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Identifying research interests within the association of schools of public health in the european region: a pilot study
Public Health
(1991), 105, 153 159
© The Society of Public Health, 1991
Identifying Research Interests w i t h i n the Association of Schools of Public Health in the European Region: a Pilot S t u d y A. W. M a c a r a 1 and N. W o o d 2
1Department of Epidemiology and Public Health Medicine, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR 2Avon Micro Consultancy, 53 Cecil Avenue, St George, Bristol, BS5 7SE
A questionnaire survey of individuals working within schools of public health in Europe was carried out in order to identify research interests, the use of computer facilities and research collaborations being conducted. One hundred and sixteen replies were received. Just under one quarter of respondents had conducted research into health care systems or policy within the past five years and about 10% had conducted research into new educational methodologies and their evaluation. A total of 371 research collaborations were identified. The results are discussed in relation to the methodology employed and the objectives of the World Federation for Education and Research in Public Health. Introduction It is a truism a m o n g epidemiologists who are concerned to apply their findings to raising the quality o f health care, that 'not everything that can be counted counts and not everything that counts can be counted'. Nevertheless, reliable up-to-date information is the key to the provision o f relevant health care and to the education and training of the personnel required to provide it. Hence, a priority for the World Federation for Education and Research in Public Health, which was set up following a meeting in Cairo in 1988, was to compile a global database of schools of public health and other educational and research institutions responsible for postgraduate education in this field. The plan was to link this together with appropriate information a b o u t individuals undertaking research of any kind which is relevant to the strategy and targets of the HFA/2000 European strategy. It was agreed in the consultation meeting which the World Federation held with staff members o f the World Health Organisation in Geneva later that year that such a database had obvious potential for identifying education resources and individuals who can collaborate in multicentre research and contribute to the work of agencies such as World Health Organisation ( W H O ) and United Nations Children's Fund ( U N I C E F ) . The need to establish a computerised database to provide information which will help to develop stronger links between schools of public health, has also been recognised by the Association o f Schools o f Public Health in Washington. ~ We were especially interested in activities being conducted by Association of Schools of Public Health in Europe ( A S P H E R ) members in connection with the HFA/2000 European s t r a t e g y Y ,4 We were also particularly interested in the innovative application of computerised methods of teaching or p r o g r a m m e evaluation in the epidemiological area. Some relevant applications have been published. 5,6 Correspondence: Dr Macara
154
A. W. Macara and N. Wood
A pilot study was therefore carried out in 1989 o f individuals working in member institutions of A S P H E R , which was a founder member o f the World Federation and of which one of us (AWM) was then Secretary General. This study was especially concerned to identify specific types o f research activity, whether in pure or applied epidemiology or in relation to educational programmes and methods. The report describes the results of that survey. Method
A questionnaire was designed to obtain information about individuals' teaching commitments and research activities and interests. Research was classified under 20 headings covering the major aspects of epidemiology, organisation and management of health care, social and behavioural science and educational initiatives. Respondents were asked about publications and research people with whom they have working relationships, and questions were included about the types of computer system and software in use, and the individual's availability to serve in an advisory capacity for organisations such as W H O and UNICEF. Questionnaires were sent out during July and August 1989 to Deans and Directors of the Institutional Members of the Association o f Schools of Public Health in Europe, which include the leading schools and many departments of public health and social medicine throughout the European Region of WHO. Each received a number of questionnaires and was asked to distribute them to appropriate staff members. Twenty three copies of the questionnaire were also sent to individual members o f the Association. In total, 83 questionnaires were despatched. The purpose of the enquiry was fully explained in a covering letter in which it was indicated that further copies of the questionnaire were available upon request; alternatively, the Institution could itself make further copies. No queries were received about the questionnaire and no reminder was sent. A period of six months was allowed for all replies to be returned. All data from returned questionnaires was entered on microcomputer using the dBASE IV database management system and statistical analyses were carried out using the 'Minitab' package. Results
