachers in China. It can be used in practice to develop high humanistic qualities in undergraduate nursing teachers.

Construction of an evaluation index system of core competencies for critical care blood purification nurses in China: A Delphi study

AimThe purpose of this study was to construct a core competencies evaluation index system for critical care blood purification nurses in China. BackgroundWhile nursing is an integral part of critical care blood purification treatment, there are no established indicators to evaluate the core competencies of critical care blood purification nurses. DesignA Delphi study. MethodsAn initial draft of the competencies evaluation index system for critical care blood purification nurses was developed through a literature review and semi-structured interviews. From February 2023 to March 2023, a two-round Delphi survey was conducted to consult with 18 experts in the field of critical care blood purification from eight provinces in China to rate the importance of each item and propose modifications to the evaluation index system. ResultsThe effective questionnaire recovery rates in two rounds of expert consultation were 94.4 % and 94.1 % and the average expert authority coefficients were 0.88 in both rounds. The core competencies evaluation index system of critical care blood purification nurses consisted of 39 items in five domains, namely theoretical knowledge, practical skills, professional development capability, critical thinking ability and personal qualities and attributes. The Kendall’s W coefficients for the first- and second-level indicators were.21 and.20 in the first round and.23 and.25, respectively, in the second round of consultations (p < .01). ConclusionThe core competencies evaluation index system of critical care blood purification nurses is scientific and reliable and can provide references for the recruitment, training and management of critical care blood purification nurses.

International Trauma-Informed Practice Principles for Schools (ITIPPS): expert consensus of best-practice principles

Recognition that schools should be responsive to children who are impacted by adversity and trauma is burgeoning internationally. However, consensus regarding the necessary components of a trauma-informed school is lacking. This research developed expert-informed and internationally relevant best-practice trauma-informed principles for schools. A four-phase methodology included (i) identification of school-relevant trauma-informed practice programs, (ii) inductive thematic analysis of the main concepts underlying programs, (iii) phrasing of draft Principles and (iv) Principle revision and finalisation via a two-round Delphi survey with international experts. Excellent agreement by experts on the importance of all Principles was achieved (round 1 ≥ 86.4%, 2 ≥ 92.3%). The final ‘International Trauma-Informed Practice Principles for Schools’ (ITIPPS) include four Overarching (A–D) and 10 Practice Principles (1–10). Summarised, these include that the school: (A) is student focussed; (B) models compassion and generosity; (C) is understanding and responsive; (D) incorporates recognition of their First Nations peoples in the school’s ethos: (1) prioritises safety and wellbeing; (2) models positive relationships; (3) provides a positive culture and connects; (4) consults and collaborates; (5) supports vulnerable students; (6) teaches social and emotional learning; (7) provides trauma-informed practice training; (8) is predictable yet flexible; (9) identifies and nurtures strengths and (10) reflects, changes and grows. The ITIPPS provide clear guidance for education sectors, schools and other settings about appropriate learning environments for children and young people impacted by trauma. Research is now underway in Western Australian schools to pilot test the feasibility and impact of using the ITIPPS within a framework (thoughtfulschools.org.au) to establish trauma-informed schools.

Vietnam national competency standards for midwifery: A Delphi study

Background: After nearly a decade, Vietnam’s basic midwifery competency standards need to be updated to effectively implement midwives, enhance the quality of midwifery human resources to meet the requirements of integration of countries in the region and around the world. This study aims to develop the competency standards for midwifery in Vietnam by using a Delphi process. Methods: The draft midwifery competency standard was initially developed based on a literature review. Midwives and professionals working with midwives completed a two-round Delphi survey to evaluate the relevance of standards of competence on a four-point Likert scale. The criteria with consensus of under 80% were revised and included in the second round. 75 participants were in the first round and 72 participants were in the second round. Phase 3 was led by the Ministry of Health to finalize the consensus on the midwifery competency standards in Vietnam. Results: The research results indicated that midwifery competency was mostly rated as quite relevant or higher (over 80%). Some standards were removed, and some were included in the second round of the Delphi process. The final competency standards were issued with 4 areas (midwifery professional practice; care management; midwifery management; professional development), 11 standards and 44 criteria; along with the general skills of midwifery. Conclusions: The study developed a midwifery competency standard in Vietnam. These competency standards are consistent with the perceptions of the International Confederation of Midwives and the domestic midwifery context. The higher education institutions, employers, policy makers and midwives themselves benefit from this developed midwifery competency standards. Future research needs to be conducted to validate midwifery competency standards in clinical settings for further responses.

