Research priorities for parenting and child health: a Delphi study

Top 10 (plus 1) research priorities for expectant families and those with children to age 24 months in Alberta, Canada: results from the Family Research Agenda Initiative Setting (FRAISE) priority setting partnership project

OBJECTIVE

The study objective was to identify the top 10 research priorities for expectant parents and caregivers of children up to age 24 months.

DESIGN

A priority setting partnership using a modified James Lind Alliance approach was implemented. First, a core steering committee was formed, consisting of 17 parents, clinicians and community agency representatives. Second, through in-person collaboration with steering committee members, we developed and distributed a survey to identify research priorities across 12 topics. In total, 596 participants consented and 480 completed the survey. Survey responses were grouped and themed into codes during a consensus-building workshop with steering committee members (n=18). Research and practice experts were consulted to provide feedback on which themes had already been researched. An in-person (n=21) workshop was used to establish the top 34 priorities, which were circulated to the broader steering committee (n=25) via an online survey. Finally, the core steering committee members (n=18) met to determine and rank a top 10 (plus 1) list of research priorities.

SETTING

This study was conducted in Alberta, Canada.

PARTICIPANTS

Expectant parents and caregivers of children up to age 24 months.

RESULTS

Survey results provided 3232 responses, with 202 unique priorities. After expert feedback and steering committee consensus, a list of 34 priorities was moved forward for final consideration. The final top 10 (plus 1) research priorities included three priorities on mental health/relationships, two priorities on each of access to information, immunity and child development, and one priority on each of sleep, pregnancy/labour and feeding. Selecting 11 instead of 10 priorities was based on steering committee consensus.

CONCLUSIONS

The findings will direct future maternal-child research, ensuring it is rooted in parent-identified priorities that represent contemporary needs. To provide meaningful outcomes, research in these priority areas must consider diverse socioeconomic backgrounds and experiences.

Achieving consensus on the undergraduate curriculum of public health nursing in Turkey

OBJECTIVE

The aim of this study was to construct a consensus on the undergraduate learning objectives and topics for public health nursing (PHN) in Turkey.

DESIGN

A three-round e-mail-based Delphi study was conducted between May and July 2015 with a national sample.

SAMPLE

Ninety-one academics from 54 universities were invited as experts to participate by e-mail. Fifty-nine academics from 43 universities participated in the study.

MEASUREMENTS

Data were analyzed by computing the median, quartiles one and three, and the interquartile range for each learning outcome and topic. Consensus was considered as less than the interquartile range of 1.2.

RESULTS

Experts who participated in the study added 70 learning outcomes, eight main topics, and 278 sub-topics during the first round. Round I generated 170 learning outcomes, 28 main topics, and 385 sub-topics. At the end of Round II, consensus was reached on 126 learning outcomes, 22 main topics and 168 sub-topics. At the end of Round III, consensus was achieved for 126 learning outcomes, 22 main topics, and 169 sub-topics.

CONCLUSION

The learning outcomes and topics that were decided upon through a consensus process will contribute to the standardization and development of PHN education.

Metodologías para la priorización en investigación en salud: una revisión sistemática de la literatura

Objetivo.

Identificar elementos metodológicos clave para la priorización en investigación en salud, a partir de las metodologías reportadas en la literatura científica.

Métodos.

Se realizó una búsqueda sistemática en Medline, Embase, LILACS, y fuentes complementarias de literatura gris. Se utilizaron las palabras clave: research, methods y health priorities, en combinación con términos libres. Dos revisores independientes, de acuerdo con criterios previamente definidos, seleccionaron revisiones de la literatura o documentos metodológicos que presentaran metodologías para priorización en investigación en salud. Se extrajeron las principales características de las metodologías reportadas y se identificaron elementos comunes.

Resultados.

Se incluyeron siete revisiones y cinco documentos metodológicos, que reportaron cuatro metodologías estructuradas específicas y múltiples aproximaciones metodológicas que combinan elementos diversos. En general, estas metodologías integran la perspectiva de actores clave con información objetiva, mediante la aplicación de técnicas estandarizadas de participación, para establecer un ranking de prioridades, con base en criterios previamente definidos. Se identificaron elementos metodológicos comunes relacionados con pasos del proceso, mecanismos de participación, criterios para priorizar y análisis de resultados.

Conclusión.

La priorización en investigación en salud requiere el empleo de una metodología definida a priori, que debe contener como mínimo cuatro elementos clave: pasos claros del proceso, criterios para priorizar, técnicas formales de participación y métodos de análisis de resultados. Estos elementos deben ajustarse a las condiciones y necesidades del contexto de aplicación.

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods

Background

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified.

Methods

The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods.

Results

A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others contributed further potential topic areas instead.

Conclusions

Delphi-like survey methods are practical and productive as a means of obtaining opinions from a wide number of relevant experts identifying potential priority topic areas for research; however, this method is less appropriate for framing tractable research questions.

Electronic supplementary material

The online version of this article (doi:10.1186/s12961-017-0252-2) contains supplementary material, which is available to authorized users.

