Determining and Exploring Stakeholder-Identified Research Priorities for Child and Family Health: A Priority Setting Study and Qualitative Systematic Review
Creators: Eaton, Andrea
Publisher: name: University of Alberta Library
Year: 2022

<p>Background. Patient-oriented research promotes the exploration of topics that align with stakeholder- identified, patient-focused priorities. Partnering with caregivers and healthcare professionals to determine their priorities for child and family health research provides direction for future patient-oriented research to address practical, relevant, and meaningful issues. Identifying stakeholder-identified priorities and conducting patient-oriented research leads to improved health care delivery and health outcomes.<br>
Objectives. To (i) determine the top priority research topics in child and family health according to stakeholders, and (ii) systematically locate, appraise, and synthesize the current literature regarding a top health research priority identified by stakeholders.<br>
Methods. This thesis was completed from 2018 to 2022 and followed a patient-oriented research approach across two distinct, but connected studies. Study 1 was a mixed-methods priority setting study conducted in partnership with stakeholders (caregivers and healthcare professionals [HCPs]) at the Northeast Community Health Centre (NECHC) in Edmonton, Alberta, Canada. This study followed a modified, six step, James Lind Alliance methodology to generate a ‘top 10’ list of stakeholder-identified priorities for child and family health research (objective i). Study 2, informed by the stakeholder-identified research topics generated in Study 1, included a systematic qualitative evidence synthesis on the impacts of COVID-19-related restrictions on physical activity (PA) for children and youth (objective ii).<br>
Results. For Study 1, in partnership with stakeholders at the NECHC, a steering committee was formed to oversee and advise throughout the study process. The initial survey, to gather potential priority questions, generated 1,265 submissions from 100 caregivers and 25 HCPs. Out of scope submissions were removed and similar questions were combined to create a master list of questions (n=389). Only unanswered questions advanced (n=108) and were rank-ordered through a second survey by 100 caregivers and 25 HCPs. Stakeholders (n=12) gathered for a final workshop to discuss and finalize the ‘top 10’ list. Priority questions included a range of topics, such as mental health, screen time, impacts of COVID-19 restrictions, and behaviour. Study 2 emerged from one of the highest ranked stakeholder-<br>
ii<br>
identified priorities generated from Study 1. For Study 2, qualitative evidence was reviewed regarding the impacts of COVID-19 restrictions on PA for children and youth. After 3,505 record titles and abstracts were screened and 717 full-texts were reviewed, 15 studies were included in the review. Curriculum- based PA, organized sport, and active transportation were negatively impacted by COVID-19 restrictions. Restrictions disrupted PA routines and reduced opportunities for energy expenditure, training for sport performance, and socialization, resulting in negative impacts on mental health and social connections. Negative changes in PA were affected by perceived risk of COVID-19 exposure; inadequate PA instruction; poor access to supportive PA spaces, equipment, and programming; increased screen time; and poor weather. Unstructured PA (i.e., active play) was inconsistently impacted. Some children and youth experienced increases in unstructured PA, particularly outdoors. Positive changes in PA were facilitated by family co-participation, availability of outdoor space, and a perception of mental health benefits.<br>
Conclusion. In Study 1, caregiver and HCP stakeholders prioritized diverse topics within the ‘top 10’ list; questions regarding mental health were the most common. Future patient-oriented research at this site can be guided by these stakeholder-identified research priorities. In Study 2, qualitative data indicated that pandemic-related restrictions had a predominantly negative impact on curriculum-based PA, organized sport, and active transporting among children and youth, with inconsistent impacts on unstructured PA.</p>