Abstract
Epidemiology has traditionally used quantitative approaches to characterizing disease prevalence and studying the effects of medical and public health interventions. Despite the power of ...such methods, they leave important gaps in understanding population health that can be addressed using qualitative and mixed methods. In this commentary, I describe philosophical differences in qualitative and quantitative approaches to research and explain how they can be used together to strengthen epidemiologic inquiry.
Beginners to the discipline of implementation science often struggle to determine whether their research questions "count" as implementation science.
In this paper, three implementation scientists ...share a heuristic tool to help investigators determine where their research questions fall in the translational research continuum. They use a "subway model" that envisions a journey to implementation research with stops along the way at efficacy and effectiveness research.
A series of structured questions about intervention efficacy, effectiveness, and implementation can help guide researchers to select research questions and appropriate study designs along the spectrum of translational research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective
To describe health equity research priorities for health care delivery systems and delineate a research and action agenda that generates evidence‐based solutions to persistent racial and ...ethnic inequities in health outcomes.
Data Sources and Study Setting
This project was conducted as a component of the Agency for Healthcare Research and Quality's (AHRQ) stakeholder engaged process to develop an Equity Agenda and Action Plan to guide priority setting to advance health equity. Recommendations were developed and refined based on expert input, evidence review, and stakeholder engagement. Participating stakeholders included experts from academia, health care organizations, industry, and government.
Study Design
Expert group consensus, informed by stakeholder engagement and targeted evidence review.
Data Collection/Extraction Methods
Priority themes were derived iteratively through (1) brainstorming and idea reduction, (2) targeted evidence review of candidate themes, (3) determination of preliminary themes; (4) input on preliminary themes from stakeholders attending AHRQ's 2022 Health Equity Summit; and (5) and refinement of themes based on that input. The final set of research and action recommendations was determined by authors' consensus.
Principal Findings
Health care delivery systems have contributed to racial and ethnic disparities in health care. High quality research is needed to inform health care delivery systems approaches to undo systemic barriers and inequities. We identified six priority themes for research; (1) institutional leadership, culture, and workforce; (2) data‐driven, culturally tailored care; (3) health equity targeted performance incentives; (4) health equity‐informed approaches to health system consolidation and access; (5) whole person care; (6) and whole community investment. We also suggest cross‐cutting themes regarding research workforce and research timelines.
Conclusions
As the nation's primary health services research agency, AHRQ can advance equitable delivery of health care by funding research and disseminating evidence to help transform the organization and delivery of health care.
The COVID-19 pandemic halted research operations at academic medical centers. This shutdown has adversely affected research infrastructure, the current research workforce, and the research pipeline. ...We discuss the impact of the pandemic on overall research operations, examine its disproportionate effect on underrepresented minority researchers, and provide concrete strategies to reverse these losses.
Chesley and Lane-Fall discuss the study by D. White and colleagues demonstrate that as health systems face strain, they can also play an important role as safeguards that ensure healthcare equity. In ...anticipation of a 24-day period of remdesivir shortage, researchers engaged a multidisciplinary panel of stakeholders that included specialists in equity and inclusion, bioethics, economics, and hospital operations to develop a novel resource allocation strategy. Crucially, they also engaged an advisory panel of community members and patient families as key stakeholders. Explicit goals of their allocation strategy, set from the outset, prioritized geographic equity, mitigating disparities, and providing an overall benefit to their community. Through their collaboration, researchers developed a lottery allocation protocol that prioritized two key populations: patients from disadvantaged neighborhoods (identified on the basis of the Area Deprivation Index 10) and frontline-essential workers.
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