Health Research Policy and Systems最新文献

{"title":"Mind the (research) gap: a retrospective observational study on the utilization of new medical technologies and related research activities in German hospitals.","authors":"Tanja Rombey, Helene Eckhardt, Susanne Felgner, Marie Dreger, Alessandro Campione, Hanna Ermann, David Ehlig, Hendrikje Rödiger, Dimitra Panteli, Cornelia Henschke","doi":"10.1186/s12961-025-01342-8","DOIUrl":"https://doi.org/10.1186/s12961-025-01342-8","url":null,"abstract":"<p><strong>Objectives: </strong>Hospitals play a major role in generating clinical evidence on new medical technologies. Thus far, the extent of German hospitals' contribution to the evidence base has not been sufficiently investigated. This study aims to: (1) examine the utilization of new medical technologies in German hospitals and its relationship to different hospital characteristics; (2) investigate the participation of German hospitals in research on these technologies and the association between hospital characteristics and research involvement; and (3) investigate the contribution of German hospitals to international research activities, including the levels of evidence of any studies conducted.</p><p><strong>Methods: </strong>Using a systematically derived sample of 13 new medical technologies and various data sources, we retrospectively analyzed the utilization of and research activities by German hospitals between 2005 and 2017 and explored which hospital characteristics they were associated with. The data were analyzed descriptively and are expressed as bar plots, box plots, quartiles, and crude odds ratios (ORs).</p><p><strong>Results: </strong>The proportion of German hospitals using new technologies while also being involved in related clinical research was relatively low (ranging from 0.3% to 29.4%, except for transcatheter aortic valve implantation (TAVI), with 60.7%), particularly for prospective studies. Research involvement was positively associated with university hospital status, larger bed capacity, and public ownership. Overall, the research involving German hospitals predominantly consisted of single-arm studies and not randomized controlled trials (RCTs).</p><p><strong>Conclusions: </strong>Our study identified a gap between hospitals using new medical technologies and their involvement in evidence generation. This imbalance can contribute to uncertainty regarding the actual efficacy, effectiveness and safety of new medical technologies. To ensure evidence-based patient care, it is therefore essential to strengthen the link between research and practice, in both directions. A first step to achieve this could entail restricting the use of new medical technologies to specialized innovation centers (e.g., university hospitals, specialized hospitals) during the initial years of their utilization to ensure an adequate evidence base is generated before widespread implementation.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"72"},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing evidence into practice for the management of frozen shoulder: engaging with key stakeholders and evaluating barriers and facilitators using the Consolidated Framework for Implementation Research.","authors":"Natalie Louise Clark, Melissa Johnson, Lucksy Kottam, Stephen Brealey, Joy Adamson, Amar Rangan","doi":"10.1186/s12961-025-01335-7","DOIUrl":"https://doi.org/10.1186/s12961-025-01335-7","url":null,"abstract":"<p><strong>Background: </strong>Frozen shoulder (FS) is a painful, stiff and disabling shoulder condition affecting adults of working age. A multi-centre randomised controlled trial (UK FROST) comparing three of the most common treatments provided by the National Health Service (NHS) in secondary care found all three treatments improved patient outcomes, with none being overall clinically superior. Each treatment had its advantages and disadvantages. This paper describes the use of the Consolidated Framework of Implementation Research (CFIR) as an exemplar of knowledge translation for the latest evidence from UK FROST in the management of FS. It describes using stakeholder feedback in the development of a FS pathway, considering the barriers and facilitators to implementation in relation to the UK FROST findings and current clinical practice.</p><p><strong>Methods: </strong>Healthcare professionals, academics, policymakers and patient and public representatives were invited as stakeholders to three meetings held in November 2022 and January 2023. An overview of the United Kingdom Frozen Shoulder Trial (UK FROST) study, current pathways, referral processes and guidelines for FS in the context of the study results and the development of patient resources were discussed at the first meeting in November. Outcomes from this meeting informed the January meetings. The CFIR was used to guide analysis of the discussions from the stakeholder meetings.