Prioritisation of future research topics in paediatric palliative care in Ireland: a Delphi study

This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies. As a new specialty, there is a need to develop an evidence-based approach to providing children's palliative care. In order to do this in a systematic way, identification of the research priorities in children's palliative care within Ireland is required.

Extended parenting education in an early parenting centre: A mixed-methods study

This article reports findings from a process and impact study of a residential early parenting centre programme in Australia. The programme supports parents with young children under the age of three, referred from health and child protection services. Multiple sources of data were used from interviews, focus groups, direct observations, observer notes and a parenting sense of competence questionnaire. Qualitative data were analysed using thematic analyses, and paired t-tests were used to test data from the questionnaire. Three themes emerged from thematic analysis of the qualitative data: engaging families, building parenting capacity and transitioning back to the community. Parents' perceptions of parent competence improved significantly between admission and discharge for participating families. Detailed accounts of the way in which nurses work to achieve positive outcomes in relation to parenting confidence and satisfaction in the short term have provided useful insights into often taken-for-granted support processes in working with referred parents. The complexity of the nurses' role and implications for nursing practice in residential parenting centres are discussed. Future research is warranted to determine longer-term benefits of this programme being delivered in a residential early parenting centre.

Paternal depression during pregnancy and postpartum: An international Delphi study

BACKGROUND

Fathers are at risk for depression during a mother's gestation and postpartum. Assessment, detection, and treatment are hampered by the lack of consensus on this issue. The purpose of this study was to reach expert consensus through the Delphi method on the defining factors of depression in peripartum fathers.

METHODS

Purposive sampling resulted in the surveying of 14 international expert panelists. The study used a modified Delphi approach in which experts participated in two rounds of open-ended and scale questionnaires, followed by two rounds of opportunities to adjust their responses and/or comment on evolving data until consensus was achieved.

RESULTS

Experts responded to 10 questions on terminology, diagnostics, symptomology, risk/protective factors, biological factors, assessment tools/protocol, cost implications, and key stakeholders. Of these 10 questions presented for discussion, the analysis resulted in 197 coded themes. Consensus was met for 119 of the 197 coded responses (60.41%).

LIMITATIONS

Diversity of opinion within this Delphi Study was excluded for the sake of consensus. Regression to the mean may have occurred after continuous surveying and when evolving results were shared with panelists. Critics of Delphi methodologies have pointed to the issue of small expert samples typically used and the subjectivity of "expert."

CONCLUSION

Consensus identified diagnostic criteria and symptomology that differentiates the paternal experience of peripartum depression. Experts indicated the importance of a father's social context, biological risk factors, limitations of current assessment tools, key stakeholders, and potential financial costs. Stakeholders on this issue would benefit from translating consensus into assessment and treatment.

Research priorities for children's nursing in Ireland: a Delphi study

This paper is a report of a study which identified research priorities for children's nursing in an acute care setting in Ireland. A limited number of studies have examined research priorities for children's nursing. This study was undertaken against the backdrop of significant proposed changes to the delivery of children's healthcare. A three round Delphi survey design was used to identify and rate the importance of research priorities for children's nursing. In round I participants were asked to identify five of the most important research priorities for children's nursing. Participants in round II were asked to rate the importance of each research priority on a 7-point Likert scale. In round III participants were presented with the mean score of each research priority from the second questionnaire, and again asked to consider the importance of each topic on a 7-point Likert scale. The aim was to reach consensus on the priorities. The top three priorities identified were recognition and care of the deteriorating child, safe transfer of the critically ill child between acute health care facilities, and the child and family's perceptions of care at end-of life. The wide variation of priorities reflects the scope of care delivery of children's nurses and mirrors many global care concerns in caring for children.

Developing nursing and midwifery research priorities: a Health Service Executive (HSE) North West study

AIM

The primary purpose of this study was to identify research priorities for nurses and midwives across the Health Service Executive (HSE) North West region. The rationale for the study was underlined during meetings of HSE North West Directors of Nursing and Midwifery in January 2011. It was agreed that a more strategic approach to generating synergy among nursing and midwifery research, evaluation, and evidence-based practice should be developed through the Nursing and Midwifery Planning and Development Unit.

METHODS

The research design was founded upon collaborative processes for consensus building that included the Delphi technique and nominal group technique. The study sample included a panel of experts. Data were collected between March 2011 and December 2011.

FINDINGS

Findings from this study validate the efficacy of the research methodology in enabling the effective identification of priority areas for research. These include: (a) an evaluation of the impact of postgraduate nursing and midwifery education programs focusing upon patient, professional, and organizational outcomes; (b) development and evaluation of an effective culture of nurse- and midwife-led audit across all services within a Regional Health Trust in Ireland; (c) an examination of the efficacy of approaches to clinical supervision within the context of the Irish health system; (d) an evaluation of the impact of an Advanced Nurse Practitioner role in supporting the effective management of long-term conditions within the context of Regional Health Trust primary care settings in Ireland; and (e) Supporting and developing an ethical framework for nursing and midwifery research within a Regional Health Trust in Ireland.

LINKING EVIDENCE TO ACTION

It is anticipated that future work, outlined within this paper, will lead to important improvements in patient care and outcomes. Furthermore, this study provides evidence that a strong nursing and midwifery research agenda can be established upon genuine collaborations and partnerships across varying levels of research knowledge and skills, but with a shared purpose and shared values.

