Development and application of a rapid research prioritisation process for identifying health research priorities in low- and middle-income countries: the RAPID-RP stakeholder analysis
Authors: Dickens Andrew P , Gale Nicola , Adab Peymane , Cheng KK , Chi Chunhua , Correia de Sousa Jaime , Enocson Alexandra , Farley Amanda , Jolly Kate , Jowett Sue , Maglakelidze Mariam , Maghlakelidze Tamaz , Martins Sonia , Pan Zihan , Sitch Alice , Stavrikj Katrina , Turner Alice , Williams Siân , Jordan Rachel E 
Published: September 2024

Background
Health research should be locally prioritised by key stakeholders to ensure the best use of available resources, maximum likelihood of research leading to uptake into policy and practice and relevance to the needs of the potential beneficiaries. Established approaches are complex and time-consuming, therefore not feasible in settings where prioritisation is uncommon and time is limited.

Objectives
We developed and applied a simple, rapid research prioritisation approach to elicit the views of stakeholders.

Setting and participants
This was a collaboration between a multidisciplinary group of United Kingdom academics, the International Primary Care Respiratory Group and primary care respiratory researchers from four low- and middle-income countries: Brazil, China, Georgia and North Macedonia. We identified 10 topics for research prioritisation through workshops involving 26 topic, methods and local context experts, and considering the programme remit, to develop, adapt and evaluate culturally appropriate community and behavioural approaches for the prevention, early identification and management of chronic obstructive pulmonary disease in primary care.

Design and methods
In each setting, local research teams convened stakeholder groups of patients, clinicians, managers/policymakers and researchers. Each group briefly discussed the 10 potential research study topics. Discussions were facilitated using short vignettes for each topic, and participants were encouraged to consider importance, feasibility and equity. Individual participants rated each study on a three-point traffic light scale, then ranked them following a facilitated discussion on what drove the ratings. The research team rated then ranked each study considering three further criteria (international novelty, potential for future funding and capacity building on a five-point scale). Within each group, ranks were summed to create a final rank order which guided our research programme and provided insight for future projects.

Results
In each country, four to eight members attended each stakeholder group. The engagement process was completed in less than 4 hours and feedback was very positive, especially from patients who valued the opportunity to contribute to research decision-making about their own condition. Ranking varied to some extent between groups and settings, but there was consistency around topics that were prioritised among the top five in all groups (identifying efficient chronic obstructive pulmonary disease screening test strategies, evaluations of lung age to aid smoking cessation, feasibility of locally adapted pulmonary rehabilitation, clinical education for primary care staff) and study topics that consistently ranked low (use of e-cigarettes for smoking cessation, weight management to improve chronic obstructive pulmonary disease symptoms and handwashing to reduce infections).

Limitations
Despite attempts to maximise inclusivity and diversity, stakeholders were mainly limited geographically to the centres where researchers were based, potentially limiting generalisability of views across the countries. Facilitator styles varied and may have influenced some of the discussions and potentially the ranking.

Conclusions
Despite some limitations, we demonstrated the feasibility and acceptability of the rapid research prioritisation approach stakeholder analysis for identifying locally relevant research priorities in low- and middle-income country settings.

Future work
Further validation is needed for aspects of the process. We have identified some useful lessons from our evaluation of the process, to facilitate future use of this approach.

Funding
This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 16/137/95.