Describing the evidence-base for research engagement by health care providers and health care organisations: a scoping review

Research metrics of Australian eating disorders researchers

Building the research capacity and capability of Australia's eating disorder (ED) research workforce has been identified as a key strategy to respond to the increasing prevalence of EDs. However, there is currently a limited understanding of the research strengths and scope of this workforce and this is a barrier to capacity building efforts and to evaluating the impacts of these efforts. This study sought to understand and summarise the current research metrics of the top 50 research experts in Australia identified through Expertscape. Publicly available publication, citation and funded research grants metrics, were extracted from Expertscape, Scopus, SciVal, Dimensions.ai and researcher profiles and summarised. The results indicate that Australian Feeding and Eating Disorder (FED) researchers are competitive internationally, and are spread across professional disciplines with the highest representation from psychology. Expertscape researcher rank was associated with higher numbers of publications in feeding and eating disorders overall, but not to total outputs, field-weighted citation impact (FWCI), or number of publications in top percentile journals. Publications were heavily focused on Anorexia Nervosa. Public grants awarded to the identified ED researchers in Australia over the past 10 years were largely National Health and Medical Research Council (NHMRC) project grant schemes, targeting innovative and creative research across any area of health and medical research. Cumulative dollars awarded over the 10-year period up to 2023 were approximately $23.9 million AUD, roughly 6 times less than that awarded to Schizophrenia research. These results summarise the current state of Australian FED research, comprised of a productive high performing research workforce limited by inadequate research funding.

The RISES Model: A New Approach to Promoting Health Professionals' Motivation to Engage in Research

Purpose

A decline in the number of health professionals (HPs) engaging in clinical and healthcare research has spurred governments, educational and healthcare organisations to focus on developing strategies to promote a resurgence of clinical researchers. Based on the Expectancy-Value-Cost theory which offers a comprehensive framework to understand motivation in research, this study aimed to explore how motivations and perceived values of research evolve across different career stages, and develop a model that promotes sustained research motivation.

Methods

This study employed a phenomenological qualitative research design and individual interviews to explore the experiences of 30 HPs (doctors, nurses, midwives, and allied health professionals) across three career stages-early, mid, and late-at three North Queensland Public Hospitals from March 19 to April 15, 2021. A purposive sampling technique was used to select participants, and data were analysed through inductive thematic analysis.

Results

Six themes emerged, categorised into individual, organizational, and sociocultural factors. Individual: Back to Basics and Career Aspirations Influence Research Value; Organisational: Cumbersome Processes and Resource Accessibility; Sociocultural: Building Research Capacity through Connections and Supportive Relationships Enhance Motivation. These themes informed the development of the RISES model, a multi-layered framework emphasising a collaborative approach to addressing individual, organisational, and sociocultural factors to support HPs' sustained research engagement.

Conclusion

The study provides valuable insights into the lived experiences of HPs in relation to research, highlighting the intricate interplay of factors affecting their motivation. It introduces the RISES model to encourage ongoing research motivation and suggests further research to expand on these findings and explore additional aspects of research engagement in healthcare.

Collaborations between health services and educational institutions to develop research capacity in health services and health service staff: a systematic scoping review

BACKGROUND

Participation of health service staff in research improves health outcomes and adherence to clinical guidelines. To increase research participation, many health services seek to build research capacity which adds to the development of individual and organisational skills and abilities in order to conduct health research. Numerous approaches to research capacity building have been trialed with inter- and intra-institutional, or university-health service collaborative approaches being frequently described strategies. University-health service research collaborations have potential for high impact and mutual benefit, by harnessing respective strengths across both organisations. However, the range and scope of research capacity building approaches, including their relative value and success have not been consolidated. The aim of this review was to examine and describe the collaborative strategies employed by health services in conjunction with educational partners to enhance the research capability of health service staff.

METHODS

The scoping review framework by Arksey and O'Malley was used to inform the review method. A systematic search was conducted of four major databases: Medline, CINAHL, Embase, and Cochrane, focusing on publications after 1995. Inclusion and exclusion criteria were established through iterative team discussions. The two-stage screening process and data extraction was managed in Covidence. Collaboration, Research Capacity, Health Services, and Health workforce were the primary concepts, contexts and populations guiding the search.

