Research priority setting related to older adults: a scoping review to inform the Cochrane-Campbell Global Ageing Partnership work programme.

OBJECTIVE: To explore and map the findings of prior research priority-setting initiatives related to improving the health and well-being of older adults. DESIGN: Scoping review. DATA SOURCES: Searched MEDLINE, EMBASE, AgeLine, CINAHL and PsycINFO databases from January 2014 to 26 April 2021, and the James Lind Alliance top 10 priorities. ELIGIBILITY CRITERIA: We included primary studies reporting research priorities gathered from stakeholders that focused on ageing or the health of older adults (≥60 years). There were no restrictions by setting, but language was limited to English and French. DATA EXTRACTION AND SYNTHESIS: We used a modified Reporting Guideline for Priority Setting of Health Research (REPRISE) guideline to assess the transparency of the reported methods. Population-intervention-control-outcome (PICO) priorities were categorised according to their associated International Classification of Health Interventions (ICHI) and International Classification of Functioning (ICF) outcomes. Broad research topics were categorised thematically. RESULTS: Sixty-four studies met our inclusion criteria. The studies gathered opinions from various stakeholder groups, including clinicians (n=56 studies) and older adults (n=35), and caregivers (n=24), with 75% of the initiatives involving multiple groups. None of the included priority-setting initiatives reported gathering opinions from stakeholders located in low-income or middle-income countries. Of the priorities extracted, 272 were identified as broad research topics, while 217 were identified as PICO priorities. PICO priorities that involved clinical outcomes (n=165 priorities) and interventions concerning health-related behaviours (n=59) were identified most often. Broad research topics on health services and systems were identified most often (n=60). Across all these included studies, the reporting of six REPRISE elements was deemed to be critically low. CONCLUSION: Future priority setting initiatives should focus on documenting a more detailed methodology with all initiatives eliciting opinions from caregivers and older adults to ensure priorities reflect the opinions of all key stakeholder groups

Development of an Agile Requirements Risk Prioritization Method: A Design Science Research Study

The practice of information systems development (ISD) has changed during the past two decades from very structured approaches to agile ISD methods. However, many methods available for managing requirements-related risks in the literature follow the structured way of doing ISD. If any, few methods offer solutions to prioritize requirements risks for agile ISD projects based on recognizing requirements-related risks and patterns to mitigate these. To fill this gap in the literature, we apply the design science research methodology to develop an agile requirements risk prioritization method together with industry experts (n=54) in Finland and New Zealand in a multi-year study. The method was developed by applying contingency theory, and our study makes an artifactual contribution to the literature. The method helps practitioners prioritize the overall requirements-related risks for ISD projects

Engaging Multistakeholder Perspectives to Identify Patient-Centered Research Priorities Regarding Vaccine Uptake Among Adults With Autoimmune Conditions

Objective: The study objective was to prioritize topics for future patient-centered research to increase uptake of common vaccines, such as for pneumococcal pneumonia, influenza, herpes zoster, human papillomavirus, and severe acute respiratory syndrome coronavirus 2, among adults living with autoimmune conditions. Methods: A steering committee (SC) was formed that included clinicians, patients, patient advocates, and researchers associated with rheumatic diseases (psoriatic arthritis, rheumatoid arthritis, vasculitis), inflammatory bowel disease, and multiple sclerosis. Through a scoping review and discussions, SC members identified research topics regarding vaccine uptake and/or hesitancy for prioritization. A larger multistakeholder alliance that included patients and patient advocates, clinicians, researchers, policy makers, regulators, and vaccine manufacturers conducted a modified Delphi exercise online with three rating rounds and one ranking round. Frequency analysis and comparisons across stakeholder groups were conducted. A weighted ranking score was generated for each item in the ranking round for final prioritization. Results: Through the Delphi process, 33 research topics were identified, of which 13 topics were rated as critical by more than 70% of all stakeholders (n = 31). The two highest ranked critical topics per the full stakeholder group were “How well a vaccine works for adults with autoimmune conditions” and “How beliefs about vaccine safety affect vaccine uptake.”. Conclusion: A multistakeholder group identified key topics as critically important priorities for future research to decrease vaccine hesitancy and improve uptake of vaccines for adults with autoimmune conditions

Core competencies for family and community nurses: a European e-Delphi study

Aim: To identify the core competencies of family and community nurses. Background: The European Union is facing common health challenges in the field of primary care, according to European health policies and the World Health Organization, which need to be addressed through better and innovative ways of working that require joint actions. There is evidence that ‘Family and Community Nurses’ play a key role in the field of primary care, but there is no agreement on which core competencies they are required to have. Design: An e-Delphi study Methods: A 4-round e-Delphi study was conducted from March to July 2018 as part of the Erasmus+ Project “EuropeaN curriculum for fAmily aNd Community nursE” (ENhANCE). A panel of 23 experts from 10 European countries were asked to approve, modify, or add items and then prioritize each skill. Results: This e-Delphi, as part of the ENhANCE project, produced core 28 competencies, which were used by the “ENhANCE” partners to develop the European Core Curriculum for Family and Community Nurses. The ENhANCE partners ensured that the core competencies were consistent with World Health Organization recommendations, the European Skills/Competencies, Qualifications and Occupations (ESCO) and with the European Credit System for Vocational Education and Training (ECVET). Conclusions: The results of this study will provide the basis for universities across Europe to develop their own post-graduate teaching programs with common educational goals for Family and Community Nurses and a cadre of nurse practitioners with transferrable skills across the continent. Tweetable Abstract: This e-Delphi, as part of the ENhANCE project, produced 28 competencies for the European Core Curriculum for Family and Community Nurses