Defining core outcomes of reproductive genetic carrier screening: A Delphi survey of Australian and New Zealand stakeholders.

Understanding the value, benefits and harms of health interventions is needed to inform best practice and ensure responsible implementation of new approaches to patient care. Such value is demonstrated through the assessment of outcomes; however, which outcomes are assessed is often highly varied across studies and can hinder the ability to draw robust conclusions. The Core Outcome Development for Carrier Screening study aims to understand the outcomes that can meaningfully capture the value of reproductive genetic carrier screening (RGCS). The authors report an iterative, two-round online Delphi survey of Australian and New Zealand stakeholders to determine the degree of consensus regarding the core outcomes of RGCS. Panellists ranked 83 outcomes according to their perceived importance on a nine-point Likert scale. Using the distribution of rankings, outcomes were grouped into tiers representative of their perceived level of importance and agreement between groups. The top tier outcomes represent those agreed to be critically important for all future studies of RGCS to assess and were used to define a preliminary core outcome set encompassing the domains (1) primary laboratory outcomes, (2) pregnancy outcomes, (3) resource use and, (4) perceived utility of RGCS. These findings can guide the selection of meaningful outcomes in studies aiming to demonstrate the value of RGCS. A future international consensus process will expand on these findings and guide the inclusion of diverse perspectives across the range of settings in which RGCS is offered.

Vaginal birth core information set: study protocol for a Delphi study to achieve a consensus on a ‘core information set’ for vaginal birth

IntroductionStudies have shown that women are often underinformed about potential benefits and risks of vaginal birth. This is in contrast to other modes of birth, such as caesarean birth, for...

Understanding the Critical Inducers of International Contractors' Corruption

International contractors' corruption severely threatens the transparency and sustainability of the construction industry. This study aims to identify critical inducers of international contractors' corruption and explore their interrelationships. Leveraging the fraud diamond theory, the critical inducers were identified through the semi-systematic review, context analysis, and a two-round Delphi survey with 26 experts. Then, the cause-effect associations among the critical inducers were captured by integrating the decision-making trial and evaluation laboratory (DEMATEL) method and the interpretive structure modeling (ISM) method. Following this hybrid approach, the corruption inducer system incorporating 12 inducers and 32 conditions was proposed. Institutional pressure and inefficient compliance management were the most critical inducers in the system. Additionally, the interrelationships among these inducers were organized into a seven-level hierarchy pattern. Intricate rules and institutional pressure were the root causes of corruption. Inadequate formal sanctions were the key node in the causal chain. Neutralization techniques and execution skills were the immediate causes of corruption. This study develops the corruption inducer system by combining theory with practice in the international construction industry. It contributes to the sparse research on corruption by clarifying the cause-effect relationships among inducers from a holistic perspective. The findings would help industry practitioners, multinational company executives, and international aspirants understand corruption comprehensively and prioritize countermeasures.

Fuzzy quantitative risk allocation model (FQRAM) to guide decision-making on risk allocation in Ghanaian public-private partnership (PPP) power projects

PurposePublic-private partnership (PPP) power projects are associated with varying risk factors. This paper aims to develop a fuzzy quantitative risk allocation model (QRAM) to guide decision-making on risk allocation in PPP power projects in Ghana.Design/methodology/approachA total of 67 risk factors and 9 risk allocation criteria were established from literature and ranked in a two-round Delphi survey using questionnaires. The fuzzy synthetic evaluation method was used in developing the risk allocation model.FindingsThe model’s output variable is the risk allocation proportions between the public body and private body based on their capability to manage the risk factors. Out of the 37 critical risk factors, the public sector was allocated 12 risk factors with proportions = 50%, while the private sector was allocated 25 risk factors with proportions = 50%.Originality/valueTo the best of the authors’ knowledge, this research presents the first attempt in Ghana at endeavouring to develop a QRAM for PPP power projects. There is confidence in the model to efficiently allocate risks emanating from PPP power projects.

