Health literacy and adolescents: a framework and agenda for future research

Health literacy is an important issue in public health today, especially as patients are taking a greater role in obtaining information about their health. Health literacy is commonly defined as 'the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions'. While there is a large body of literature concerning health literacy and adults, few studies have focused on adolescents. Adolescents may have less interaction with the health care system and lower health care costs than adults, but they are increasingly involved with their health care, especially those with chronic illness. They are frequent users of mass media and other technology to access health information and are a target group for many health-related educational interventions. Adolescents are also at a crucial stage of development, learning skills they will carry with them into adulthood. The goal of this paper is to provide a summary of issues justifying the importance of studying health literacy as it relates to adolescents and to provide a framework and suggestions for future research.     

Consumer involvement in health research: a review and research agenda

The involvement of consumers in health research is now Department of Health policy within the UK. Despite the existence of policy directives, there is a dearth of knowledge on the effects of such involvement. This paper critically reviews the state of our knowledge on this issue, and maps out a research agenda with the aim of stimulating systematic, empirical inquiry into consumer involvement in health research. The paper discusses definitions of 'the consumer'; considers why consumer involvement is believed to be important to health research; traces the development of the policy; analyses the epistemological and methodological implications of the policy; discusses the various levels of consumer involvement in research; and outlines the objections to the policy that have been put forward by clinicians and researchers. Four questions were identified during the review as being in need of theoretical and empirical attention: (1) how can consumer involvement in health research be further conceptualised? (2) how and why does consumer involvement influence health research? (3) how can the influence of consumers in health research be measured and evaluated? and (4) what factors are associated with 'successful' consumer involvement in health research?     

Case mix planning in hospitals: a review and future agenda

The case mix planning problem deals with choosing the ideal composition and volume of patients in a hospital. With many countries having recently changed to systems where hospitals are reimbursed for patients according to their diagnosis, case mix planning has become an important tool in strategic and tactical hospital planning. Selecting patients in such a payment system can have a significant impact on a hospital’s revenue. The contribution of this article is to provide the first literature review focusing on the case mix planning problem. We describe the problem, distinguish it from similar planning problems, and evaluate the existing literature with regard to problem structure and managerial impact. Further, we identify gaps in the literature. We hope to foster research in the field of case mix planning, which only lately has received growing attention despite its fundamental economic impact on hospitals.     

Lesbian health research: a review and recommendations for future research

Prior to 1990 lesbians were "invisible" in health care research. Researchers who asked questions specifically about lesbian health concerns were rare, and the burgeoning research on women's health seldom included variables that measured sexual orientation or behavior. In the last decade, however, lesbian health has emerged as a major area of study. A 1999 Institute of Medicine (IOM) report on Lesbian Health has outlined the challenges and gaps in this area of research and has called for focus and funding on specific areas of need. In this article I review research on lesbian health, discuss methodological issues specific to this area of research, and summarize the recommendations of the IOM report.     

Trust relations in health care: an agenda for future research

PURPOSE: The aim of this paper is to draw together suggestions for future research from the papers and from the discussion that took place at the workshop. DESIGN/METHODOLOGY/APPROACH: The suggestions are summarised under four broad themes. FINDINGS: At an international workshop on trust organised by the U.K. MRC Health Services Research Collaboration there was broad agreement that trust was still a salient issue in diverse health care contexts. The workshop proceedings identified a number of important questions for empirical research and several key conceptual, theoretical and methodological questions relating to trust that need to be addressed in support of or alongside this. The collection of papers in this volume starts to address some of these questions. ORIGINALITY/VALUE: Considers trust relations in health care from patient, clinical, organisational and policy perspectives.     

Childhood obesity prevention and treatment: recommendations for future research

This report summarizes the National Heart, Lung, and Blood Institute Working Group's recommendations on future research directions in childhood obesity prevention and treatment. The Working Group consisted of leaders and representatives from public and private academic and medical institutions with expertise in a variety of health specialties. They reviewed the literature and discussed the findings as well as their own experiences in the prevention and treatment of childhood obesity. The Working Group made recommendations that were based on scientific importance, the potential likelihood of public health impact, and the feasibility and timeliness for childhood obesity prevention and treatment research. These recommendations are intended to assist investigators in the development of research agendas to advance the knowledge of effective childhood obesity prevention and treatment.     

Social capital and health in the least developed countries: A critical review of the literature and implications for a future research agenda

Research on the linkage between social capital and health has grown in recent years; however, there is a dearth of evidence from resource-poor countries. This review examines the association between social capital and physical health (including health behaviours) in the least developed countries (LDCs). Citations were searched using three databases from 1990 to 2011 using the keyword ‘social capital’ combined with the name of each of the 48 LDCs. Of the 14 studies reviewed, 12 took place in Africa and 2 in South Asia. All used cross-sectional study designs, including five qualitative and nine quantitative studies. The literature reviewed suggests that social capital is an important factor for improving health in resource-poor settings; however, more research is needed in order to determine the best measures for social capital and elucidate the mechanisms through which social capital affects health in the developing world. Future research on social capital and health in the developing world should focus on applying appropriate theoretical conceptualisations of social capital to the developing country context, adapting and validating instruments for measuring social capital, and examining multilevel models of social capital and health in developing countries.     