A total of 116 replies were returned and analysed. It is impossible to calculate a conventional response rate as we have no way of knowing how many questionnaires were circulated by the Deans and Directors o f Schools. Replies were most frequently received from organisations in the U K (47), Yugoslavia (17), Sweden (11), Greece (9) and the Netherlands (7). Table I presents a breakdown of the number o f responses by Institution. This response pattern can be compared with the number o f institutions in each country which received questionnaires--the most frequent being the U K (13), Belgium (7), The Netherlands (6) and France (4). All respondents were engaged in the teaching of postgraduates, 80 (69%) were currently teaching undergraduates and 32 (27.6%) said they were teaching at other levels. We asked respondents to tick fields from a list o f 20 c o m m o n interest areas within the epidemiological/public health fields. The frequency of responses to each are indicated in Table II. As might be expected, the frequency with which individuals indicated an interest in various topic areas exhibits some clustering. The categorical responses were correlated with each other and those demonstrating correlations above 0.4 were cross-tabulated. The
155
Identifying Research Interests within A S P H E R Table 1
B r e a k d o w n o f responses by s c h o o l / d e p a r t m e n t o f public health No. o f replies
Institution
City/town
Country
Andrija Stampar School of Public Health Nordic School of Public Health Athens School of Public Health Glasgow University, Department of Community Medicine Bristol University, Department of Epidemiology and Public Health Medicine Leeds University, Department of Community Medicine Manchester University, Department of Community Medicine Catholic University of Leuven, School voor Maatschappelijke Gesondheidszorg Institute of Social Health Care Nottingham University, Department of Community Health London School of Hygiene and Tropical Medicine Birmingham University, Department of Social Medicine Liege University, School of Public Health Ecole Nationale de Sante Publique Uludag University, Department of Public Health Liverpool School of Tropical Medicine/Liverpool University, Department of Community Health Academy of Public Health Postgraduate Medical and Pharmaceutical Institute The Valencian School of Public Health Karolinska Institute, Department of Environmental Hygiene Copenhagen University, Institute of Social Medicine Ghent University, Institute of Social Medicine Catholic University of Nijmegen, Institute of Social Medicirle Royal Tropical Institute Turin University, Department of Hygiene and Community Medicine Faculte Xavier Bichat, Dept of Public Health
Zagreb Goteborg Athens Glasgow
Yugoslavia Sweden Greece UK
Bristol Leeds Manchester
UK UK UK
9 8 8
Leuven Utrecht Nottingham London Birmingham Liege Rennes Bursa
Belgium Netherlands UK UK UK Belgium France Turkey
6 5 5 4 3 3 3 2
Liverpool Dusseldorf Bratislava Valencia Stockholm Copenhagen Ghent Nijmegen Amsterdam
UK W. Germany Czechoslovakia Spain Sweden Denmark Belgium Netherlands Netherlands
2 2 2 2 2 1 1 l l
Turin Paris
Italy France
1 I
Total replies
17 9 9 9
116
interest areas which were particularly associated in the responses received were (in decreasing strength of associations): Roles/relationships between health care professionals with relationships between health care professionals and consumers Health care systems with health policy issues Descriptive epidemiology/analytic epidemiology/evaluative epidemiology Medical application of computer technology with health information systems Social policy with health care systems Health economics with evaluation of health care/medical audit Relevant aspects of human behaviour with roles/relationships between health care professionals One of the principal aims of this study was to find out how frequently individuals were conducting research bearing on two key areas: the development of educational methodology and evaluation and health care systems/policy. A list of respondents' major research activities over the past five years was requested. Responses which mentioned the
156
A. W. Macara and N. Wood
Table 1I Frequency and percentage of responses to a list of 20 fields in which respondents had a particular personal interest Field of interest
Yes (n)
Percentage of respondents
