Development of self-administered questionnaire on barriers, prescription practices, and guideline adherence of osteoporosis management among tertiary care clinicians: content validity and reliability analysis

Objective

This study outlined the development of the barriers, prescribing practices, and guideline adherence for osteoporosis management according to the Clinicians' Osteoporosis Questionnaire (COQ) followed by an assessment of the content validity index and reliability test.

Methods

The development of the COQ was performed in two stages. Stage I involved the development of the COQ, and stage II involved judgmental evidence and quantification of the questionnaire. Five panel experts related to the study area and five clinicians participated in the validity of the COQ assessment. Fifty clinicians took part in the reliability test evaluation by filling out the questionnaire twice at 2-week intervals. The content validity index (CVI) and content validity ratio (CVR) were analyzed using Microsoft Excel, while Cohen's kappa statistic was used to determine the test-retest reliability using SPSS version 29.

Results

Forty items and three domains, namely, barriers, prescribing practices, and guideline adherence for osteoporosis management, were identified in the COQ (version 4.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVRs for all the items were above 0.7, except for two items in the barrier domain and two items in the guideline adherence domain. Two items were revised to improve the clarity of the item, and other items were retained based on consensus among the expert panel. Between the test and retest, the reliability of individual items ranged from moderate to almost perfect for the barrier domain (k = 0.42-0.86), prescribing practice domain (k = 0.79-0.87), and guideline adherence domain (k = 0.46-1). None of the items had "fair" or "poor" agreement. Thus, the 40-item COQ (version 4.0) was finalized following the content and face validity analysis.

Conclusions

Through an iterative process, the development and assessment of the COQ showed a high degree of content validity and reliability in measuring the barriers, prescribing practices, and guideline adherence among clinicians managing osteoporosis. Future studies should aim to further validate this instrument across different populations and settings, as well as explore methods to enhance its reliability and validity.

The disconnect between researcher ambitions and reality in achieving impact in the Earth & Environmental Sciences – author survey

Background: There is an increasing desire for research to provide solutions to the grand challenges facing our global society, such as those expressed in the UN SDGs (“real-world impact”). Herein, we undertook an author survey to understand how this desire influenced the choice of research topic, choice of journal, and preferred type of impact. Methods: We conducted a survey of authors who had published in >100 of our Earth & Environmental Science journals. The survey was sent to just under 60,000 authors and we received 2,695 responses (4% response rate).   Results: Respondents indicated that the majority of their research (74%) is currently concerned with addressing urgent global needs, whilst 90% of respondents indicated that their work either currently contributed to meeting real-world problems or that it would be a priority for them in the future; however, the impetus for this research focus seems to be altruistic researcher desire, rather than incentives or support from publishers, funders, or their institutions. Indeed, when contextualised within existing reward and incentive structures, respondents indicated that citations or downloads were more important to them than contributing to tackling real-world problems. Conclusions: At present, it seems that the laudable and necessary ambition of researchers in the Earth & Environmental Sciences to contribute to the tackling of real-world problems, such as those included in the UN SDGs, is seemingly being lost amidst the realities of being a researcher, owing to the prioritisation of other forms of impact, such as citations and downloads.

The disconnect between researcher ambitions and reality in achieving impact in the Earth & Environmental Sciences – author survey

Background: There is an increasing desire for research to provide solutions to the grand challenges facing our global society, such as those expressed in the UN SDGs (“real-world impact”). Herein, we undertook an author survey to understand how this desire influenced the choice of research topic, choice of journal, and preferred type of impact. Methods: We conducted a survey of authors who had published in >100 of our Earth & Environmental Science journals. The survey was sent to just under 60,000 authors and we received 2,695 responses (4% response rate).   Results: Respondents indicated that the majority of their research (74%) is currently concerned with addressing urgent global needs, whilst 90% of respondents indicated that their work either currently contributed to meeting real-world problems or that it would be a priority for them in the future; however, the impetus for this research focus seems to be altruistic researcher desire, rather than incentives or support from publishers, funders, or their institutions. Indeed, when contextualised within existing reward and incentive structures, respondents indicated that citations or downloads were more important to them than contributing to tackling real-world problems. Conclusions: At present, it seems that the laudable and necessary ambition of researchers in the Earth & Environmental Sciences to contribute to the tackling of real-world problems, such as those included in the UN SDGs, is seemingly being lost amidst the realities of being a researcher, owing to the prioritisation of other forms of impact, such as citations and downloads.