RESULTS

Of the 1462 studies identified, 61 were selected for the review. These studies reported on partnerships between universities and health services with a specific focus on building research capacity of health service staff. Studies predominantly hailed from Australia, USA, UK, and Canada. Collaboration approaches varied and leveraged different activities to build research capacity included training, mentoring, shared funding, and networking. Training partnerships emerging as the most prevalent. Findings emphasised the importance of localisation in approaches, with some studies indicating the intrinsic value of such collaborations for both partners involved. Despite the emphasis on individual interventions like training and mentoring, team-level interventions were notably scarce.

CONCLUSION

This review highlights the diverse range of approaches in research capacity building collaborations between health services and educational partners. It advocates for a shared understanding of goals, highlighting the critical nature of relationship-building and the pivotal role of sustainable infrastructure in long-term collaboration success. Future directions should consider the tangible impacts of these models on clinical outcomes.

If health organisations and staff engage in research, does healthcare improve? Strengthening the evidence base through systematic reviews

BACKGROUND

There is an often-held assumption that the engagement of clinicians and healthcare organizations in research improves healthcare performance at various levels. Previous reviews found up to 28 studies suggesting a positive association between the engagement of individuals and healthcare organizations in research and improvements in healthcare performance. The current study sought to provide an update.

METHODS

We updated our existing published systematic review by again addressing the question: Does research engagement (by clinicians and organizations) improve healthcare performance? The search covered the period 1 January 2012 to March 2024, in two phases. First, the formal updated search ran from 1 January 2012 to 31 May 2020, in any healthcare setting or country and focussed on English language publications. In this phase two searches identified 66 901 records. Later, a further check of key journals and citations to identified papers ran from May 2020 to March 2024. In total, 168 papers progressed to full-text appraisal; 62 were identified for inclusion in the update. Then we combined papers from our original and updated reviews.

RESULTS

In the combined review, the literature is dominated by papers from the United States (50/95) and mostly drawn from the Global North. Papers cover various clinical fields, with more on cancer than any other field; 86 of the 95 papers report positive results, of which 70 are purely positive and 16 positive/mixed, meaning there are some negative elements (i.e. aspects where there is a lack of healthcare improvement) in their findings.

CONCLUSIONS

The updated review collates a substantial pool of studies, especially when combined with our original review, which are largely positive in terms of the impact of research engagement on processes of care and patient outcomes. Of the potential engagement mechanisms, the review highlights the important role played by research networks. The review also identifies various papers which consider how far there is a "dose effect" from differing amounts of research engagement. Additional lessons come from analyses of equity issues and negative papers. This review provides further evidence of contributions played by systems level research investments such as research networks on processes of care and patient outcomes.

A research internship scheme for nurses and its wider implications for clinical managers

There is growing evidence that clinical research activity is linked to better patient outcomes and that staff involvement in research is linked to enhanced morale and retention. Clinical managers have a pivotal role in supporting staff to engage with research, but they are not always given the means to do so and are not always aware of the benefits. In 2021 a research internship scheme was set up as a collaboration between two London NHS trusts and a university, enabling nurses and midwives to undergo training and undertake a range of research activities. Some participants experienced challenges in fitting internship activities around clinical duties despite the fact that the scheme was planned to give them protected time. This article describes the scheme, reports the findings of its evaluation at one of the two trusts, and discusses its implications for clinical managers in terms of how they can be supported to contribute to the development of a research culture.

Learning Health System to rapidly improve the implementation of a school physical activity policy

BACKGROUND

Learning Health Systems (LHS) - characterised by cycles of evidence generation and application - are increasingly recognised for their potential to improve public health interventions and optimise health impacts; however there is little evidence of their application in the context of public health practice. Here, we describe how an Australian public health unit applied a LHS approach to successfully improve a model of support for implementation of a school-based physical activity policy.

