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Developing Programs of Research - Health Research Priority Themes and Questions

Preamble

This document describes a new initiative on the part of AHFMR, in collaboration with Alberta Health and Wellness, to develop longer-term programs of health research to inform policy and decision-making, and to contribute to developing further capacity for health services research in Alberta. This initiative is additive to the ongoing activities supported by AHFMR and Alberta Health and Wellness.

The Foundation's investment in health services and population health research in Alberta has grown from less than 3% to 19% of its total yearly investment in research over the last decade. At the same time the total Foundation investment in all types of research has been increasing steadily. The major portion of this investment in health research (> 75%) has been in the building of research capacity through the training and recruitment of investigators. This has included the Population Health Investigator, Health Scholar and Health Senior Scholar programs, Health Studentships and Fellowships, SEARCH, and other initiatives. In collaboration with Alberta Health & Wellness, the Foundation has administered the Health Research Fund, which has supported two-year research projects at $50,000 per annum. These programs will continue.

 

Developing the Themes and Questions

The purpose of these themes and questions is to help guide the development of new competitively awarded long-term (five years) programs of research to inform policy and decision-making, and at the same time contribute to the development of Alberta-based or linked research capacity to address the research information needs of these themes.

These health research themes and questions have been developed through processes advised by the following sources of information and the following groups.

AHFMR Regional Health Authority consultations 1999-2000

Alberta Health & Wellness

Listening for Direction -- a national consultation on health services and policy issues

AHFMR Health Research Advisory Committee

AHFMR Health Advisory Committee

The criteria for choosing these themes and questions related to them are outlined in the following six points. Whether the chosen themes and questions fit well with all of the criteria may only be established following experience with the response to the call for State of the Science reviews, and the subsequent programs of research.

  1. Relevant for policy and decision-makers in Alberta.
  2. The issue is likely to remain a high priority in decision-making in Alberta for at least three to five years, thereby allowing networks of researchers and decision-makers to form a significant body of knowledge and to influence decision-making in the theme area. The activities of the group should position Alberta as a national leader in this area.
  3. The issue is focused enough to be distinctive, yet broad enough to warrant program funding and networking of investigators.
  4. The leadership exists in the area in Alberta to respond with high-quality research, and the research capacity is present either in Alberta, or by linking with expertise from elsewhere. The theme enables one to expand and exploit interdisciplinarity and capacity building in Alberta.
  5. Potential for significant funding partnerships to carry the research forward. The expectations are reasonably aligned with available resources.
  6. The Alberta based initiative in this area would be complementary to the activities of other major research sponsors or agencies.

 

Each theme area is very broad, and the question under the theme is meant to focus the attention of the research and decision-making communities on specific areas under the theme. The sub question in bold will serve as the basis of a call for "State of the Science" reviews. The purpose of including the other sub-questions is to indicate an Alberta interest in these questions also. At some time in the future, they may serve as a focus for programs of research.

 

  1. Continuum of care and delivery models
    2.
    1. What structures and processes lead to effective integration of services across different delivery components (public health, acute care, long term care and home care), and to improved individual and population health outcomes?
      2.
    2. What models or approaches in health services minimize the disruption of living circumstances for citizens, such as the elderly, those with chronic illness or disability, or those in remote areas?
  2. Information management and information technology for health improvement
    3.
    1. Does utilization of information management through information technology improve individual and population health outcomes? What information management systems and tools are most effective?
      2.
    2. What information systems and tools are appropriate in supporting and evaluating the effective integration of primary health care with other components of the health system (public health, acute care, long term care and home care)?
  3. Financing and public expectations
    4.
    1. What processes most effectively reconcile public values and technical information to inform resources allocation decisions, particularly in the areas of new technology assessment and defining publicly funded health care services?
      2.
    2. What are the effects of different incentive systems for health professionals on costs and quality of service, and recruitment and retention?
    3. How do you balance evidence and other influences to inform resource allocation decisions? What processes contribute to the formation of public values and expectations that lead to decisions?
  4. Governance and accountability
    5.
    1. What are the appropriate models to inform the development of indicators and benchmarks at different levels of accountability in the health system? Which different performance indicators and benchmarks are appropriate to reflect the responsibilities and challenges faced by the different levels of the health system?
    2. What are the actual accountability practices currently in place at all levels of the health care systems and how do they relate to stated and expected accountability practices? How do accountability practices contribute to governments', health authorities', and provincial boards' ability to take action on cross-sectoral initiatives to improve population health?

Programs of Health Research

The process to develop programs of research in these themes and to increase the related Alberta research capacity is in three stages.

Stage 1. The first stage has been completed with the identification of the broad research themes and some relevant questions concerning the information needs of the themes.

 

Stage 2. The second stage is described separately in a document entitled "Request for Applications: Informing Directions in Health Research: "State of the Science" reviews. The purpose of these reviews is to summarize the scientific research literature in a content area and provide a summary of the areas of strength and weakness in the research base and identify gaps in knowledge. They will be the initial research document available to provide an information base to assist policy and decision-makers. They will also be available to inform and strengthen the proposals of the research community seeking support from AHFMR and other funding agencies, and inform the external and committee reviewers of the Foundation in their assessment of proposals for projects or programs of health services research.

The time-frame to complete these reviews will be eight months, and the budget may be up to $70,000.

 

Stage 3. The third stage, which will follow the dissemination of the "State of the Science" reviews will be a call for proposals for programs of research to inform the knowledge gaps identified through the "State of the Science" reviews.

 

A program will involve a group of investigators and potential users of the research. A program may be formed through a series of research questions asked and answered concurrently and/or consecutively in an interdependent series of projects. The program will be expected to be an important platform for training. The Foundation expects that these programs of research will be supported for up to five years, with a budget of up to $300,000 per year. These funds may be used for personnel, research operating costs, travel, and other research-related expenses. The call for proposals for programs of research will be open to all qualified groups of investigators, including those who may have prepared the "State of the Science" review.

The principal investigator and some members of the research group should be primarily affiliated with an Alberta institution/organization that will be responsible for the administration of the funds awarded. In cases where a substantial portion of the team is not resident in Alberta, the plans for the group should include plans to develop research capacity in the province so that future research activities in this area can be mounted on an Alberta base.