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      Defining Research to Improve Health Systems

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          Abstract

          Robert Terry and colleagues present working definitions of operational research, implementation research, and health systems research within the context of research to strengthen health systems.

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          Most cited references30

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          The meaning of translational research and why it matters.

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            Knowledge transfer for the management of dementia: a cluster-randomised trial of blended learning in general practice

            Background The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone. Methods In this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed. Results 166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores. Conclusion A blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge. Trial registration Current Controlled Trials ISRCTN36550981.
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              Overcoming health-systems constraints to achieve the Millennium Development Goals.

              Effective interventions exist for many priority health problems in low income countries; prices are falling, and funds are increasing. However, progress towards agreed health goals remains slow. There is increasing consensus that stronger health systems are key to achieving improved health outcomes. There is much less agreement on quite how to strengthen them. Part of the challenge is to get existing and emerging knowledge about more (and less) effective strategies into practice. The evidence base also remains remarkably weak, partly because health-systems research has an image problem. The forthcoming Ministerial Summit on Health Research seeks to help define a learning agenda for health systems, so that by 2015, substantial progress will have been made to reducing the system constraints to achieving the MDGs.
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                Author and article information

                Journal
                PLoS Med
                PLoS
                plosmed
                PLoS Medicine
                Public Library of Science (San Francisco, USA )
                1549-1277
                1549-1676
                November 2010
                November 2010
                16 November 2010
                : 7
                : 11
                : e1001000
                Affiliations
                [1 ]UNICEF/UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
                [2 ]The Alliance for Health Policy and Systems Research, Geneva, Switzerland
                [3 ]Council on Health Research for Development, Mexico City, Mexico
                [4 ]World Health Organization, Department of Reproductive Health and Research, Geneva, Switzerland
                [5 ]Council on Health Research for Development, Geneva, Switzerland
                [6 ]Global Forum for Health Research, Geneva, Switzerland
                [7 ]World Health Organization, Initiative for Vaccine Research, Geneva, Switzerland
                [8 ]World Health Organization, Department of Public Health, Innovation and Intellectual Property, Geneva, Switzerland
                [9 ]World Health Organization, Department of Research Policy and Cooperation, Geneva, Switzerland
                Author notes

                ICMJE criteria for authorship read and met: RFT JHFR TA FBP CD MD CG AG JH JFKK AM MTM ZM TP RGR FZ. Agree with the manuscript's results and conclusions: RFT JHFR TA FBP CD MD CG AG JH JFKK AM MTM ZM TP RGR FZ. Conceived and designed the experiments: RFT JHFR CD MD CG JH MTM TP RGR. Wrote the first draft: RFT JHFR FBP CD MD CG JH MTM TP RGR. Wrote the paper: RFT JHFR TA FBP CD MD CG AG JH JFKK MTM ZM TP RGR FZ. Developed original concept: JHFR CD MD CG JH MTM TP RGR RFT. Commented on drafts: TA FBP AG JFKK ZM FZ.

                Article
                PMEDICINE-D-10-00030
                10.1371/journal.pmed.1001000
                2993153
                21124816
                f927920a-b18e-475e-9f5f-55dd27b73a18
                World Health Organization; licensee Public Library of Science (PLoS). This is an Open Access article in the spirit of the Public Library of Science (PLoS) principles for Open Access http://www.plos.org/oa/, without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
                History
                Page count
                Pages: 7
                Categories
                Policy Forum
                Medicine
                Clinical Research Design
                Global Health
                Non-Clinical Medicine
                Evidence-Based Medicine
                Health Care Policy
                Health Care Providers
                Health Care Quality
                Health Informatics
                Health Services Administration and Management
                Health Services Research
                Public Health

                Medicine
                Medicine

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