</p><p><strong>Results: </strong>Overall, 67 stakeholders attended across three meetings. From the meetings, we categorised the FS pathway into four components (1) presentation and assessment; (2) initial management; (3) treatment options - physiotherapy and steroid injection, secondary care referrals; and (4) enhanced recovery and follow-up, with shared decision-making emphasised throughout the pathway. Barriers and facilitators in each of the pathway components were identified using the five domains of the CFIR. A proposed evidence-based FS pathway was developed with stakeholders using an eight-step process.</p><p><strong>Conclusions: </strong>This study has led to the development of an evidence-based FS care pathway, ready to be considered by policymakers for implementation, with considerations of barriers and facilitators. There was consensus that it is feasible to embed a modified physiotherapy intervention form UK FROST within current primary and community care settings to optimise service delivery and referral pathways. Trial Registration The trial registration is ISRCTN48804508.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"73"},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review.","authors":"Uday Narayan Yadav, Stefan Thottunkal, Jason Agostino, Victoria Sinka, Rosemary Wyber, Belinda Hammond, Danielle C Butler, Mary Belfrage, Kate Freeman, Megan Passey, Emma Walke, Matthew Smith, Benjamin Jones, Raymond Lovett, Kirsty A Douglas","doi":"10.1186/s12961-025-01325-9","DOIUrl":"10.1186/s12961-025-01325-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic disease is the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. A comprehensive health assessment is available as an annual health check (HC) to Aboriginal and Torres Strait Islander peoples through the Medicare Benefits Schedule in primary health care settings. This review aims to systematically identify contextual and mechanistic factors that contribute to the success or failure of implementing effective HCs in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care (PHC).</p><p><strong>Methods: </strong>We systematically searched for peer-reviewed and grey literature, including policy reports, theses, and guidelines, between 1 November 1999 and 30 June 2023, using a combination of keywords and subject headings related to \"health checks\", \"chronic disease\", and \"Aboriginal and Torres Islander peoples\" in seven databases. The extracted data were summarized using a content analysis approach, applying strength-based approaches.</p><p><strong>Results: </strong>In total, 16 peer-reviewed articles and five grey literature that met the inclusion criteria were used for evidence synthesis that identified several contextual and mechanistic factors that influenced the implementation of HCs. Barriers included resource constraints driven by complexities in administrative, workforce and policy domains that significantly impeded the implementation of HCs. Within PHC, physical space constraints, competing demands and a focus on acute care over preventive measures hindered HC implementation. In addition, inconsistent identification of Aboriginal and Torres Strait Islander status, negative attitudes of PHC staff towards HC efficacy and patients' fear of stigma or confidentiality breaches were barriers. Patients reported HCs as failing to address holistic health needs. To improve HC implementation, enablers included strong clinical leadership, recruitment of culturally competent non-Indigenous and Aboriginal and Torres Strait Islander staff, Indigenous partnership and community engagement and incentives for participation. Effective electronic records, transport provision and flexible scheduling also increased accessibility.</p><p><strong>Conclusions: </strong>Our findings suggest that future implementation research must adopt a more comprehensive and holistic approach across different models of PHC, with clearly identified contextual and mechanistic factors linked to people-reported and service outcomes, to guide the implementation and evaluation of HCs. While undertaking future research, it is crucial to implement policy and practice reforms as identified in this review to create a culturally safe service at the PHC level required to drive the uptake of quality HCs that aligns with community priorities and aspirations for the prevention and early detection of chronic diseases.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"70"},"PeriodicalIF":3.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategizing towards the future hospital: a systems thinking approach.","authors":"Ashish Kumar, Sean Shao Wei Lam, Sze Ling Chan, Yingqi Xu, Yao Ge, Geoffrey Kah Tack Gui, Hiang Khoon Tan","doi":"10.1186/s12961-025-01333-9","DOIUrl":"10.1186/s12961-025-01333-9","url":null,"abstract":"<p><strong>Background: </strong>The complex systemic nature of Future Hospital design in the rapidly ageing city-state of Singapore calls for systems thinking. We apply this approach to answer two research questions: (i) What are the variables that drive the present and future dynamics of the Future Hospital system? (ii) How are these driving variables related?