Health promotion/education Analytic epidemiology Medical audit Descriptive epidemiology HFA/2000 European strategy targets Health information systems Evaluative epidemiology Educational methodology/evaluation Health care systems Health policy Aspects of human behaviour Environmental health Relationships with consumers Biostatistics Social policy Roles/relationships of health care professionals Occupational health Health economics Demography Medical applications of computer technology
44 42 42 41 40 39 37 36 35 34 29 28 26 25 23 22 19 16 16 14
37.9 36.2 36.2 35.3 34.5 33.6 31.9 31.0 30.2 29.3 25.0 24. l 22.4 21.6 19.8 19.0 16.4 13.8 13.8 t2.1
key terms 'effectiveness and efficacy of medical care', 'health service evaluation/medical audit/health services organisation' or 'health/clinical/management information systems' or close synonyms were classed as research activities concerned with health care systems or policy. Responses which included the key terms 'education/courses evaluation', 'computer assisted instruction' or close synonyms were classed as research into educational methodology/evaluation. Twenty-seven respondents (23.3%) had conducted research into health care systems/policy over the past five years, and 11 individuals (9.5%) had conducted research into educational methodology/evaluation. We asked respondents to provide separate lists of people with w h o m they had working relationships in their organisation, within their country, and elsewhere. We were particularly concerned to establish whether such research collaboration involved (a) the development of new educational strategies, or (b) research into health care systems/policy. Table I I I indicates a s u m m a r y of the responses. Ten respondents (8.6%) were not making use of a microcomputer of one type or another. The breakdown of c o m p u t e r facilities available to the respondents and the frequency of usage o f five types of c o m m o n software packages amongst the respondents are indicated in Table IV. One hundred and three (88.8%) said they would be willing to act in an advisory or consultative capacity for international organisations such as W H O / U N I C E F . Fourteen (12.1%) indicated they would be available but for less than one week at a time, 39 (33.6%) indicated they would be available for 1 4 weeks, 28 (24. 1%) for 1-3 months, two (1.7%) for 3 ~ months and nine (7.8%) for periods o f over six months at a time. The remainder did not specify a period of time.
IdentO~ying Research Interests within ASPHER
157
Table II| Research collaborations of respondents which involved either the development of new educational strategies or research into health care systems/policy (Collaborations A) and research collaborations of a different nature (Other collaborations) Collaborations Other Total A collaborations of all (n) (n) collaborations Within respondent's organisation Within respondent's country Elsewhere globally
47 20 22
127 93 62
174 ll3 84
Total
89
282
371
Each figure represents one research collaboration.
Discussion The study described here is the first stage of a global evaluation of the scale and activities of members of schools of public health. This report describes the results o f a pilot study and therefore should not be interpreted as a comprehensive survey o f individuals working within schools of public health in Europe. It should also be pointed out that such information arising from this study is not of a quantitative nature and is not reported here. Much of this information, including the names of people with whom respondents had working relationships, will be used to expand the database and is of great value to the
Table IV Availability and use of computer facilities by ASPHER respondents Yes (n)
% of sample
89 57 28 17 23 10 17 67
76.7 49.1 20.3 14.7 19.8 8.6 14.7 57.8
88 75 49 35 8 13
75.9 64.7 42.2 30.2 6.9 11.2
(a) Type of computer IBM XT type IBM AT type IBM PS/2 type Apple Macintosh Other micro Workstation system Minicomputer Mainframe
(b) Type of software Wordprocessing Statistical analysis Database management Spreadsheet Expert systems Other software
158
A. W. Macara and N. Wood
World Federation. Nevertheless, some interesting overall indicators have emerged from the data presented. It is clear that the response rates by country and by institution are uneven and do not properly reflect the balance o f members within the organisation. Three schools were contacted in Yugoslavia and two in Sweden. The members within these institutions provided us with the greatest frequency o f replies, apart from those in the UK. That the UK should provide the most responses is not unexpected as this study was conducted from the U K and the largest number of institutions (13) contacted were in that country. The range of individual research activities being carried out by the respondents is considerable and diverse as might be expected. They range from conventional fields of epidemiological enquiry to specialised social and psychological areas. The growing importance of health care