Research can be integrated into public health policy-making: global lessons for and from Spanish economic evaluations

WHO promotes the use of research in policy-making to drive improvements in health, including in achieving Sustainable Development Goals such as tobacco control. The European Union’s new €95 billion Horizon Europe research framework programme parallels these aims, and also includes commitments to fund economic evaluations. However, researchers often express frustration at the perceived lack of attention to scientific evidence during policy-making. For example, some researchers claim that evidence regarding the return on investment from optimal implementation of evidence-based policies is frequently overlooked. An increasingly large body of literature acknowledges inevitable barriers to research use, but also analyses facilitators encouraging such use. This opinion piece describes how some research is integrated into policy-making. It highlights two recent reviews. One examines impact assessments of 36 multi-project research programmes and identifies three characteristics of projects more likely to influence policy-making. These include a focus on healthcare system needs, engagement of stakeholders, and research conducted for organizations supported by structures to receive and use evidence. The second review suggests that such characteristics are likely to occur as part of a comprehensive national health research system strategy, especially one integrated into the healthcare system. We also describe two policy-informing economic evaluations conducted in Spain. These examined the most cost-effective package of evidence-based tobacco control interventions and the cost-effectiveness of different strategies to increase screening coverage for cervical cancer. Both projects focused on issues of healthcare concern and involved considerable stakeholder engagement. The Spanish examples reinforce some lessons from the global literature and, therefore, could help demonstrate to authorities in Spain the value of developing comprehensive health research systems, possibly following the interfaces and receptor model. The aim of this would be to integrate needs assessment and stakeholder engagement with structures spanning the research and health systems. In such structures, economic evaluation evidence could be collated, analysed by experts in relation to healthcare needs, and fed into both policy-making as appropriate, and future research calls. The increasingly large local and global evidence base on research utilization could inform detailed implementation of this approach once accepted as politically desirable. Given the COVID-19 pandemic, increasing the cost-effectiveness of healthcare systems and return on investment of public health interventions becomes even more important.

Development and validation of a questionnaire to evaluate the knowledge, attitude and practices regarding travel medicine amongst physicians in an apex tertiary hospital in Northern India

OBJECTIVES

Travel medicine focuses primarily on pre-travel preventive care and the conditions and diseases acquired during or after travel. There is a paucity of validated tools to assess the knowledge, attitude and practises of physicians with regard to travel medicine. We attempted to develop a tool to assess existing expertise among Medicine and Infectious Diseases resident doctors with respect to travel medicine.

METHODS

Item level content validity index (I-CVI) and scale level content validity index (S-CVI/Ave) were estimated for each of the items to establish the content validity. Refined measures of inter-rater agreement (Brennan and Prediger Agreement Coefficient and Gwet's Agreement Coefficient) were estimated for the tool.

RESULTS

The final version of the questionnaire had satisfactory content validity (I-CVI > 0∙6 and S-CVI/Ave > 0∙9) and possessed high agreement among the raters (Brennan and Prediger AC > 0∙7, p < 0∙01 and Gwet's AC > 0∙8, p < 0∙01) with regard to necessity, clarity and relevance of the scale.

CONCLUSIONS

This tool covers a wide range of questions and is scientifically validated. The final version of the tool can be used largely for the assessment of knowledge, attitude and practices among medical practitioners. This is instrumental to build targeted intervention programs to enhance the knowledge regarding travel medicine among health care providers.

Student perceptions on synchronous virtual versus face-to-face teaching for leader-centered and participant-centered postgraduate activities during COVID-19

Consequent to the unprecedented COVID-19 pandemic, pedagogic changes were introduced in postgraduate courses in Physiology, where face-to-face teaching was replaced with synchronous virtual mode for leader-centered (seminar, symposium) and participant-centered (journal club, group discussion) academic activities. We hypothesized that the effectiveness of virtual and face-to-face modes as perceived by postgraduate students in terms of facilitating their overall learning may differ across the spectrum of leader-centered and participant-centered activities. To assess the same, we designed and administered a comprehensive, structured, and validated feedback questionnaire. Postgraduate students (n = 29) rated virtual sessions significantly more convenient, but less attentive and comprehensible, and reported better audiovisual experience during face-to-face sessions. Students rated flexibility to attend, self-paced learning, ability to revise, lookup for information in real time, and accessibility to distant expertise as important features of virtual sessions and instant feedback, eye-to-eye contact, and ability to interact in the group for face-to-face sessions. Virtual and face-to-face sessions were perceived as equally effective in facilitating their overall learning for the conduct of leader-centered seminars and symposia. However, face-to-face sessions were considered more effective for the conduct of participant-centered group discussions and journal clubs. During the pandemic, students perceive the synchronous virtual mode as an equally effective alternative for the conduct of leader-centered academic activities, but face-to-face teaching is still preferred for the conduct of participant-centered academic activities.

