Perceptions on principle of priority setting in disaster triage: A Q-method study

Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children’s educational attainment, or should they just focus on health outcomes? Does age matter for priority-setting or should it be ignored? Are health gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? This book provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policymakers, and clinicians from around the world assess the state of current practice in national and global priority-setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocating health resources.

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Long-term views on chronic kidney disease research priorities among stakeholders engaged in a priority-setting partnership: A qualitative study

Health Expectations ◽

10.1111/hex.12818 ◽

2018 ◽

Vol 21 (6) ◽

pp. 1142-1149 ◽

Cited By ~ 3

Author(s):

Meghan J. Elliott ◽

Joanna E. M. Sale ◽

Zahra Goodarzi ◽

Linda Wilhelm ◽

Andreas Laupacis ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Qualitative Study ◽

Priority Setting ◽

Research Priorities ◽

Disease Research ◽

A Priority ◽

Priority Setting Partnership

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Sharing power in global health research: an ethical toolkit for designing priority-setting processes that meaningfully include communities

International Journal for Equity in Health ◽

10.1186/s12939-021-01453-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Bridget Pratt

Keyword(s):

Global Health ◽

Priority Setting ◽

Health Research ◽

Reflective Equilibrium ◽

Empirical Work ◽

The Philippines ◽

Project Planning ◽

Global Health Research ◽

Research Priority ◽

Health Research Priority Setting

AbstractTo promote social justice and equity, global health research should meaningfully engage communities throughout projects: from setting agendas onwards. But communities, especially those that are considered disadvantaged or marginalised, rarely have a say in the priorities of the research projects that aim to help them. So far, there remains limited ethical guidance and resources on how to share power with communities in health research priority-setting. This paper presents an “ethical toolkit” for academic researchers and their community partners to use to design priority-setting processes that meaningfully include the communities impacted by their projects. An empirical reflective equilibrium approach was employed to develop the toolkit. Conceptual work articulated ethical considerations related to sharing power in g0l0o0bal health research priority-setting, developed guidance on how to address them, and created an initial version of the toolkit. Empirical work (51 in-depth interviews, 1 focus group, 2 case studies in India and the Philippines) conducted in 2018 and 2019 then tested those findings against information from global health research practice. The final ethical toolkit is a reflective project planning aid. It consists of 4 worksheets (Worksheet 1- Selecting Partners; Worksheet 2- Deciding to Partner; Worksheet 3- Deciding to Engage with the Wider Community; Worksheet 4- Designing Priority-setting) and a Companion Document detailing how to use them. Reflecting on and discussing the questions in Worksheets 1 to 4 before priority-setting will help deliver priority-setting processes that share power with communities and projects with research topics and questions that more accurately reflect their healthcare and system needs.

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Q-methodology identifies distinctive viewpoints of the facilitators and barriers to six-month exclusive breastfeeding in Northeast Thailand

Nutrition and Health ◽

10.1177/02601060211011823 ◽

2021 ◽

pp. 026010602110118

Author(s):

Thiwawan Thepha ◽

Debbie Marais ◽

Jacqueline Bell ◽

Somjit Muangpin

Keyword(s):

Exclusive Breastfeeding ◽

Q Methodology ◽

Private Hospital ◽

Demographic Data ◽

Q Method ◽

Northeast Thailand ◽

Breastfeeding Knowledge ◽

Facilitators And Barriers ◽

Method Analysis ◽

Patient Department

Background: The six-month exclusive breastfeeding (EBF) rate almost halved between 2009 and 2013 in Northeast Thailand for no clear reason. Specific facilitators and barriers to six-month EBF have been identified for Thailand, but mothers’ views on these factors to continuing EBF breastfeeding until six months have not been explored in this region. Aim: This study aimed to prioritize mothers’ views on the identified facilitators and barriers of continuing six-month exclusive breastfeeding. Methods: Q-methodology was applied. This research was conducted at Well Baby Out-Patient Department of Khonkaen Hospital, Numphong Hospital and a private hospital. Thirty-four mothers, who had recently delivered infants aged between four and six months, were breastfeeding/had breastfed, were 20 to 40 years old, participated. Demographic data were analysed descriptively, and Q-method analysis was conducted using the PQ Method software 2.35. Results: There was consensus that having knowledge about the advantages of EBF was the most important facilitator of six-month EBF, and ‘not having any other responsibilities besides caring for her infant’ was the least important facilitator of six-month EBF. Three viewpoints emerged identifying different groups/clusters of mothers, namely, (1) caring for self, (2) requiring support and (3) breastfeeding knowledge. Conclusions: Despite some consensus among participants, three distinct viewpoints emerged regarding which facilitators and barriers were important to mothers. It is clear that a programme to improve the six-month EBF rate in Northeast Thailand would need to incorporate interventions or activities that address the different viewpoints identified.