A survey of NAPNAP members' clinical and professional research priorities

INTRODUCTION

The purpose of this methodological article is to describe the development, implementation, and analysis of the survey used to determine NAPNAP members' ranking of research priorities, to describe the top priorities ranked by participants, and to determine if priorities differed by area of practice (primary, acute, or specialty care) or participant age.

METHOD

A cross-sectional descriptive design with an online survey was used. Completed by 324 NAPNAP members, the survey consisted of a demographic section and 90 statements in two domains: Clinical Priorities and Professional Role Priorities.

RESULTS

Survey respondents strongly supported the top priorities with an average overall mean score of 4.0 or above on a 5-point Likert scale. Only three of the top 10 clinical and professional priorities differed by area of practice. No clinical priorities and only three professional priorities differed by age.

DISCUSSION

The survey results were used to develop the NAPNAP Research Agenda. Both the survey results and the agenda can provide guidance for the NAPNAP Board, committees and interests groups as they develop initiatives and programs.

What research questions matter to Australian paediatricians? National Delphi Study

AIM

The newly formed Australian Paediatric Research Network (APRN) aims to facilitate general paediatricians' participation in research in secondary care settings. This (its first) project aimed to identify Australian paediatricians' top research priorities and preferred research designs.

METHODS

All Australian general paediatricians were invited into a national Delphi process survey. In Stage 1, they were asked 'Thinking about your clinical practice, what are the most important research questions which need addressing?'. Using qualitative methods, a 'top 20' list of the most common, feasible research questions was generated. In Stage 2, respondents prioritised these 'top 20' research questions in terms of perceived importance to their practice, and rated their interest in participating in various types of research.

RESULTS

A total of 685 (68%) of 1006 paediatricians completed the baseline survey, with 209 paediatricians contributing 430 Stage 1 research questions. Of these, 128 (30%) had not been addressed in the literature and were researchable in the secondary care outpatient setting. The top five questions ranked in Stage 2 by 348 paediatricians were obesity management (two questions), long-term ADHD educational outcomes, autism spectrum outcomes, and prophylactic antibiotics in preventing urinary tract infections. Paediatricians were willing to participate in research designs, including longitudinal research (75%) and randomised trials (64%).

CONCLUSIONS

Australian paediatricians are interested in research, and their ideas can provide direction for APRN and potentially other networks in Australia. Many of the questions generated could not be easily answered by traditional biomedical and clinical research methods, highlighting the potential benefit of practice-based research networks.

Prioritization of future research topics for children's hospice care by its key stakeholders: a Delphi study

The Delphi process, widely used in health research to seek consensus on key issues amongst large stakeholder groups, was adopted to allow families, hospice staff/volunteers and linked professionals to identify and prioritize future research priorities for children's hospice care. In the qualitative Round 1, interviews with families (n = 5), linked professionals (n = 18) and focus groups with hospice staff and volunteers (n = 44) led to the generation of 56 research topics categorised within 14 broad themes. To give a larger number of stakeholders (n = 621) (including families n = 293; hospice staff/volunteers n = 216 and professionals n = 112) the opportunity to rate the importance of each research topic and seek group consensus on the future research priorities for children's hospice care, subsequent Rounds 2 and 3 involved the use of postal questionnaires. Response rates to questionnaires were 44% in Round 2 (274/621) and 83% in Round 3 (204/247). Participants prioritized research topics relating to 1) hospice and respite care needs of young people (aged 16 +), 2) pain and symptom management and 3) bereavement and end-of-life care. There was wide acknowledgement by those took part in the process of the difficulty in rating the topics, and emphasis on the fact that all of the topics raised during the project are of high importance and merit further research. The current salient issues perceived by key stakeholders as being the research priorities for children's hospice care were identified. Addressing these priority topics for research would further contribute to the development of a much needed evidence base in children's hospice and palliative care research and optimise the delivery of children's hospice services that are underpinned by valid and robust research.

Exploring the experiences and perspectives of families using a children's hospice and professionals providing hospice care to identify future research priorities for children's hospice care

The main objective of this study is to generate a list of priority topics for children's hospice care research in Scotland from the perspective of its key stakeholders. The method consists of qualitative semi-structured interviews with families using hospice services (n = 5), four focus groups with hospice staff and volunteers (n = 44) and telephone interviews with professionals associated with the hospice (n = 18). Fourteen broad themes emerged following thematic content and interpretive analysis of the interview data. Some of the research themes were specific to certain stakeholder groups, whereas other themes were identified unanimously across all the stakeholder groups as being priority areas for future research. Increasing awareness of and improving access to children's hospice care, hospice and respite care needs of young people, community/home care and issues related to supporting the wider family arose, independently, in all three stakeholder groups as being priority topics for future research. In conclusion, a greater evidence base is required in the field of children's palliative care and the topics researched should be identified and led by those most closely involved in the hospices. Engaging families and care providers in the process of identifying research priorities resulted in the development of an extensive research agenda, which will contribute to quality hospice care for children and families.