Applying for, reviewing and funding public health research in Germany and beyond

Priority setting to support a public health research agenda: a modified Delphi study with public health stakeholders in Germany

BACKGROUND

Research priority setting (RPS) studies are necessary to close the significant gap between the scientific evidence produced and the evidence stakeholders need. Their findings can make resource allocation in research more efficient. However, no general framework for conducting an RPS study among public health stakeholders exists. RPS studies in public health are rare and no such study has been previously conducted and published in Germany. Therefore, we aimed to investigate which research topics in public health are prioritised by relevant stakeholders in Germany.

METHODS

Our RPS study consisted of a scoping stage and a Delphi stage each split into two rounds. Firstly, we invited members of the German Public Health Association to gather expert insights during two initial workshops. Next, we defined the relevant stakeholder groups and recruited respondents. Thereafter, we collected research topics and assessment criteria with the respondents in the first Delphi round and aggregated the responses through content analysis. Finally, we asked the respondents to rate the research topics with the assessment criteria in the second Delphi round.

RESULTS

In total, 94 out of the 140 invited public health organisations nominated 230 respondents for the Delphi study of whom almost 90% participated in both Delphi rounds. We compiled a comprehensive list of 76 research topics that were rated and ranked by several assessment criteria. We split the research topics into two types, substantive research topics and methodological-theoretical research topics respectively, to ensure the comparability among the research topics. In both types of research topics-substantive research topics and methodological-theoretical research topics-the respective top five ranked research topics hardly differed between public health researchers and public health practitioners. However, clear differences exist in the priority ranking of many (non-top priority) research topics between the stakeholder groups.

CONCLUSIONS

This research demonstrates that it is possible, with limited resources, to prioritise research topics for public health at the national level involving a wide range of pertinent stakeholders. The results can be used by research funding institutions to initiate calls for research projects with an increased relevance for health and/or scientific progress.

Global health in Germany: Understanding interdisciplinarity in the academic sector

BACKGROUND

Global Health (GH) in Germany increasingly becomes subject of political priority and scientists and policy makers. The aim of this study was to gain understanding of the current state, potential barriers and enablers of interdisciplinarity in GH in the academic sector in Germany.

METHODS

Between October 2019 and February 2020, we conducted thirteen semi-structured interviews with ten academics and three policymakers engaged in GH in Germany. Purposive and maximum contrast sampling based on review of the literature was performed to ensure a heterogenous set of study participants.

FINDINGS

We found that interdisciplinary exchange in GH research and education is limited in the German academic setting. Several context-specific barriers of interdisciplinary collaboration in the academic sector in Germany were detected, including terminological ambiguities and more biomedical actors being involved in global health compared to other disciplines. At the same time, enablers such as promotion of young academics and fostering topic-specific collaboration in GH research and education were identified to improve interdisciplinary working.

CONCLUSION

The importance of following an interdisciplinary approach is discussed and acknowledged across scientists working on GH in Germany. The current challenge is to identify which GH topics lend themselves to the collaboration of Germany-based scientists from various backgrounds and to establish common goals to advance interdisciplinarity research.

Evaluating Public Health Efforts to Prevent and Control Chronic Disease: A Systems Modeling Approach

The growing burden of chronic disease represents a complex challenge to public health. Innovative approaches, such as system dynamics simulation modeling, can aid public health professionals in understanding such complex issues and identifying effective solutions. This paper describes a system dynamics model and its application in projecting the impacts of evidence-based interventions on chronic disease for the state of Colorado. The development of the model was guided by data and input from subject matter expertise, peer-reviewed literature, and surveillance data. The model includes 28 intervention levers for chronic disease prevention, screening, and management. Interventions were simulated from 2020 to 2050 to project their impact on ten preventable causes of death. The simulations indicated the 6 most impactful interventions by 2050 to be adult smoking prevention, diabetes prevention, smoking cessation, blood pressure management, adult physical activity promotion, and colorectal cancer screening. Together, these 6 interventions could reduce preventable deaths by 7.1%, or 74% of the 9.6% reduction from all 28 interventions combined. This system dynamics model is a flexible tool that could be adapted or extended to include other populations or preventable chronic diseases. Prioritization and wide-scale implementation of the most impactful interventions could significantly reduce preventable deaths resulting from chronic disease.

Scar formation from the perspective of complexity science: a new look at the biological system as a whole

A burn wound is a complex systemic disease at multiple levels. Current knowledge of scar formation after burn injury has come from traditional biological and clinical studies. These are normally focused on just a small part of the entire process, which has limited our ability to sufficiently understand the underlying mechanisms and to predict systems behaviour. Scar formation after burn injury is a result of a complex biological system-wound healing. It is a part of a larger whole. In this self-organising system, many components form networks of interactions with each other. These networks of interactions are typically non-linear and change their states dynamically, responding to the environment and showing emergent long-term behaviour. How molecular and cellular data relate to clinical phenomena, especially regarding effective therapies of burn wounds to achieve minimal scarring, is difficult to unravel and comprehend. Complexity science can help bridge this gap by integrating small parts into a larger whole, such that relevant biological mechanisms and data are combined in a computational model to better understand the complexity of the entire biological system. A better understanding of the complex biological system of post-burn scar formation could bring research and treatment regimens to the next level. The aim of this review/position paper is to create more awareness of complexity in scar formation after burn injury by describing the basic principles of complexity science and its potential for burn care professionals.