</p><p><strong>Methods: </strong>Causal loop diagrams (CLDs) were developed collaboratively by a cross-functional system modelling team through group modelling discussions and reviews, totalling 20 sessions. Network analysis of the resulting CLDs was used to identify dominant variables.</p><p><strong>Results: </strong>Seven interlocking CLDs (national view, cluster view, and study hospital top level, outpatient, emergency department, inpatient and surgeries and procedures views) were created to serve as \"boundary objects\" for different Future Hospital stakeholders, as well as researchers and planners of other Future Hospital systems. Important feedback loops and 15 interventions for redesign were identified. In all the modelled services (outpatient, emergency, inpatient and surgeries and procedures), capacities are subject to positive feedback loops. Alternative models of care are needed to restrain ever-increasing demand. Need for agility (the need for ability to quickly deploy and pivot capacity in responses to crises) is the variable with the highest betweenness centrality in the combined network of seven CLDs.</p><p><strong>Conclusions: </strong>We address the need for greater openness on Future Hospital initiatives by making our resulting logic maps public. Due to their qualitative nature, the CLDs are insightful for Future Hospital strategic planning exercises globally.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"71"},"PeriodicalIF":3.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of music and singing as research methods to improve migrants' involvement in health research and policy-making.","authors":"Helen Phelan, Ahmed Hassan, Anne MacFarlane","doi":"10.1186/s12961-025-01317-9","DOIUrl":"10.1186/s12961-025-01317-9","url":null,"abstract":"<p><p>This commentary explores the potential of arts-based research methods, particularly music and singing, to address issues of participatory inequity and the structural bias this creates in health research systems and policies. Focusing on migration as a pressing public health issue in resettlement countries in the Global North, this commentary's objective is to investigate the use of such creative methods as a means of improving migrants' participation in health research, knowledge translation and the development of health policy. In doing so, it challenges the overreliance on cognitively and verbally oriented methods in the Global North, which fail to harness the participatory potential of the whole-body sensorium. Drawing on Palmer et al.'s explanatory theoretical model of change and centralizing the concept of participatory space, it advances this discussion within a participatory health research paradigm. The exploration is further informed by a recent scoping review on the use of music as an arts-based method in migrant health research, as well as two case studies using the Irish World Music Café method. It concludes with the proposal that further exploration of music and singing as mechanisms of change in health research is essential if we are to fully understand whether/how music and singing for participatory space-making may reset the health research agenda, putting meaningful, whole-person engagement at the heart of research to inform systems and policies.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"67"},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline assessments of research capacity, capability and culture in UK local authorities: reflections from evaluators embedded in Health Determinants Research Collaborations.","authors":"Lauren Bell, Rachel Chapman, Charlotte Ashton, Claire Batey, Jack Brazier, Elizabeth Castle, Arundeep Chaggar, Julian Elston, Faye Esat, Hannah Goldwyn Simpkins, Leonard Ho, Cath Quinn, Jessica Sheringham, Demelza Smeeth, Irene Stylianou, Simon Twite, James Woodall, Beck Taylor","doi":"10.1186/s12961-025-01323-x","DOIUrl":"10.1186/s12961-025-01323-x","url":null,"abstract":"<p><strong>Background: </strong>In the United Kingdom, local government is well placed to conduct and apply research regarding the wider determinants of health. However, local authorities often lack sufficient research infrastructure to support research capacity, capability and culture. Since 2022, the UK National Institute for Health and Care Research has funded 30 Health Determinants Research Collaborations (HDRCs) to develop this infrastructure. HDRCs are hosted by local authorities collaborating with universities and other partners to strengthen a culture of evidence-informed decision-making. HDRCs are conducting local evaluations, including baseline assessments of local authority research capacity, capability and culture.</p><p><strong>Methods: </strong>A national peer-support group was formed to support shared learning amongst teams evaluating HDRCs. Here, as embedded evaluators from 10 HDRCs, we present reflections on the planning, delivery and interpretation of baseline assessments. Reflections were gathered via group discussions and written submissions. All 10 HDRC baseline assessments explored local authority research capacity, capability and culture, and two also studied early HDRC team collaboration.