METHODS

This body of work was undertaken in the context of a strong research-practice partnership. Core LHS capabilities included: i) partnerships and stakeholder engagement; ii) workforce development and learning health communities; iii) multi-disciplinary scientific expertise; iv) practice data collection and management system; v) evidence surveillance and synthesis; and vi) governance and organisational processes of decision making. Three cycles of data generation and application were used. Within each cycle, randomised controlled trials conducted in NSW primary schools were used to generate data on the support model's effectiveness for improving schools' implementation of a government physical activity policy, its delivery costs, and process measures such as adoption and acceptability. Each type of data were analysed independently, synthesised, and then presented to a multi-disciplinary team of researchers and practitioners, in consult with stakeholders, leading to collaborative decisions for incremental improvements to the support model.

RESULTS

Cycle 1 tested the first version of the support model (composed of five implementation strategies targeting identified barriers of policy implementation) and showed the model's feasibility and efficacy for improving schools' policy implementation. Data-informed changes were made to enhance impact, including the addition of three implementation strategies to address outstanding barriers. Cycle 2 (now, testing a package of eight implementation strategies) established the model's effectiveness and cost-effectiveness for improving school's policy implementation. Data-informed changes were made to reduce delivery costs, specifically adapting the costliest strategies to reduce in-person contact from external support personnel. Cycle 3 showed that the adaptations minimised the relative cost of delivery without adversely impacting on the effect.

CONCLUSIONS

Through this process, we identified an effective, cost-effective, acceptable and scalable policy implementation support model for service delivery. This provides important information to inform or support LHS approaches for other agencies seeking to optimise the health impact of evidence-based interventions.

Models and approaches for building knowledge translation capacity and capability in health services: a scoping review

BACKGROUND

Building healthcare service and health professionals' capacity and capability to rapidly translate research evidence into health practice is critical to the effectiveness and sustainability of healthcare systems. This review scoped the literature describing programmes to build knowledge translation capacity and capability in health professionals and healthcare services, and the evidence supporting these.

METHODS

This scoping review was undertaken using the Joanna Briggs Institute scoping review methodology. Four research databases (Ovid MEDLINE, CINAHL, Embase, and PsycInfo) were searched using a pre-determined strategy. Eligible studies described a programme implemented in healthcare settings to build health professional or healthcare service knowledge translation capacity and capability. Abstracts and full texts considered for inclusion were screened by two researchers. Data from included papers were extracted using a bespoke tool informed by the scoping review questions.

RESULTS

Database searches yielded 10,509 unique citations, of which 136 full texts were reviewed. Thirty-four papers were included, with three additional papers identified on citation searching, resulting in 37 papers describing 34 knowledge translation capability building programmes. Programmes were often multifaceted, comprising a combination of two or more strategies including education, dedicated implementation support roles, strategic research-practice partnerships and collaborations, co-designed knowledge translation capability building programmes, and dedicated funding for knowledge translation. Many programmes utilised experiential and collaborative learning, and targeted either individual, team, organisational, or system levels of impact. Twenty-seven programmes were evaluated formally using one or more data collection methods. Outcomes measured varied significantly and included participant self-reported outcomes, perceived barriers and enablers of knowledge translation, milestone achievement and behaviour change. All papers reported that programme objectives were achieved to varying degrees.

CONCLUSIONS

Knowledge translation capacity and capability building programmes in healthcare settings are multifaceted, often include education to facilitate experiential and collaborative learning, and target individual, team, organisational, or supra-organisational levels of impact. Although measured differently across the programmes, the outcomes were positive. The sustainability of programmes and outcomes may be undermined by the lack of long-term funding and inconsistent evaluation. Future research is required to develop evidence-informed frameworks to guide methods and outcome measures for short-, medium- and longer-term programme evaluation at the different structural levels.

A survey of research involvement and priorities among occupational therapists in Norway

BACKGROUND

Involvement in research and shared priorities among occupational therapists (OTs) can enhance the quality of occupational therapy practice.

AIMS

To explore the research involvement and research priorities of OTs in Norway.

MATERIALS AND METHODS

An online survey comprising 14 open-ended and closed questions was made available to participants at the Seventh Norwegian Congress in Occupational Therapy to fill out.

RESULTS

Out of 633 congress participants, 307 (49%) OTs completed the survey. Among the respondents, ∼40% were involved in research. The most commonly reported area of research was rehabilitation. Research involvement was associated with employment in education or specialist healthcare services and with greater work experience and post-bachelor's degree education. The most frequently prioritized research question addressed the effect of occupational therapy. Unmet needs and factors conducive to increasing OT's involvement in research were identified.