information systems and related issues surrounding medical audit is emphasised in the pattern of response we have received. Table II indicates that about a third of our respondents had personal interest in these topics, and we have discovered that almost a quarter had personally conducted research into an aspect of health care systems/policy in the past five years. This emphasis on work which might be described as the 'new public health' is encouraging in the light of statements prepared by a consultative meeting of A S P H E R and E U R O (European Regional Office of the World Health Organisation) in Dusseldorf in December 1988. This emphasis was endorsed by the W H O Regional Committee for Europe in September 1989 when it was recognised that there was a growing demand for schools of public health to actively pursue research in these areas. More than one third o f the respondents indicated that work towards the HFA/2000 European strategy targets was an area of particular personal interest. One of the essential requirements o f the HFA/2000 European strategy is that individual scientists, national and international research bodies must all be involved in developing the regional strategy. 7 The European member states are moving towards the fulfilment of this objective, but much remains to be completed. It is intended that the results of this survey will assist in the identification o f new individuals who can facilitate this objective. A number of points have emerged from this study which have helped to clarify the objectives and procedures being used. For instance, the replies received which were used to compile the list o f 20 areas of members' interests (Table II) show that about 10% of respondents indicated a personal interest in nine or more major areas within public health medicine. Whilst this may be the case, it is unlikely that these respondents are actively pursuing research in each of these different fields, and in the global study information will be sought about active research interests. The questionnaire appears to be a valid means of collecting the new information required. We cannot however say that the data attained so far is representative of Schools o f Public Health throughout Europe, as a number did not reply and the results probably reflect a bias to work being conducted by individuals in the UK. We can speculate on the reasons for failure to respond. Many schools are small and relatively inactive. Of the non-responding institutions, 16 (59%) persistently fail to respond to correspondence or to attend meetings, or else had joined A S P H E R within the previous six months. This leaves eleven active Institutional Members which did not respond on this occasion. One aim of this pilot study was to test the effectiveness of this snowball method of gathering new information by inviting individuals to pass round the questionnaire, rather than confining the recipients to a list o f known responding members. As a result the World Federation has the nucleus of a new working database. The next stage is to make use of the W H O and World Federation networks in order to expand this framework worldwide.
Identifying Research Interests within A S P H E R
159
Acknowledgements The authors gratefully acknowledge the financial support received from the World Federation to carry out this study. We should also like to thank Dr Eric Goon, Director of the Division of Development of Human Resources for Health (WHO Geneva), Dr Jean-Paul Menu, Chief Medical Officer for Human Resource Management, and Dr Charles Boelen, Chief Medical Officer for Educational Planning, Methodology and Evaluation, also of the Divison of Development of Human Resources for advice and discussions concerning this project. Invaluable research and secretarial assistance was provided by Mrs Blandine Richards and Mrs Jill Bindloss.
References 1. Spring, J. C. (1985). Proposal submitted to the US Center for Disease Control, Atlanta (Unpublished). 2. WHO Regional Office for Europe. (1988). Health for All and Schools of Public Health: Implications for Training. World Health Organization Publication. 3. WHO Regional Office for Europe (1988). Research Policies for Health Jbr All. World Health Organization (European Health for all Series No. 2), Copenhagen, ISBN 92 890 1053 33. 4. WHO Regional Office for Europe (1988c). Priority Research for Health for All. World Health Organisation, (European Health for All Series No.3), Copenhagen, ISBN 92 890 1054 1. 5. Baker, E.L., Letz, R. and [=idler, A. (1985). A computer-administered neurobehavioral evaluation system for occupational and environmental epidemiology. Rationale, methodology, and pilot study results. Journal of Occupational Medicine, 27(3), 206-212. 6. Dardick, K. R. (1985). A computer program for international travel advice. Journal of Family Practitioners, 20(1), 85 87. 7. WHO Regional Office For Europe (t988) Consultation on HFA-based Public Health Training. Unpublished WHO document.