Consensus guidelines on the management of musculoskeletal infection affecting children in the UK.

The aim of this study was to determine the consensus best practice approach for the investigation and management of children (aged 0 to 15 years) in the UK with musculoskeletal infection (including septic arthritis, osteomyelitis, pyomyositis, tenosynovitis, fasciitis, and discitis). This consensus can then be used to ensure consistent, safe care for children in UK hospitals and those elsewhere with similar healthcare systems. A Delphi approach was used to determine consensus in three core aspects of care: 1) assessment, investigation, and diagnosis; 2) treatment; and 3) service, pathways, and networks. A steering group of paediatric orthopaedic surgeons created statements which were then evaluated through a two-round Delphi survey sent to all members of the British Society for Children's Orthopaedic Surgery (BSCOS). Statements were only included ('consensus in') in the final agreed consensus if at least 75% of respondents scored the statement as critical for inclusion. Statements were discarded ('consensus out') if at least 75% of respondents scored them as not important for inclusion. Reporting these results followed the Appraisal Guidelines for Research and Evaluation. A total of 133 children's orthopaedic surgeons completed the first survey, and 109 the second. Out of 43 proposed statements included in the initial Delphi, 32 reached 'consensus in', 0 'consensus out', and 11 'no consensus'. These 11 statements were then reworded, amalgamated, or deleted before the second Delphi round of eight statements. All eight were accepted as 'consensus in', resulting in a total of 40 approved statements. In the many aspects of medicine where relevant evidence is not available for clinicians to base their practice, a Delphi consensus can provide a strong body of opinion that acts as a benchmark for good quality clinical care. We would recommend clinicians managing children with musculoskeletal infection follow the guidance in the consensus statements in this article, to ensure care in all medical settings is consistent and safe.

Measuring the determinants of implementation behavior in multiprofessional rehabilitation.

The Determinants of Implementation Behavior Questionnaire (DIBQ) measures facilitators or barriers of healthcare professionals' implementation behaviors based on the current implementation research on practice and policy. The DIBQ covers 18 domains of the Theoretical Domains Framework and consists of 93 items. A previously tailored version (DIBQ-t) covering 10 domains and 28 items focuses on implementing best-practice low back pain care. To tailor a shortened version of DIBQ to multiprofessional rehabilitation context with cross-cultural adaptation to Finnish language. A two-round Delphi study. National-level online survey. Purposively recruited experts in multiprofessional rehabilitation (N.=25). Cross-cultural translation of DIBQ to Finnish was followed by a two-round Delphi survey involving diverse experts in rehabilitation (physicians, physiotherapists, occupational therapists, psychologists, nursing scientists, social scientists). In total, 25 experts in Round 1, and 21 in Round 2 evaluated the importance of DIBQ items in changing professionals' implementation behavior by rating on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree) of including each item in the final scale. Consensus to include an item was defined as a mean score of ≥4 by ≥75% of Delphi participants. Open comments were analyzed using inductive content analysis. Items with agreement of ≤74% were either directly excluded or reconsidered and modified depending on qualitative judgements, amended with experts' suggestions. After completing an analogous second-round, a comparison with DIBQ-t was performed. Lastly, the relevance of each item was indexed using content validity index on item-level (I-CVI) and scale-level (S-CVI/Ave). After Round 1, 17 items were included and 48 excluded by consensus whereas 28 items were reconsidered, and 20 items added for Round 2. The open comments were categorized as: 1) "modifying"; 2) "supportive"; and 3) "critical". After Round 2, consensus was reached regarding all items, to include 21 items. After comparison with DIBQ-t, the final multiprofessional DIBQ (DIBQ-mp) covers 11 TDF domains and 21 items with I-CVIs of ≥0.78 and S-CVI/Ave of 0.93. A Delphi study condensed a DIBQ-mp with excellent content validity for multiprofessional rehabilitation context. A potential tool for evaluating determinants in implementing evidence-based multiprofessional rehabilitation interventions.