Using chi-squared automatic interaction detection modelling to identify student opinion profiles regarding same-sex couples as a family structure

The aim was to determine the opinions held by a sample of students in relation to homoparenting as a family modality. A cross-sectional study was conducted on a sample of university students specialization: social sciences using the AHFH. It is patent that opinions of students about the three factors (support, rejection and acceptance) that compose the construct of attitudes towards same-sex couples as a family structure, differ greatly depending on the positive or negative nature of these components. In conclusion, in relation to the dimension pertaining to rejection of same-sex couples as a family entity, we derived a configuration determined by 1 of the 4 predictor variables. In this case, gender was the only one of the 4 variables considered to support formation of a profile. This profile was constituted by male students who, independent of their birthplace setting, qualification and whether they personally know any same-sex couples, showed stronger agreement with the dimension describing rejection of same-sex couples as a family structure.

A cross-sectional multicenter survey on the future of dental education in the era of COVID-19: Alternatives and implications

PURPOSE

The coronavirus disease 2019 (COVID-19) pandemic has significantly challenged dental education. This study investigated the procedures outlined by dental faculty members to maintain quality dental education in a safe bioenvironment and adequately control the risk of cross-infection METHOD: Dental educators from dental schools around the world were invited to join an online survey considering different demographic factors. The survey consisted of 31 questions that were classified into separate sections, including academic characteristics, college size and facilities, action taken after announcement of the COVID-19 pandemic, perception of the pandemic, opinion regarding teaching, patient flow, possible facilities to implement for short- and long-term plans, and actions suggested to deal with the COVID-19 pandemic RESULTS: Two hundred-twelve responses were received. Respondents commonly agreed that COVID-19 will have major negative effects on dental education, adversely affecting all clinical disciplines. Shifting to virtual curricula, simulation labs, and distant learning were the prevailing actions taken in different dental colleges during the pandemic. Special attention was raised by the majority of respondents regarding dental aerosolizing procedures, preferring to postpone their training to a postpandemic/later phase. Coinciding opinions suggested adopting a future dynamic hybrid strategy analysis that combines online distant learning, virtual simulation, and haptic labs together with traditional direct clinical training on real patients CONCLUSION: The future of dental education will have far-reaching changes in strategies and tools to cope with COVID-19 pandemic and the postpandemic requirements of an effective, yet safe, dental learning environment. Dental colleges need to invest in infection precautions and in modern virtual education and training facilities.

Evaluating Research Centers in Minority Institutions: Framework, Metrics, Best Practices, and Challenges

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators' Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs' impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.

The use of an impact framework to evaluate the impact of research on policy and practice: Screening questionnaires for intellectual disability

There is an increasing emphasis on the importance of research having an impact on policy and practice. This can be more difficult to evidence in intellectual disability services because of the wide range of stakeholders involved. We evaluated whether an impact questionnaire covering: knowledge production, capacity building, informing policy and practice, social and economic benefits could successfully be used to evaluate the impact of research into and use of two screening questionnaires: the Learning Disability Screening Questionnaire (LDSQ) and Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). We conducted an online search for published peer reviewed and grey literature, and Internet resources that referenced LDSQ and/or CAIDS-Q. The resultant literature and resources were assessed for relevance and organized according to the categories outlined in the impact questionnaire. Evidence was found for all the areas of impact, with the largest body of evidence being in relation to informing policy and practice and social benefits and the least for economic benefits. The impact questionnaire provided the basis for a comprehensive and useful evaluative framework to assess impact, although there was some overlap between the different categories. The process of using it highlighted some wider issues to consider when attempting to evaluate impact. The results indicated that the research underpinning the LDSQ and CAIDS-Q had resulted in significant, generally positive, and wide-reaching impact on policy and practice in intellectual disability and other services, resulting in a number of positive outcomes.