(1991), 105, 153 159
© The Society of Public Health, 1991
Identifying Research Interests w i t h i n the Association of Schools of Public Health in the European Region: a Pilot S t u d y A. W. M a c a r a 1 and N. W o o d 2
1Department of Epidemiology and Public Health Medicine, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR 2Avon Micro Consultancy, 53 Cecil Avenue, St George, Bristol, BS5 7SE
A questionnaire survey of individuals working within schools of public health in Europe was carried out in order to identify research interests, the use of computer facilities and research collaborations being conducted. One hundred and sixteen replies were received. Just under one quarter of respondents had conducted research into health care systems or policy within the past five years and about 10% had conducted research into new educational methodologies and their evaluation. A total of 371 research collaborations were identified. The results are discussed in relation to the methodology employed and the objectives of the World Federation for Education and Research in Public Health. Introduction It is a truism a m o n g epidemiologists who are concerned to apply their findings to raising the quality o f health care, that 'not everything that can be counted counts and not everything that counts can be counted'. Nevertheless, reliable up-to-date information is the key to the provision o f relevant health care and to the education and training of the personnel required to provide it. Hence, a priority for the World Federation for Education and Research in Public Health, which was set up following a meeting in Cairo in 1988, was to compile a global database of schools of public health and other educational and research institutions responsible for postgraduate education in this field. The plan was to link this together with appropriate information a b o u t individuals undertaking research of any kind which is relevant to the strategy and targets of the HFA/2000 European strategy. It was agreed in the consultation meeting which the World Federation held with staff members o f the World Health Organisation in Geneva later that year that such a database had obvious potential for identifying education resources and individuals who can collaborate in multicentre research and contribute to the work of agencies such as World Health Organisation ( W H O ) and United Nations Children's Fund ( U N I C E F ) . The need to establish a computerised database to provide information which will help to develop stronger links between schools of public health, has also been recognised by the Association o f Schools o f Public Health in Washington. ~ We were especially interested in activities being conducted by Association of Schools of Public Health in Europe ( A S P H E R ) members in connection with the HFA/2000 European s t r a t e g y Y ,4 We were also particularly interested in the innovative application of computerised methods of teaching or p r o g r a m m e evaluation in the epidemiological area. Some relevant applications have been published. 5,6 Correspondence: Dr Macara
154
A. W. Macara and N. Wood
A pilot study was therefore carried out in 1989 o f individuals working in member institutions of A S P H E R , which was a founder member o f the World Federation and of which one of us (AWM) was then Secretary General. This study was especially concerned to identify specific types o f research activity, whether in pure or applied epidemiology or in relation to educational programmes and methods. The report describes the results of that survey. Method
A questionnaire was designed to obtain information about individuals' teaching commitments and research activities and interests. Research was classified under 20 headings covering the major aspects of epidemiology, organisation and management of health care, social and behavioural science and educational initiatives. Respondents were asked about publications and research people with whom they have working relationships, and questions were included about the types of computer system and software in use, and the individual's availability to serve in an advisory capacity for organisations such as W H O and UNICEF. Questionnaires were sent out during July and August 1989 to Deans and Directors of the Institutional Members of the Association o f Schools of Public Health in Europe, which include the leading schools and many departments of public health and social medicine throughout the European Region of WHO. Each received a number of questionnaires and was asked to distribute them to appropriate staff members. Twenty three copies of the questionnaire were also sent to individual members o f the Association. In total, 83 questionnaires were despatched. The purpose of the enquiry was fully explained in a covering letter in which it was indicated that further copies of the questionnaire were available upon request; alternatively, the Institution could itself make further copies. No queries were received about the questionnaire and no reminder was sent. A period of six months was allowed for all replies to be returned. All data from returned questionnaires was entered on microcomputer using the dBASE IV database management system and statistical analyses were carried out using the 'Minitab' package. Results