CONCLUSIONS AND SIGNIFICANCE

The survey revealed that a considerable, but uneven, distribution of OTs were involved in research. To encourage greater participation in research, researchers, decision-makers, and employee associations should take steps to make research more appealing to OTs. The research priorities highlighted by Norwegian OTs align with those stated by OTs in other countries.

Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial

Background

Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes.

Methods

A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10).

Ethics and dissemination

Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication.

Host trial registration

ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].

Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial

Background

Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes.

Methods

A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10).

Ethics and dissemination

Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication.

Host trial registration

ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].

Research translation mentoring for emerging clinician researchers in rural and regional health settings: a qualitative study

BACKGROUND

Building clinician and organisation-level research translation capacity and capability is fundamental for increasing the implementation of research into health practice and policy and improving health outcomes. Research translation capacity and capability building is particularly crucial in rural and regional settings to address complex problems impacting these socially and economically disadvantaged communities. Programs to build clinicians' research translation capability typically involve training and mentoring. Little is known about the features of and influences on mentorships in the context of training for emerging clinician-researchers working in rural and regional healthcare settings. Research translation mentorships were established as part of the Supporting Translation Research in Rural and Regional settings (STaRR) program developed and delivered in Victoria, Australia from 2020 to 2021. The study sought to address the following research questions: 1) What context-specific types of support do research translation mentors provide to emerging researchers?. 2) How does the mentoring element of a rural research translational training program influence research translation capacity and capability development in rural emerging researchers and mentors, if at all?. 3) How does the mentoring element of the program influence translation capacity and capability at the organisational and regional level, if at all?

METHODS

We conducted a qualitative descriptive study. Interviews with individuals involved in the STaRR program took place approximately 12 months after the program and explored participants' experiences of the mentored training. Interviews were undertaken via telephone, audio-recorded, and transcribed. Data were analysed using a team-based five-stage framework approach.

RESULTS

Participants included emerging researchers (n = 9), mentors (n = 5), and managers (n = 4), from five health services and two universities. We identified four themes in the interview data: (1) Mentors play an educative role; (2) Mentoring enhanced by a collaborative environment; (3) Organisational challenges can influence mentorships, and (4) Mentorships help develop research networks and collective research and translation capacity.

CONCLUSIONS

Mentorships contributed to the development of research translation capabilities. The capabilities were developed through mentors' deepened understanding of the rural and regional healthcare contexts in which their emerging researchers worked, the broadening and strengthening of rural and regional research networks, and building and sharing research translation knowledge and skills.

Association between residents' scholarly activities and publication requirement policy

BACKGROUND

Scholarship is recognized as important in residency training worldwide. The Japan Pediatric Society (JPS) enacted a reform in 2017 to require publication of an article as a prerequisite for taking the board certification test, with the goal of increasing scholarly activity.

METHODS

The purpose of this study was to provide a detailed description of the trends in residents' scholarly activities related to the JPS reform. A secondary analysis was performed on the cross-sectional database of pediatrics residents who took the certification test in 2015-2018.

RESULTS

The enrolled participants were 2399 residents of which 79.7% passed the test. Publication of any type of article increased significantly (21%-22% to 100%; 0.1 to 0.3/person-year) after the implementation of the JPS reform, whereas academic presentations did not (89% to 91%; 1.2 to 1.3/person-year), both in terms of the percentage of the number of those who created them and the average rate of research production. Not only Japanese articles (11%-13% to 49%-53%; 0.04 to 0.15-0.17/person-year) or case reports (10%-14% to 51%-52%; 0.03-0.05 to 0.16-0.17/person-year), but also English articles (4%-5% to 15%-16%; 0.01-0.02 to 0.05/person-year) and original articles (5% to 11%-17%; 0.01 to 0.03-0.05/person-year) increased significantly. The number of each type of article publication was correlated with success in the board certification test (odds ratio 1.5-1.8).

CONCLUSIONS

Scholarly activities of pediatrics residents were enhanced by the JPS implementation of the article requirement policy, which is crucial to fostering a scholarly culture. The most efficient measures to promote scholarship need to be persistently investigated.