Namyalo Prossy Kiddu, Wodnik Breanna K, Michaelides Ophelia, Kane Sumit, Essue Beverley, Di Ruggiero Erica
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
BMJ Glob Health. 2025 Aug 7;10(8):e018562. doi: 10.1136/bmjgh-2024-018562.
Despite efforts to advance universal health coverage (UHC) in different contexts, evidence gaps remain, and implementation science has been underused to address these gaps and determine 'what works'. The study aimed to establish a research agenda that could guide future research by identifying implementation science research priorities to advance UHC. A three-round modified Delphi study design with a multi-country panel was employed. Initial implementation science research gaps were identified from two scoping reviews conducted by our team, supplemented by 10 papers that we identified through a search of Medline and CINAHL databases. We generated 64 research gaps that were shared with 272 participants in Round I. Round I responses were analysed using descriptive statistics and a cut-off of 75% to move to Round II. Round I qualitative analysis resulted in an additional 15 research gaps and one new topic area. Based on Round I findings, an improved set of research gaps was shared in Round II. Quantitative data in Round II were analysed using the same approach as Round I, using an 85% cut-off point. Open-ended responses were analysed thematically. Round II research gaps were then presented in a virtual workshop. Results from the workshop were analysed using weighted ranking analysis. Round I response rate was 34.9% with 43 research gaps across 12 topic areas. Round II response rate was 77.9% with 42 gaps across 13 topic areas that passed to the virtual workshop. The workshop response rate was 39%. Through this process, the top 10 ranked implementation science research gaps were identified. Identified research gaps are focused on assessing equity in the delivery of health services and financial risk protection interventions. Future research will further contextualise this research agenda with country-level actors.
尽管在不同背景下为推进全民健康覆盖（UHC）做出了努力，但证据差距依然存在，实施科学在解决这些差距以及确定“什么有效”方面一直未得到充分利用。该研究旨在通过确定推进全民健康覆盖的实施科学研究重点，建立一个能够指导未来研究的议程。采用了三轮修改后的德尔菲研究设计，并组建了一个多国专家小组。我们团队进行的两项范围综述确定了最初的实施科学研究差距，并通过检索Medline和CINAHL数据库确定的10篇论文进行了补充。我们提出了64个研究差距，并在第一轮与272名参与者分享。第一轮的回复使用描述性统计进行分析，并设定75%的截止点进入第二轮。第一轮的定性分析又产生了15个研究差距和一个新的主题领域。基于第一轮的结果，在第二轮中分享了一组改进后的研究差距。第二轮的定量数据采用与第一轮相同的方法进行分析，截止点为85%。开放式回复进行了主题分析。然后在一个虚拟研讨会上展示了第二轮的研究差距。使用加权排名分析对研讨会的结果进行了分析。第一轮的回复率为34.9%，在12个主题领域有43个研究差距。第二轮的回复率为77.9%，在13个主题领域有42个差距进入了虚拟研讨会。研讨会的回复率为39%。通过这个过程，确定了排名前十的实施科学研究差距。确定的研究差距集中在评估卫生服务提供和金融风险保护干预措施中的公平性。未来的研究将与国家层面的行为者进一步结合这一研究议程。
