SLIDE 1
Developing a Research Agenda for Public Health Services in Canada
SLIDE 2 Funders
- Canadian Institutes of Health Research
- Ontario Agency for Health Promotion and Protection
- Public Health Agency of Canada
- CIHR Applied Public Health Chair Awards to
MacDonald and Paradis
- BC Centre for Disease Control
- University of Western Ontario
SLIDE 3 Background
- A series of PH Emergencies in Canada (SARS,
tainted blood scandal, Walkerton water contamination)
- Decimated public health infrastructure
- Need identified to define Core Functions of PH
- Need to renew and reform PH Systems
- Renewal process initiated across the country
SLIDE 4 Background
- Core Functions Framework developed in BC
- Interdisciplinary team of researchers and
decision makers created with infrastructure funding
- Think Tank held to develop PHSR priorities
- Leveraged $3M for research 2006-2011
- Challenges in finding funding to support PHSR
– falls through funding agency cracks
SLIDE 5 Purpose of Project
- To expand PHSR agenda Canada wide
- To identify PHSR research priorities in Canada
- Establish consensus on agenda
- Develop a strategic plan to advance the
agenda
- Develop a national network of PHSR
researchers, practitioners and decision makers
SLIDE 6 Purpose of Presentation
- To present preliminary findings of literature
search and survey
- To identify some implications arising from the
literature review and survey that might inform
- ur deliberations over the next two days
SLIDE 7 Literature Review
Purpose
- 1. Identify work being done to define PHSR,
scope, potential, benefits
- 2. Describe the nature of PHSR being done in
Canada
- 3. Identify PHSR priorities in the 5 countries
under review (Can, US, UK, NZ, Aus)
SLIDE 8 Review Methods
- Comprehensive search strategy using keyword
searches in major databases, hand searching relevant journals, gray literature internet searches, key website searchers, reference lists of key articles
- 1000 articles identified, 800 coded and
abstracted
SLIDE 9
- Only 38 articles specifically used the term
PHSR or PHSSR
- Only 14 articles made reference to or
discussed establishing a research agenda for PHSR
SLIDE 10
Article Types
TYPE Empirical Theoretical Review Opinion/Editorial Report TOTAL Can US UK NZ Aus 18 201 15 2 11 26 130 23 5 12 17 101 19 3 9 19 107 13 9 14 8 54 2 1 0 88 593 72 20 46
SLIDE 11 PHSR Topic Areas
Topics Partnerships PH Infrastructure EB Practice Policy/Legislation Health Disparities Ph Workforce PH Performance Core Functions Can US UK NZ Aus 26 169 19 3 8 24 122 10 5 9 21 82 21 3 13 21 121 24 5 14 19 95 20 7 15 15 147 15 4 8 12 155 10 7 4 9 124 9 2 8
*Top 3 priorities highlighted in red
SLIDE 12 Brainstorming Survey
- Developed brief 10 minute online survey
based on priorities identified in preliminary literature review
- Not intended to be a population-based
representative sample
- Distributed widely through a variety of public
health listserves across the country
SLIDE 13
Respondent Position
SLIDE 14
Work Level
SLIDE 15
Familiarity with Concept
PH Systems/services PH Research PH Systems/services research Mean Min Max St. Dev 7.8 1 10 1.95 6.7 1 10 2.10 5.8 1 10 2.32
SLIDE 16
Familiarity with PHSR by Employment Category
Academics Practitioners Managers/Admin Policy Makers Policy Analysts Consultant Other Mean Min Max St. Dev 7.0 2 20 1.96 5.3 1 10 2.27 5.4 1 10 2.38 6.2 2 10 1.95 6.1 2 10 2.06 6.1 1 10 2.08 5.9 1 10 2.08
SLIDE 17
PHSR Priorities
SLIDE 18
Canadian PHSR Priorities
Literature Partnerships PH Infrastructure Evidence-based practice Policy/Legislation Health Disparities Survey Evidence-based practice PH Performance PH Infrastructure Health Disparities Core PH Functions
SLIDE 19 Summary &Implications
- Only in the US has there been explicit,
collaborative efforts to define the field
- Shift in language from PHSR to PHSSR to link
the field explicitly with health services research
- Is this a good thing? Are there any drawbacks
to making this connection? If we do want to link our agenda to HSR, how do we do this?
SLIDE 20
- Similarities and overlaps between Population
Health Intervention Research (PHIR) and PHSR
- “the use of scientific methods to produce
knowledge about policy and program interventions that operate within or outside of the health sector and have the potential to impact health at the population level”
- PHIR brings issue of intersectoral collaboration
to the table
SLIDE 21
- PHSR literature is more focused on describing
and defining what it is that PH people do, rather than what it is they should be doing
- A limited literature emerging that explores
broader issues related to how societies can create the conditions in which people can be healthy
- Is this a focus we want to ensure gets
integrated into a Canadian PHSR agenda?
SLIDE 22
- The need to identify the key infrastructure
elements and capacity necessary to address the PH goal of reducing health inequities by focusing on the SDOH is more prominent in the Canadian, Australian, UK and NZ literature.
- It does appear in the US literature but has not
yet attained such a prominent role.
- To what extent do we want to orient our
agenda to reduction of health inequities?
SLIDE 23
- Empirical literature has a strong focus on
“traditional” methodologies, primarily quantitative
- We need innovative and creative
methodologies that can take the systems focus into account – and this means explicit attention to context
SLIDE 24
- People are more likely to understand the
concept of public health research than public health services/systems research
- What are the implications of this finding for
moving the agenda forward?
SLIDE 25
- Survey findings reflect a high priority on
health disparities/inequities, but this it is less
- f a priority for practitioners and managers
than for other respondents
- How do we move an equity research agenda
forward if this is not a priority for those PH professionals closest to practice?
SLIDE 26 What is missing?
- There is nothing at all in the PHSR literature
about public health ethics, yet many ethical concerns arise and are identified
- Is this an issue that we want to see integrated
into our agenda?