</p><p><strong>Results: </strong>Competing priorities during early HDRC implementation called for pragmatic and timely baseline assessment methods. Most HDRCs developed baseline surveys, though interviews and focus groups were conducted by some. Despite similar aims, methods varied substantially according to local contexts. Evaluators often adapted existing validated survey tools, for example, from health settings, as none were identified for use across local government. Definitions of research also ranged from academic definitions to broader notions of evidence. Useful insights were gathered across diverse samples to aid implementation locally, however, low response rates were received to all-staff surveys and heterogeneous approaches limited comparison across HDRCs. Findings contributed to recommendations for evaluating and developing HDRC activities (e.g. communications and training provisions) appropriate for local authorities with stretched resources. Where measured, collaborations were functioning well, with recommendations to enhance communication.</p><p><strong>Conclusions: </strong>The early contexts and challenges of HDRCs influenced pragmatic baseline assessments. Methods were often chosen to capture baseline contexts rapidly, and they will be refined and complemented by additional evaluation methods as HDRCs progress. Developing new validated measures and an agreed definition of research for local authorities may strengthen understanding of research capacity, capability and culture across local government.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"68"},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying a participatory system dynamics approach to childhood overweight and obesity in the local context: reflections from the LIKE project.","authors":"Angie Luna Pinzon, Karien Stronks, Arnoud Verhoeff, David Vaandrager, Karen den Hertog, Wilma Waterlander","doi":"10.1186/s12961-025-01345-5","DOIUrl":"10.1186/s12961-025-01345-5","url":null,"abstract":"<p><strong>Background: </strong>Methods based in system dynamics (SD) have gained prominence within public health research in recent years. SD is grounded in theory and explains how central principles, such as adaptation, dynamics and emergence can be used to understand and/or change complex systems. To date, few examples exist where this theory has been applied consistently in a prevention approach in a local context. This study aimed to reflect upon the application of theoretical SD principles in context of the Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) project.</p><p><strong>Methods: </strong>A multi-methods qualitative evaluation was conducted using the LIKE project, situated in Amsterdam, the Netherlands, as a case study. LIKE applied a participatory system dynamics approach for obesity prevention in youth, throughout the project during a time period of 6 years (2017-2023). Data collection included document reviews, a Ripple Effects Mapping workshop, and semi-structured interviews with involved stakeholders, followed by in-depth reflective analysis.</p><p><strong>Results: </strong>We identify three key lessons combining theory and practice: (1) theory: interdependency programme and context; lesson: avoid becoming overly focused on achieving a complete understanding of the system related to the topic under study (for example, obesity). Instead, ensure sufficient attention is given to comprehending the dynamics of the local context, including existing initiatives and policy processes; (2) theory: dynamic and adaptive character; lesson: while the ability to encompass real-world dynamics is a foundational strength of system dynamics theory, its practical application can be constrained by more static elements, such as budget planning, and the need for clearly defined roles and responsibilities; and (3) theory: strong governance; lesson: SD projects require strong governance including strategic planning and enduring commitment, but in the absence of clear milestones or measurable impact on the short term.</p><p><strong>Conclusions: </strong>Applying SD principles in practice requires a collective shift in thinking and working for all parties involved. Challenges in particular relate to the many uncertainties that arise whereby everything continues to change over time, including the focus of the system under study; relevant stakeholders; and momentum for change. This necessitates strategies different from our accustomed linear research working practices, shifting instead towards more iterative approaches that accommodate complexity and uncertainty.