Artículo traducido] Consenso de la Sociedad Española de Farmacia Hospitalaria sobre el manejo fármacoterapéutico óptimo de la dermatitis atópica

AimThis study’s aims are: 1) To use the Delphi method to determine the level of consensus among HPs as regards the factors involved in the current approach to patients with AD; 2) To identify potential areas for improvement in hospital pharmacy in terms of dealing with patients with severe AD; and 3) To contribute to adequate pharmaceutical care for patients with AD by drawing up recommendations. MethodsA two-round Delphi survey with participation from HPs from all over Spain. Three theme-based blocks were set out: 1) AD; 2) Management of patients with severe AD in the Hospital Pharmacy setting; and 3) Unmet needs (pathology, patient, treatment and management). ResultsThe 42 HPs participating reached a consensus in recognizing the impact of severe AD on the patients suffering from it, the need to encourage adherence and the recommendations to use scales that take into account the patient's quality of life and indicators of the patient’s experience. It has also been demonstrated that it is worthwhile evaluating the results in real clinical practice in consensus with other specialists from the multidisciplinary team. Finally, it is advisable to use drugs that have demonstrated long-term effectiveness and safety for patients with severe AD, given the disease´s chronic nature. ConclusionsThis Delphi consensus highlights the impact of severe AD on patients, the importance of a multidisciplinary and holistic approach, in which HP play a major role. It also highlights the importance of increased access to new drugs to improve health outcomes.

Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)

ObjectivesNo consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on...

Identifying drivers affecting air quality in metropolitan areas of developing countries: evidence from Tehran metropolitan area.

Environmental issues and the significant reduction of air quality in the metropolitan areas of developing countries have become chronic challenges. While the impacts of many reasons such as the rapid trend of urbanization, lacking sustainable thinking in urban planning approaches, and urban sprawl have been explored in previous literature, the role of political economy, especially the structure based on the rentier economy, in the change of air quality as an environmental challenge in the metropolitan areas of developing countries has received little attention. To fill this gap, this study focuses on the role of the rentier economy and identifies the drivers based on it that have a tremendous impact on the air quality in Tehran metropolitan area, Iran. To this end, using the Grounded Theory (GT) foundation database and two-round Delphi survey, the opinions of 19 experts were used to identify and explain major drivers that impact air quality in Tehran. Our findings revealed that nine major drivers have an increasing impact on the air quality in the metropolitan area of Tehran. These drivers considering the dominance of the rentier economy are interpreted as the lack of powerful local governance, the rental economy, centralized structure of government, unsustainable economic development, institutional conflicts, a faulty planning system, financial unsustainability of municipalities, unfair distribution of power, and inefficient urban development policies. Among the drivers, the impacts of institutional conflicts and lack of powerful local governance on air quality are more considerable. This study highlights the role of the rentier economy as a major obstacle to resilient responses and constructive actions against chronic environmental challenges such as drastic changes in air quality in metropolitan areas of developing countries.

Educational experiences and needs of students in out-of-home care: a Delphi study

Numerous studies show that children and young people in out-of-home care (OOHC) face significant disadvantage in completing high school and accessing post-secondary education. The current research involved a two-round Delphi survey which aimed to identify educational challenges and school reforms to improve the educational experiences of children and young people in OOHC. A total of 45 participants from three OOHC stakeholder groups (carers of children in OOHC, professionals/educators, and young people with lived experience of OOHC) completed the round one survey which consisted of open-ended questions analysed using thematic analysis. In the second survey round, 19 participants completed a Likert scale questionnaire which drew on themes from the round one thematic analysis. Using a consensus threshold of 70% for the round two survey, participants agreed that students in OOHC face a myriad of educational challenges, such as dealing with a history of trauma, frequent home and school transitions, mental health issues and stigma as a result of being in OOHC. It was agreed that teachers lack knowledge and experience, and schools lack support for students in OOHC. Stakeholders recommended provision of greater mental health support, coordination of services and more autonomy for OOHC students regarding their education.