A total of 116 replies were returned and analysed. It is impossible to calculate a conventional response rate as we have no way of knowing how many questionnaires were circulated by the Deans and Directors o f Schools. Replies were most frequently received from organisations in the U K (47), Yugoslavia (17), Sweden (11), Greece (9) and the Netherlands (7). Table I presents a breakdown of the number o f responses by Institution. This response pattern can be compared with the number o f institutions in each country which received questionnaires--the most frequent being the U K (13), Belgium (7), The Netherlands (6) and France (4). All respondents were engaged in the teaching of postgraduates, 80 (69%) were currently teaching undergraduates and 32 (27.6%) said they were teaching at other levels. We asked respondents to tick fields from a list o f 20 c o m m o n interest areas within the epidemiological/public health fields. The frequency of responses to each are indicated in Table II. As might be expected, the frequency with which individuals indicated an interest in various topic areas exhibits some clustering. The categorical responses were correlated with each other and those demonstrating correlations above 0.4 were cross-tabulated. The
155
Identifying Research Interests within A S P H E R Table 1
B r e a k d o w n o f responses by s c h o o l / d e p a r t m e n t o f public health No. o f replies
Institution
City/town
Country
Andrija Stampar School of Public Health Nordic School of Public Health Athens School of Public Health Glasgow University, Department of Community Medicine Bristol University, Department of Epidemiology and Public Health Medicine Leeds University, Department of Community Medicine Manchester University, Department of Community Medicine Catholic University of Leuven, School voor Maatschappelijke Gesondheidszorg Institute of Social Health Care Nottingham University, Department of Community Health London School of Hygiene and Tropical Medicine Birmingham University, Department of Social Medicine Liege University, School of Public Health Ecole Nationale de Sante Publique Uludag University, Department of Public Health Liverpool School of Tropical Medicine/Liverpool University, Department of Community Health Academy of Public Health Postgraduate Medical and Pharmaceutical Institute The Valencian School of Public Health Karolinska Institute, Department of Environmental Hygiene Copenhagen University, Institute of Social Medicine Ghent University, Institute of Social Medicine Catholic University of Nijmegen, Institute of Social Medicirle Royal Tropical Institute Turin University, Department of Hygiene and Community Medicine Faculte Xavier Bichat, Dept of Public Health
Zagreb Goteborg Athens Glasgow
Yugoslavia Sweden Greece UK
Bristol Leeds Manchester
UK UK UK
9 8 8
Leuven Utrecht Nottingham London Birmingham Liege Rennes Bursa
Belgium Netherlands UK UK UK Belgium France Turkey
6 5 5 4 3 3 3 2
Liverpool Dusseldorf Bratislava Valencia Stockholm Copenhagen Ghent Nijmegen Amsterdam
UK W. Germany Czechoslovakia Spain Sweden Denmark Belgium Netherlands Netherlands
2 2 2 2 2 1 1 l l
Turin Paris
Italy France
1 I
Total replies
17 9 9 9
116
interest areas which were particularly associated in the responses received were (in decreasing strength of associations): Roles/relationships between health care professionals with relationships between health care professionals and consumers Health care systems with health policy issues Descriptive epidemiology/analytic epidemiology/evaluative epidemiology Medical application of computer technology with health information systems Social policy with health care systems Health economics with evaluation of health care/medical audit Relevant aspects of human behaviour with roles/relationships between health care professionals One of the principal aims of this study was to find out how frequently individuals were conducting research bearing on two key areas: the development of educational methodology and evaluation and health care systems/policy. A list of respondents' major research activities over the past five years was requested. Responses which mentioned the
156
A. W. Macara and N. Wood
Table 1I Frequency and percentage of responses to a list of 20 fields in which respondents had a particular personal interest Field of interest
Yes (n)
Percentage of respondents