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"66"},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics in implementing the Good Financial Grant Practice standard across three African universities: an Indigenous realist evaluation.","authors":"Meshack Nzesei Mutua, Ferdinand C Mukumbang","doi":"10.1186/s12961-025-01343-7","DOIUrl":"10.1186/s12961-025-01343-7","url":null,"abstract":"<p><strong>Background: </strong>Research institutions must demonstrate the capability to efficiently and effectively manage external funding. The Good Financial Grant Practice (GFGP) was developed and operationalized as a capacity assessment and improvement tool and has been used by funding partners to assess and improve grantee institutions' financial and grants management capacity. However, little is known about the effectiveness of the GFGP process. We conducted an Indigenous realist evaluation to examine how the GFGP works, why, for whom and under what circumstances to strengthen African institutional finance and grants management capacity.</p><p><strong>Methods: </strong>A multicase realist evaluation study design was employed. In total, three African universities (cases) of varying sizes were studied; 15 realist-informed qualitative interviews were conducted with research support staff, finance and grants personnel, principal investigators (PIs) and programme-level staff to test an initial programme theory. To test the theory, we applied retroductive theorizing and the context-mechanism-outcome (CMOs) framework. A realist-informed thematic analysis was employed to identify experiential, inferential and dispositional themes necessary for generating CMOs.</p><p><strong>Results: </strong>We found mechanisms that can enhance (commitment, motivation, awareness and empowerment) or limit (fear, frustration and resentment) the adoption of GFGP in different institutional contexts. Where an institution has an inefficient grants management system, fear of losing funding results in the nondisclosure of the inefficiency of the grants management system, and consequently, the inefficiency remains unresolved. Where the institution has a small external funding base but has an efficient centralized finance and grants management system, the staff are motivated and better aware of the grant processes, leading to the completion of the GFGP process and thus resulting in the review and update of the institution's grants management policies. Where the institution has a large external funding base and has undergone participatory due diligence and audits by other international funders, the staff may feel frustrated and resent, causing the team to push back on the so-called unrealistic recommendations and expectations.</p><p><strong>Conclusions: </strong>A participatory/consultative approach to the GFGP process can ensure context-sensitive engagements and recommendations and promote stakeholder buy-in. Additional resources should be provided to address the identified financial and grants management capacity gaps as necessary.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"69"},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying knowledge gaps in social determinants of health and related challenges in Iran; 2023.","authors":"Ahad Bakhtiari, Hakimeh Mostafavi, Efat Mohamadi, Fateme Yaftian, Sahar Kargar, Seyed Vahid Ahmady Tabatabaei, Zainab Alimoradi, Mahasti Alizadeh, Ali Almasi, Mostafa Amini-Rarani, Morteza Arab-Zozani, Nahid Ardian, Ghorban Asgari, Samad Azari, Majid Babaei, Narjes Bahri, Masoud Behzadifar, Sara Dadipoor, Fatemeh Ghavidel, Enayatollah Homaie Rad, Zahra Jorjoran Shushtari, Mahmood Karimy, Ali-Asghar Kolahi, Abdolhossain Madani, Zohreh Mahmoodi, Mohammad Moradi-Joo, Masoud Motalebi Kashani, Simin Mouodi, Ali Asghar Najafpoor, Majid Nakhaee, Masoumeh Namadian, Marzieh Nojomi, Fatemeh Paknazar, Bakhtiar Piroozi, Mandana Saki, Yaser Sarikhani, Neda SoleimanvandiAzar, Shahin Soltani, Elahe Tavassoli, Amin Torabipour, Reza Vazirinejad, Mehdi Vosoughi, Amirhossein Takian, Alireza Olyaeemanesh","doi":"10.1186/s12961-025-01300-4","DOIUrl":"10.1186/s12961-025-01300-4","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic determinants of health (SDH) account for about 40% of modifiable determinants of health, followed by health behaviours (30%), clinical care (20%) and physical environmental factors (10%). The \"10/90 gap\" is the idea that only 10% of global health research is devoted to conditions that account for 90% of the global disease burden. For over a decade, SDH research centres have been established in Iran to generate evidence and address SDH.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the activities and challenges faced by SDH research centres and identify knowledge gaps.</p><p><strong>Methods: </strong>We systematically categorized 759 approved projects (2012-2022) from 29 SDH centres using predefined themes (e.g. mental health, COVID-19, social inequalities). Interrater reliability was ensured through dual independent coding, with discrepancies resolved by consensus. In addition, a bibliometric analysis of 5892 PubMed-indexed articles was conducted using VOSviewer, a validated tool for mapping research trends and collaborations. This phase provided objective insights into publication patterns, keyword clusters and interdisciplinary networks. Finally, semi-structured surveys were conducted with SDH researchers to identify knowledge gaps and prioritize research areas. Prioritization criteria (e.g. disease burden, equity impact) were scored using a five-point Likert scale, and the results were validated through an expert panel to ensure alignment with real-world challenges.