Developing research priorities in Australian primary health care: a focus on nutrition and physical activity
Lauren Ball A E , Katelyn Barnes A , Michael Leveritt B , Lana Mitchell A , Lauren T. Williams A , Dianne Ball C and Elizabeth Patterson DA Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld 4222, Australia.
B School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4072, Australia.
C Communio Pty Ltd, North Sydney, NSW 2060, Australia.
D Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic. 3000, Australia.
E Corresponding author. Email: l.ball@griffith.edu.au
Australian Journal of Primary Health 23(6) 554-559 https://doi.org/10.1071/PY16068
Submitted: 31 May 2016 Accepted: 19 September 2016 Published: 17 October 2016
Abstract
Research priority setting is an important component of research planning, particularly when research options exceed available resources. This study identified the research priorities for supporting healthy lifestyle behaviours in the Australian primary healthcare setting. A five-step stakeholder engagement process was undertaken. Ten stakeholder organisations participated in the process, including patient representatives, health professional associations, health educators, researchers, government advisors and policymakers. Each organisation was asked to provide up to three research questions deemed as a priority. Research questions were critically appraised by the project team for answerability, sustainability, effectiveness, potential for translation and potential to affect disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 87–156). Thirteen unique research questions were submitted by stakeholders and achieved a range of scores from 87 to 139 points. The highest scoring research questions focused on: (i) the effectiveness of different health professionals at facilitating healthy lifestyle behaviours; (ii) the effect of health literacy on behaviour change; and (iii) cost-benefit analysis of healthy lifestyle promotion in primary health care. These priorities can be used to ensure future research projects directly align with the needs and preferences of research end-users.
Additional keywords: chronic disease, general practice, intervention studies, nutritional management, nutrition therapy, primary care, research methods.
References
Australian Bureau of Statistics (2012) Australian health survey. Available at http://www.abs.gov.au/australianhealthsurvey [Verified 1 December 2014]Australian Institute for Primary Care (2008) System reform and development for chronic disease management. La Trobe University, Melbourne.
Australian Institute of Health and Welfare (2012) Risk factors contributing to chronic disease. Australian Government, Canberra.
Ball L, Johnson C, Desbrow B, Leveritt M (2013) General practitioners can offer effective nutrition care to patients with lifestyle related chronic disease: a systematic review. Journal of Primary Health Care 5, 59–69.
Ball L, Desbrow B, Leveritt M (2014) An exploration of individuals’ preferences for nutrition care from Australian primary care health professionals. Australian Journal of Primary Health 20, 113–120.
| An exploration of individuals’ preferences for nutrition care from Australian primary care health professionals.Crossref | GoogleScholarGoogle Scholar | 23428232PubMed |
Ball L, Leveritt M, Cass S, Chaboyer W (2015) Effect of nutrition care provided by primary health professionals on adults’ dietary behaviours: a systematic review. Family Practice 32, 605–617.
Brown KH, Hess SY, Boy E, Gibson RS, Horton S, Osendarp SJ, Sempertegui F, Shrimpton R, Rudan I (2009) Setting priorities for zinc-related health research to reduce children’s disease burden worldwide: an application of the Child Health and Nutrition Research Initiative’s research priority-setting method. Public Health Nutrition 12, 389–396.
Diabetes Australia and Royal Australian College of General Practitioners (2008) ‘Diabetes Management in General Practice’, 14th edn. (Diabetes Australia: Sydney)
Faruqi N, Lloyd J, Ahmad R, Yeong LL, Harris M (2015) Feasibility of an intervention to enhance preventive care for people with low health literacy in primary health care. Australian Journal of Primary Health 21, 321–326.
| Feasibility of an intervention to enhance preventive care for people with low health literacy in primary health care.Crossref | GoogleScholarGoogle Scholar | 24913671PubMed |
Foster M, Cornwell P, Fleming J, Mitchell G, Tweedy S, Hart A, Haines T (2009) Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners. Australian Journal of Primary Health 15, 326–334.
| Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners.Crossref | GoogleScholarGoogle Scholar |
Halcomb EJ, Davidson PM, Yallop J, Griffiths R, Daly J (2007) Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management. Contemporary Nurse 26, 125–135.
| Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.Crossref | GoogleScholarGoogle Scholar | 18041993PubMed |
Herbert D, Barnett A, Graves N (2013) Funding: Australia’s grant system wastes time. Nature 495, 314
| Funding: Australia’s grant system wastes time.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXktlCms7c%3D&md5=4921ceb87976b6308798a6facdd9eca8CAS | 23518554PubMed |
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng AT-A, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FGR, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang Y-H, Khatibzadeh S, Khoo J-P, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Memish ZA, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Hanafiah KM, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CDH, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJC, Steenland K, Stöckl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, Van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJL, Ezzati M (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 2224–2260.
| A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010.Crossref | GoogleScholarGoogle Scholar | 23245609PubMed |
Maher JH, Lowe J, Hughes R (2015) Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives. Public Health Nutrition 18, 1864–1872.
| Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives.Crossref | GoogleScholarGoogle Scholar | 25295409PubMed |
Moore G, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, Moore L, O’Cathain A, Tinati T, Wight D, Baird J (2015) Guidance on process evaluation of complex interventions. British Medical Journal 350, h1258
| Guidance on process evaluation of complex interventions.Crossref | GoogleScholarGoogle Scholar | 25791983PubMed |
National Health and Medical Research Council (2013) Australian dietary guidelines. Australian Government, Canberra.
Royal Australian College of General Practitioners (2015) Smoking, Nutrition, Alcohol and Physical Activity (SNAP): A population health guide to behavioural risk factors in general practice. 2nd edn. (RACGP: Melbourne)
Rudan I, Gibson JL, Ameratunga S, El Arifeen S, Bhutta ZA, Black M, Black RE, Brown KH, Campbell H, Carneiro I, Chan KY, Chandramohan D, Chopra M, Cousens S, Darmstadt GL, Meeks Gardner J, Hess SY, Hyder AA, Kapiriri L, Kosek M, Lanata CF, Lansang MA, Lawn J, Tomlinson M, Tsai AC, Webster J, Child H, Nutrition Research Initiative (2008) Setting priorities in global child health research investments: guidelines for implementation of CHNRI method. Croatian Medical Journal 49, 720–733.
| Setting priorities in global child health research investments: guidelines for implementation of CHNRI method.Crossref | GoogleScholarGoogle Scholar | 19090596PubMed |
Sargent GM, Forrest LE, Parker RM (2012) Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: a systematic review. Obesity Reviews 13, 1148–1171.
| Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38bmsFOnsg%3D%3D&md5=9ce2636755aa8643c95702e5b338d426CAS | 22973970PubMed |
Volker N, Williams LT, Davey RC, Cochrane T (2015) Community-based lifestyle modification workforce: an underutilised asset for cardiovascular disease prevention. Australian Journal of Primary Health 22, 327–331.
Weenen TC, Jentink A, Pronker ES, Commandeur HR, Claassen E, Boirie Y, Singer P (2014) Patient needs and research priorities in the enteral nutrition market – a quantitative prioritization analysis. Clinical Nutrition 33, 793–801.
| Patient needs and research priorities in the enteral nutrition market – a quantitative prioritization analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2c3ms1aluw%3D%3D&md5=af23b526481ed5506e707b07dfdc65b6CAS | 24342258PubMed |
World Health Organization (2003) WHO Technical Report Series: diet, nutrition, and the prevention of chronic diseases. WHO Technical Report Series, Number 916 (TRS 916), WHO, Geneva.
Yoshida S (2016) Approaches, tools and methods used for setting priorities in health research in the 21st century. Journal of Global Health 6, 010507
| Approaches, tools and methods used for setting priorities in health research in the 21st century.Crossref | GoogleScholarGoogle Scholar | 26401271PubMed |