The future of obesity research

As endocrinologists, we view better treatment as the goal of obesity research. The ideal obesity treatment would reduce body fat substantially, with preferential loss from the visceral compartment, and preserve lean tissue with a minimum of side effects. Obesity has been recognized as a chronic disease since 1985. Chronic diseases recognized before obesity may predict the future of obesity research. Initial treatments of chronic diseases commonly arise from empirical observations. These observations often stimulate basic research into the physiologic mechanisms responsible. Such cross-fertilization between the clinic and basic science is desirable and expected. As more is learned about the physiology of obesity, treatments can be expected to use more downstream mechanisms with less unwanted side effects, the reliance on surgical treatments can be expected to decline, and molecular approaches are likely to play an increasingly important role. With a better physiologic understanding of obesity, advanced clinical endpoints will become more important and molecular approaches are likely to play a more important role in discovery and treatment. Due to the availability of molecular approaches, obesity treatment is expected to advance faster than chronic disease research of the past.     

HIV issues and people with disabilities: A review and agenda for research

The recent AIDS and Disability Partners Forum at the UN General Assembly High Level Meetings on AIDS in New York in June 2011 and the International AIDS Conference in Washington, DC in July 2012 underscores the growing attention to the impact of HIV and AIDS on persons with disabilities. However, research on AIDS and disability, particularly a solid evidence base upon which to build policy and programming remains thin, scattered and difficult to access. In this review paper, we summarise what is currently known about the intersection between HIV and AIDS and disability, paying particular attention to the small but emerging body of epidemiology data on the prevalence of HIV for people with disabilities, as well as the increasing understanding of HIV risk factors for people with disabilities. We find that the number of papers in the peer-reviewed literature remains distressingly small. Over the past 20 years an average of 5 articles on some aspect of disability and HIV and AIDS were published annually in the peer-reviewed literature from 1990 to 2000, increasing slightly to an average of 6 per year from 2000 to 2010. Given the vast amount of research around HIV and AIDS and the thousands of articles on the subject published in the peer-reviewed literature annually, the continuing lack of attention to HIV and AIDS among this at risk population, now estimated to make up 15% of the world's population, is striking. However, the statistics, while too limited at this point to make definitive conclusions, increasingly suggest at least an equal HIV prevalence rate for people with disabilities as for their non-disabled peers.     

Interprofessional education: a review of context, learning and the research agenda

Medical Education 2012: 46: 58–70 Context Interprofessional education (IPE) is not a recent phenomenon and has been the subject of several World Health Organization reports. Its focus is on health professionals and students learning with, from and about one another to improve collaboration and the quality of patient care. The drivers for IPE include new models of health care delivery in the context of an ageing population and the increasing prevalence of long‐term chronic disease, in addition to the patient safety agenda. The delivery of complex health care requires a team‐based and collaborative approach, although teamwork and collaborative practice are not necessarily synonymous. The rationale for IPE is that learning together enhances future working together. Discussion Systematic reviews of IPE have shown some evidence that IPE fosters positive interaction among different professions and variable evidence that it improves attitudes towards other professionals. Generalisation across published papers is difficult because IPE initiatives are diverse and good evaluation methodology and data are lacking. In terms of constructive alignment from an education viewpoint, there is a need for educators to define learning outcomes and match these with learning activities to ensure that IPE demonstrates added value over uniprofessional learning. Assessment is difficult as pre‐qualification professional education focuses on the individual and professional accreditation organisations mandate only for their own professions. Conclusions Interprofessional education draws from a number of education, sociology and psychology theories, and these are briefly discussed. The most pressing research questions for the IPE community are defined and the challenges for IPE explored.     

Physical activity and obesity research in the Asia-Pacific: a review

Obesity is a global health concern and has a great impact on countries in the Asia-Pacific region. Physical inactivity is a major risk factor for obesity, but physical activity levels are declining in much of this region. Increasing physical activity is a priority in many countries. Considerable research has been conducted on physical activity related to obesity in Western countries, but populations in the Asia-Pacific region differ in physical, psychological, social, and cultural ways that warrant local and regional research. The authors reviewed research conducted in the Asia-Pacific region that examined either the impact of physical activity interventions on obesity-related outcomes or the effect of behavior-change interventions on physical activity participation. The number of studies found was limited, and their samples and methods varied too much to draw conclusions. The authors recommend further research in the Asia-Pacific region using systematic protocols to permit sound conclusions to be drawn and promote informed action at local levels.     

Assessment of allergenic potential of genetically modified foods: an agenda for future research

Speakers and participants in the workshop "Assessment of the Allergenic Potential of Genetically Modified Foods" met in breakout groups to discuss a number of issues including needs for future research. These groups agreed that research should progress quickly in the area of hazard identification and that a need exists for more basic research to understand the mechanisms underlying food allergy. A list of research needs was developed.     

Work-arounds in health care settings: Literature review and research agenda

BACKGROUND: As health care professionals seek to balance technological and regulatory demands with the need to provide patient-centered care, all in an efficient and cost-effective manner, they may see a greater need to improvise or work around intended work practices. Health care professionals acknowledge widespread use of work-arounds, and the literature documents their prevalence and influence on performance. Despite their importance, few studies have focused exclusively on work-arounds. This suggests a key area of need in the research, particularly because work-arounds are frequently cited in the context of serious patient safety consequences. PURPOSE: The purpose of this article is to review the existing literature concerning work-arounds to elucidate the definition and nature of work-arounds, how work-arounds can be differentiated from similar constructs (e.g., errors, mistakes, and deviance), and the potential causes of work-arounds and to explore potential consequences of work-arounds in health care settings. APPROACH: We conducted a systematic review of the literature concerning work-arounds to develop themes concerning the nature of work-arounds and ideas for future research on the topic. IMPLICATIONS FOR PRACTICE: In this article, we develop links between work-arounds and potential outcomes, particularly safety outcomes. Moreover, we discuss the manner in which open discussion can allow work-arounds to facilitate work process improvement and the role that climate and culture play in reducing work-arounds.