</p><p><strong>Results: </strong>Out of the 759 approved research projects gathered from 29 reviewed centres, 79 projects were related to mental health, and 53 were related to coronavirus disease 2019 (COVID-19). A total of 5892 articles from 35 research centres obtained by searching PubMed were reviewed and analysed with VOS viewer software. The most frequently used keywords in the centres' published works are COVID-19, meta-analysis, systematic review, depression, anxiety, and quality of life. In 11 clusters, the 35 research centres under investigation collaborate with 82 additional research centres. Measuring different SDHs at the population level and carrying out related interventions cost far more than the centres' annual budget. Because of this and other factors stated in the results section, the research centres have shifted their focus to smaller research and more accessible and limited groups and subjects.</p><p><strong>Conclusions: </strong>There is a mismatch between the subjects that the research centres' researchers believe should be studied and the approved projects of the centres, as is evident from a review of the centres' projects and their opinions. Numerous issues may be the root of these discrepancies, such as methods for ranking research subjects, methods for selecting study target groups, how to assess research centres and the different criteria set by colleges and universities.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"63"},"PeriodicalIF":3.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To what extent is equity entrenched in HIV/AIDS-related policy documents in Ethiopia? A policy content analysis.","authors":"Aklilu Endalamaw, Charles F Gilks, Yibeltal Assefa","doi":"10.1186/s12961-025-01292-1","DOIUrl":"10.1186/s12961-025-01292-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;It is important to assess the extent of mentions of equity in policy and strategic documents for several reasons. First, it helps us understand the root causes of inequities, revealing both failures and successes. Second, it shows the readiness of stakeholders and leaders to take actions towards equity. Third, it identifies areas of improvement to plan strategies towards equity. The objective of this study was to assess the degree to which equity is incorporated in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)-related policy documents in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A policy content analysis was conducted on the basis of Marmot's social determinants of health framework. We have included policies, strategic plans, guidelines and reports on the basis of relevance to HIV/AIDS, timeliness and availability to the public. The search for documents took place between 1 March 2023 and 1 May 2023. The included documents in the content analysis were published between 1998 and 2022. These documents were accessed from Google, the Joint United Nations Programmes for HIV/AIDS, the WHO, the World Bank, the Ethiopian Federal Ministry of Health and the International Institute for Primary Health Care-Ethiopia websites. These documents were evaluated for mentioning equity in broader view or in relation to social categories (residence, occupation/employment, religion, sex/gender, ethnicity, education, income, region, age and multiple disadvantaged groups) and structural dimensions or health systems building blocks, such as health leadership and governance, workforce, financing, medical products and technologies and information systems. A Bardache's eightfold policy analysis guided the content analysis and synthesis of findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 26 documents were reviewed and analysed. Mentions of equity in policy documents increased over time, but the level of mention varied among national plans, treatment guidelines and reports. Over time, the mentioning of equity increased in strategic plans and guidelines, while it decreased in reports. In the same documents, there seems to be a shift from equality to equity because mentions of (in)equity increased from 149 between 2011 and 2015 to 328 between 2016 and 2022, while (in)equality mentions declined from 117 to 53 during the same period. Equity was mentioned in relation to health system functions and/or social classes. Gender (in)equity was the most frequently mentioned issue, while (in)equity related to multiple disadvantaged groups, religion, employment status and social capital was less frequently mentioned. (In)equity is deeply embedded in health system governance, but it is least integrated into the health information system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The mentioning and consideration of (in)equity in policy and strategic documents have increased over time, but not consistently or comprehensively. Growi","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"64"},"PeriodicalIF":3.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}