Integrating China in the international consortium for personalised medicine. a position paper on healthcare professionals’ education and citizens’ empowerment in personalised medicine

BackgroundPersonalised medicine (PM) has been fostered by technological and medical advances, but all stakeholders, including healthcare professionals, citizens and policy makers, should achieve adequate health literacy to promote PM implementation. The “Integrating China in the International Consortium for Personalised Medicine” (IC2PerMed) project, funded by the International Consortium for Personalised Medicine, focuses on this issue by highlighting the need to educate healthcare professionals and empower citizens. Within the aforementioned project, building on a mapping of European and Chinese policies in PM, experts in the field of PM participated in an online workshop and a following two-round Delphi survey, in order to identify the priority areas of intervention for healthcare professionals’ education and curricula, engagement and empowerment of citizens and patients.ResultsNine experts completed the survey and reached a consensus on seventeen priorities: seven were related to health professionals’ education and curricula, whereas ten on citizen and patients’ awareness and empowerment.ConclusionThese priorities emphasized the importance of education and health literacy, multidisciplinary and international collaboration, public trust, and consideration of ethical, legal, and social issues. The present experience highlights the relevance of the involvement of stakeholders in informing decision-makers, developing appropriate national plans, strategies, and policies, and ensuring the adequate implementation of PM in health systems.

A joint international consensus statement for measuring quality of survival for patients with childhood cancer.

The aim of treating childhood cancer remains to cure all. As survival rates improve, long-term health outcomes increasingly define quality of care. The International Childhood Cancer Outcome Project developed a set of core outcomes for most types of childhood cancers involving relevant international stakeholders (survivors; pediatric oncologists; other medical, nursing or paramedical care providers; and psychosocial or neurocognitive care providers) to allow outcome-based evaluation of childhood cancer care. A survey among healthcare providers (n = 87) and online focus groups of survivors (n = 22) resulted in unique candidate outcome lists for 17 types of childhood cancer (five hematological malignancies, four central nervous system tumors and eight solid tumors). In a two-round Delphi survey, 435 healthcare providers from 68 institutions internationally (response rates for round 1, 70-97%; round 2, 65-92%) contributed to the selection of four to eight physical core outcomes (for example, heart failure, subfertility and subsequent neoplasms) and three aspects of quality of life (physical, psychosocial and neurocognitive) per pediatric cancer subtype. Measurement instruments for the core outcomes consist of medical record abstraction, questionnaires and linkage with existing registries. This International Childhood Cancer Core Outcome Set represents outcomes of value to patients, survivors and healthcare providers and can be used to measure institutional progress and benchmark against peers.

Integration Building Information Modeling and Lean Construction Technologies in the Iraqi Construction Sector: Benefits and Constraints

Building Information Modeling (BIM) and Lean Construction (LC) are two quickly growing applied research areas in construction management. This study focuses on identifying the most essential benefits and analyzing the most affecting constraints on the construction sector that construction players face as they attempt to combine BIM-LC in Iraqi construction. Experts assessed 30 benefits and 28 constraints from examining the previous literature, and a two-round Delphi survey formed the responses. Expert consensus analysis was utilized to elaborate and validate responses after descriptive statistical checks had been used for data processing. According to the study's findings, the benefits include ensuring the most effective project delivery method and shortening the design project life cycle. The building industry's procedures will incorporate suppliers. In contrast, the main constraints include the government rules and industry standards for BIM and LC are not obligatory, the absence of government funding and participation, and the industry's resistance to changing from customary operating methods. The study strategies and recommendations will enhance BIM-LC-LC implementation. It allows project partners to focus on addressing the challenges identified in this study and understand the benefits of BIM-LC to be an incentive to adopt them.