Health promotion/education Analytic epidemiology Medical audit Descriptive epidemiology HFA/2000 European strategy targets Health information systems Evaluative epidemiology Educational methodology/evaluation Health care systems Health policy Aspects of human behaviour Environmental health Relationships with consumers Biostatistics Social policy Roles/relationships of health care professionals Occupational health Health economics Demography Medical applications of computer technology
44 42 42 41 40 39 37 36 35 34 29 28 26 25 23 22 19 16 16 14
37.9 36.2 36.2 35.3 34.5 33.6 31.9 31.0 30.2 29.3 25.0 24. l 22.4 21.6 19.8 19.0 16.4 13.8 13.8 t2.1
key terms 'effectiveness and efficacy of medical care', 'health service evaluation/medical audit/health services organisation' or 'health/clinical/management information systems' or close synonyms were classed as research activities concerned with health care systems or policy. Responses which included the key terms 'education/courses evaluation', 'computer assisted instruction' or close synonyms were classed as research into educational methodology/evaluation. Twenty-seven respondents (23.3%) had conducted research into health care systems/policy over the past five years, and 11 individuals (9.5%) had conducted research into educational methodology/evaluation. We asked respondents to provide separate lists of people with w h o m they had working relationships in their organisation, within their country, and elsewhere. We were particularly concerned to establish whether such research collaboration involved (a) the development of new educational strategies, or (b) research into health care systems/policy. Table I I I indicates a s u m m a r y of the responses. Ten respondents (8.6%) were not making use of a microcomputer of one type or another. The breakdown of c o m p u t e r facilities available to the respondents and the frequency of usage o f five types of c o m m o n software packages amongst the respondents are indicated in Table IV. One hundred and three (88.8%) said they would be willing to act in an advisory or consultative capacity for international organisations such as W H O / U N I C E F . Fourteen (12.1%) indicated they would be available but for less than one week at a time, 39 (33.6%) indicated they would be available for 1 4 weeks, 28 (24. 1%) for 1-3 months, two (1.7%) for 3 ~ months and nine (7.8%) for periods o f over six months at a time. The remainder did not specify a period of time.
IdentO~ying Research Interests within ASPHER
157
Table II| Research collaborations of respondents which involved either the development of new educational strategies or research into health care systems/policy (Collaborations A) and research collaborations of a different nature (Other collaborations) Collaborations Other Total A collaborations of all (n) (n) collaborations Within respondent's organisation Within respondent's country Elsewhere globally
47 20 22
127 93 62
174 ll3 84
Total
89
282
371
Each figure represents one research collaboration.
Discussion The study described here is the first stage of a global evaluation of the scale and activities of members of schools of public health. This report describes the results o f a pilot study and therefore should not be interpreted as a comprehensive survey o f individuals working within schools of public health in Europe. It should also be pointed out that such information arising from this study is not of a quantitative nature and is not reported here. Much of this information, including the names of people with whom respondents had working relationships, will be used to expand the database and is of great value to the
Table IV Availability and use of computer facilities by ASPHER respondents Yes (n)
% of sample
89 57 28 17 23 10 17 67
76.7 49.1 20.3 14.7 19.8 8.6 14.7 57.8
88 75 49 35 8 13
75.9 64.7 42.2 30.2 6.9 11.2
(a) Type of computer IBM XT type IBM AT type IBM PS/2 type Apple Macintosh Other micro Workstation system Minicomputer Mainframe
(b) Type of software Wordprocessing Statistical analysis Database management Spreadsheet Expert systems Other software
158
A. W. Macara and N. Wood
World Federation. Nevertheless, some interesting overall indicators have emerged from the data presented. It is clear that the response rates by country and by institution are uneven and do not properly reflect the balance o f members within the organisation. Three schools were contacted in Yugoslavia and two in Sweden. The members within these institutions provided us with the greatest frequency o f replies, apart from those in the UK. That the UK should provide the most responses is not unexpected as this study was conducted from the U K and the largest number of institutions (13) contacted were in that country. The range of individual research activities being carried out by the respondents is considerable and diverse as might be expected. They range from conventional fields of epidemiological enquiry to specialised social and psychological areas. The growing importance of health care information systems and related issues surrounding