Improving Beginning Teacher Effectiveness: The Most Important and Difficult Competencies and How They Differ in Low-Income Schools

Research suggests teacher quality is a significant factor predicting student achievement, especially for low-income students. However, there is insufficient research about which teaching competencies warrant emphasis during pre-service training. The purpose of this study was to investigate consensus among expert educators on the importance and difficulty of teaching competencies for beginning teachers, and whether the importance and difficulty of those competencies differ in low-income school settings. Thirty-one academic and practitioner experts in beginning teacher development participated in the study. Participants rated 8 of 25 teaching competencies as very important and very difficult for beginning teachers. Results indicate broad consensus among experts. However, consensus was not reached on several items, mostly related to differences in competency difficulty. Finally, experts rated many of the competencies as more important and more difficult for beginning teachers in low-income schools

Participant Experiences with a New Online Modified-Delphi Approach for Engaging Patients and Caregivers in Developing Clinical Guidelines

Background Patient engagement in clinical practice guideline (CPG) development has increased significantly in recent years. However, only a few patients and caregivers join CPG development groups. Objective To describe participant experiences with a novel online, scalable approach for patient and caregiver engagement in CPG development. Design We developed and tested the RAND/PPMD Patient-Centeredness Method (RPM), a novel online modified-Delphi approach to patient engagement in CPG development that consists of an optional idea generation round and two rating rounds interspersed with an online discussion round. Setting and Participants Using the online ExpertLens™ system, we ran 2 concurrent panels of patients and caregivers of individuals with Duchenne Muscular Dystrophy (DMD). Main Outcome Measures We surveyed all 95 panel participants about their participation and satisfaction with the process. We also conducted telephone interviews with 25 participants. Results Participants expressed satisfaction with various ExpertLens™ features, noting that the system fostered lively interaction among them. Panelists also appreciated participating in an educational, interactive and convenient discussion forum that allowed them to share their opinions on the importance and acceptability of different recommendations. The RPM was viewed as empowering by patients and their caregivers who felt it would be useful for CPG developers. Discussion and Conclusion The results of our study show the overall participant satisfaction with a novel, scalable, online approach to engaging patients and caregivers in CPG development, which allows them to share their perspectives and lived experiences using a rigorous, systematic and iterative way that is similar to how clinicians provide their input

Self-care management of bothersome symptoms as recommended by clinicians for patients with a chronic condition: A Delphi study

BACKGROUND: Chronically medically ill patients often need clinical assistance with symptom management, as well as self-care interventions that can help to reduce the impact of bothersome symptoms. Experienced clinicians can help to guide the development of more effective self-care interventions. OBJECTIVE: To create a consensus-based list of common bothersome symptoms of chronic conditions and of self-care management behaviors recommended to patients by clinicians to reduce the impact of these symptoms. METHODS: A two-round Delphi study was performed among an international panel of 47 clinicians using online surveys to identify common and bothersome symptoms and related self-care management behaviors recommended to patients with heart failure, chronic obstructive pulmonary disease, asthma, type 2 diabetes, or arthritis. RESULTS: A total of 30 common bothersome symptoms and 158 self-care management behaviors across the five conditions were listed. Each chronic condition has its own bothersome symptoms and self-care management behaviors. Consensus was reached on the vast majority of recommended behaviors. CONCLUSIONS: The list of common bothersome symptoms and self-care management behaviors reflect consensus across four countries on many points but also disagreement on others, and a few recommendations are inconsistent with current guidelines. Efforts to encourage clinicians to recommend effective self-care management behaviors may reduce symptom impact in chronically ill patient populations

Identification, Diagnosis, Counseling, and Referral of Overweight Military Dependent Children to Reverse Early Childhood Obesity

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention within families through primary care interventions, the revised health belief model guided the project design. A literature review was conducted in a systematic manner to identify effective strategies and interventions to inform the policy development. Then, the Delphi technique guided a 12-member expert panel to evaluate the policy and procedures in terms of the level of evidence and the implementation plan with the goal of achieving consensus with recommendations for revisions. Consensus was achieved with multiple revisions following the completion of two Delphi rounds. The first panel session (n=12) concluded with a 70% consensus, including recommended revisions to improve the policy implementation. The second panel session (n=12) concluded with 100% consensus for the revised policy. The final policy and procedures addressed the clinical practice gap with a robust process to identify, counsel, and refer overweight children to external specialty programs for obesity management. By intervening to reverse the progression of childhood obesity, this project achieved positive social change at an organization level