Development of Infectious Disease Emergency Response Competencies for Nurses in China: A Delphi Study and an Analytic Hierarchy Process

Aim. To develop a set of infectious disease emergency response competencies specific to frontline nurses in China. Background. Nurses play an important role in the infectious disease emergency response. Competency-based training is the cornerstone of the professionalization of disaster rescue, including the infectious disease emergency response. Accordingly, reaching a consensus on a set of core competencies is essential. However, information regarding the competencies needed for nurses in the infectious disease emergency response is limited. Methods. A literature review and in-depth expert interviews were conducted to establish a draft of competencies, which consisted of 53 items, including 3 first-level index items, 12 second-level index items, and 38 third-level index items. Eighteen experts with the knowledge of infectious disease management and experience with infectious disease emergency rescue from different regions in China were recruited for Delphi consultation. A two-round Delphi survey was conducted via email. Consensus was defined as a mean importance value &gt;4.5 and the coefficient of variation &lt;0.25 among the experts. Finally, the analytic hierarchy process was used to determine the weight of each index on which consensus had been reached. Results. An index system of infectious disease emergency response competencies for nurses was constructed, including 3 first-level indices (knowledge, attitudes, and skills), 10 second-level indices, and 32 third-level indices. The response rates of the two rounds of the Delphi survey were both 100%, and the authority coefficient of the 18 experts was 0.903. The weighted value of each index was established with a consistency ratio &lt;0.1, demonstrating that skill (0.5396) ranked first among the three first-level indices, followed by knowledge (0.2970) and attitudes (0.1634). Conclusion. The study developed a consensus on infectious disease emergency response competencies required for nurses in China, which provides guidance for the assessment and training of nurses on infectious disease emergency response. Implications for Nursing Management. According to the competency index system, nursing managers could develop effective training programs of infectious disease emergency response competency for nurses and select competent nurses for emergency response to infectious diseases.

Consensus of Spanish Society of Hospital Pharmacy on optimal medication therapy management of atopic dermatitis

AimThis study's aims are: 1) To use the Delphi method to determine the level of consensus among hospital pharmacists (HPs) as regards the factors involved in the current approach to patients with atopic dermatitis (AD); 2) To identify potential areas for improvement in hospital pharmacy in terms of dealing with patients with severe AD; and 3) To contribute to adequate pharmaceutical care for patients with AD by drawing up recommendations. MethodsA two-round Delphi survey with participation from HPs from all over Spain. Three theme-based blocks were set out: 1) AD; 2) Management of patients with severe AD in the Hospital Pharmacy setting; and 3) Unmet needs (pathology, patient, treatment and management). ResultsThe 42 HPs participating reached a consensus in recognising the impact of severe AD on the patients suffering from it, the need to encourage adherence and the recommendations to use scales that take into account the patient's quality of life and indicators of the patient's experience. It has also been demonstrated that it is worthwhile evaluating the results in real clinical practice in consensus with other specialists from the multidisciplinary team. Finally, it is advisable to use drugs that have demonstrated long-term effectiveness and safety for patients with severe AD, given the disease's chronic nature. ConclusionsThis Delphi consensus highlights the impact of severe AD on patients, the importance of a multidisciplinary and holistic approach, in which HP play a major role. It also highlights the importance of increased access to new drugs to improve health outcomes.

Food security definition, measures and advocacy priorities in high-income countries: a Delphi consensus study.

To establish an international consensus on the definition of food security, measures and advocacy priorities in high-income countries. A two-round online Delphi survey with closing in March 2020 and December 2021. Consensus was set a priori at 75 %. Qualitative data were synthesised and priorities were ranked. High-income countries. Household food security experts in academia, government and non-government organisations who had published in the last 5 years. Up to thirty-two participants from fourteen high-income countries responded to the Delphi with a 25 % response rate in Round 1 and a 38 % response rate in Round 2. Consensus was reached on the technical food security definition and its dimensions. Consensus was not reached on a definition suitable for the general public. All participants agreed that food security monitoring systems provide valuable data for in-country decision-making. Favoured interventions were those that focused on upstream social policy influencing income. Respondents agreed that both national and local community level strategies were required to ameliorate food insecurity, reinforcing the complexity of the problem. This study furthers the conceptual understanding of the commonly used definition of food security and its constituent dimensions. Strong advocacy is needed to ensure food security monitoring, policy and mitigation strategies are implemented. The consensus on the importance of prioritising actions that address the underlying determinants of household food security by experts in the field from across wealthy nations provides evidence to focus advocacy efforts and generate public debate.