medical audit is emphasised in the pattern of response we have received. Table II indicates that about a third of our respondents had personal interest in these topics, and we have discovered that almost a quarter had personally conducted research into an aspect of health care systems/policy in the past five years. This emphasis on work which might be described as the 'new public health' is encouraging in the light of statements prepared by a consultative meeting of A S P H E R and E U R O (European Regional Office of the World Health Organisation) in Dusseldorf in December 1988. This emphasis was endorsed by the W H O Regional Committee for Europe in September 1989 when it was recognised that there was a growing demand for schools of public health to actively pursue research in these areas. More than one third o f the respondents indicated that work towards the HFA/2000 European strategy targets was an area of particular personal interest. One of the essential requirements o f the HFA/2000 European strategy is that individual scientists, national and international research bodies must all be involved in developing the regional strategy. 7 The European member states are moving towards the fulfilment of this objective, but much remains to be completed. It is intended that the results of this survey will assist in the identification o f new individuals who can facilitate this objective. A number of points have emerged from this study which have helped to clarify the objectives and procedures being used. For instance, the replies received which were used to compile the list o f 20 areas of members' interests (Table II) show that about 10% of respondents indicated a personal interest in nine or more major areas within public health medicine. Whilst this may be the case, it is unlikely that these respondents are actively pursuing research in each of these different fields, and in the global study information will be sought about active research interests. The questionnaire appears to be a valid means of collecting the new information required. We cannot however say that the data attained so far is representative of Schools o f Public Health throughout Europe, as a number did not reply and the results probably reflect a bias to work being conducted by individuals in the UK. We can speculate on the reasons for failure to respond. Many schools are small and relatively inactive. Of the non-responding institutions, 16 (59%) persistently fail to respond to correspondence or to attend meetings, or else had joined A S P H E R within the previous six months. This leaves eleven active Institutional Members which did not respond on this occasion. One aim of this pilot study was to test the effectiveness of this snowball method of gathering new information by inviting individuals to pass round the questionnaire, rather than confining the recipients to a list o f known responding members. As a result the World Federation has the nucleus of a new working database. The next stage is to make use of the W H O and World Federation networks in order to expand this framework worldwide.
Identifying Research Interests within A S P H E R
159
Acknowledgements The authors gratefully acknowledge the financial support received from the World Federation to carry out this study. We should also like to thank Dr Eric Goon, Director of the Division of Development of Human Resources for Health (WHO Geneva), Dr Jean-Paul Menu, Chief Medical Officer for Human Resource Management, and Dr Charles Boelen, Chief Medical Officer for Educational Planning, Methodology and Evaluation, also of the Divison of Development of Human Resources for advice and discussions concerning this project. Invaluable research and secretarial assistance was provided by Mrs Blandine Richards and Mrs Jill Bindloss.
References 1. Spring, J. C. (1985). Proposal submitted to the US Center for Disease Control, Atlanta (Unpublished). 2. WHO Regional Office for Europe. (1988). Health for All and Schools of Public Health: Implications for Training. World Health Organization Publication. 3. WHO Regional Office for Europe (1988). Research Policies for Health Jbr All. World Health Organization (European Health for all Series No. 2), Copenhagen, ISBN 92 890 1053 33. 4. WHO Regional Office for Europe (1988c). Priority Research for Health for All. World Health Organisation, (European Health for All Series No.3), Copenhagen, ISBN 92 890 1054 1. 5. Baker, E.L., Letz, R. and [=idler, A. (1985). A computer-administered neurobehavioral evaluation system for occupational and environmental epidemiology. Rationale, methodology, and pilot study results. Journal of Occupational Medicine, 27(3), 206-212. 6. Dardick, K. R. (1985). A computer program for international travel advice. Journal of Family Practitioners, 20(1), 85 87. 7. WHO Regional Office For Europe (t988) Consultation on HFA-based Public Health Training. Unpublished WHO document.