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Development of a checklist to guide equity considerations in health technology assessment

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320002275 ◽

2021 ◽

Vol 37 ◽

Author(s):

Maria Benkhalti ◽

Manuel Espinoza ◽

Richard Cookson ◽

Vivian Welch ◽

Peter Tugwell ◽

...

Keyword(s):

Knowledge Translation ◽

Health Technology Assessment ◽

Priority Setting ◽

Technology Assessment ◽

Literature Search ◽

Health Inequities ◽

Health Technology ◽

Decision Makers ◽

Added Value ◽

Pilot Test

Abstract Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value. Conclusions ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

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Evidence‐based priorities of under‐served pregnant and parenting adolescents: addressing inequities through a participatory approach to contextualizing evidence syntheses

International Journal for Equity in Health ◽

10.1186/s12939-021-01458-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Anna Dion ◽

Aime Klevor ◽

Amy Nakajima ◽

Neil Andersson

Keyword(s):

Social Services ◽

Adolescent Mothers ◽

Priority Setting ◽

Service Providers ◽

Post Partum ◽

Perinatal Outcomes ◽

Health Inequities ◽

Participatory Approach ◽

Perinatal Health ◽

Evidence Based

Abstract Purpose This study describes an interdiscursive evidence-based priority setting process with pregnant and parenting adolescents and their services providers. Methods A mixed methods literature review identified studies reporting on perinatal outcomes and experiences of adolescents during pregnancy to 12 months post-partum published in Canada after 2000. We also calculated relative risks for common perinatal risk factors and outcomes for adolescents compared to adult populations from 2012 to 2017 based on data from a provincial database of maternal and newborn outcomes. Two trained peer researchers identified outcomes most relevant to their peers. We shared syntheses results with four service providers and 13 adolescent mothers accessing services at a community service organization, who identified and prioritized their areas of concern. We repeated the process for the identified priority issue and expanded upon it through semi-structured interviews. Results Adolescent mothers face higher rates of poverty, abuse, anxiety and depression than do adult mothers. Adolescents prioritized the experience of judgment in perinatal health and social services, particularly as it contributed to them being identified as a child protection risk. Secondary priorities included loss of social support and inaccessibility of community resources. The experience of judgment in adolescent perinatal health literature was summarized around: being invisible, seen as incapable and seen as a risk. Adolescent mothers adapted these categories, emphasizing organizational and social barriers. Conclusions Young marginalized women are disproportionately affected by inequities in perinatal outcomes, yet their perspectives are rarely centered in efforts to address these inequities. This research addresses health inequities by presenting a robust, transparent and participatory approach to priority setting as a way to better represent the perspectives of those who carry the greatest burden of health inequities in evidence syntheses. In our work, marginalized adolescent parents adapted published literature around the experience and consequences of social stigma on perinatal outcomes, shifting our understanding of root causes and possible solutions.

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Common hand and wrist conditions: creation of UK research priorities defined by a James Lind Alliance Priority Setting Partnership

BMJ Open ◽

10.1136/bmjopen-2020-044207 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044207

Author(s):

Alexia Karantana ◽

Tim Davis ◽

Donna Kennedy ◽

Debbie Larson ◽

Dominic Furniss ◽

...

Keyword(s):

Priority Setting ◽

Research Priorities ◽

Treatment Modalities ◽

Grant Applications ◽

Charitable Organisation ◽

James Lind Alliance ◽

Treatment Uncertainties ◽

The Uk ◽

Survey Responses ◽

Priority Setting Partnership

ObjectivePrioritisation of important treatment uncertainties for ‘Common Conditions Affecting the Hand and Wrist’ via a UK-based James Lind Alliance Priority Setting Partnership.SettingThis process was funded by a national charitable organisation and based in the UK.ParticipantsAnyone with experience of common conditions affecting the adult hand and wrist, including patients, carers and healthcare professionals. All treatment modalities delivered by a hand specialist, including therapists, surgeons or other allied professionals, were considered.InterventionsEstablished James Lind Alliance Priority Setting Partnership methods were employed.Electronic and paper questionnaires identified potential uncertainties. These were subsequently confirmed using relevant, up-to-date systematic reviews. A final list of top 10 research uncertainties was developed via a face-to-face workshop with representation from patients and clinicians. Impact of research was sought by surveying hand clinicians electronically.Outcome measuresThe survey responses and prioritisation—both survey and workshop based.ResultsThere were 889 individually submitted questions from the initial survey, refined to 59 uncertainties across 32 themes. Eight additional uncertainties were added from published literature before prioritisation by 261 participants and the workshop allowed the final top 10 list to be finalised. The top 10 has so far contributed to the award of over £3.8 million of competitively awarded funding.ConclusionsThe Common Conditions in the Hand and Wrist Priority Setting Partnership identified important research questions and has allowed research funders to identify grant applications which are important to both patients and clinicians

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