Research Priorities

ACHNE Research Committee
Subcommittee on Research Priorities Revision
May 2016

Introduction

For many years, the Research Committee has solicited proposals and recommended funding nursing research according to its established priorities. The priorities were determined in 1992, with revisions in 2000 and 2009. In 2014, the Committee was again tasked with review and revision of the research priorities. This report briefly describes the review process and presents proposed revision of ACHNE’s research priorities for 2016. Upon request, we will be happy to submit a detailed report for publication.

Review and Recognition of Past Work

To begin the revision process, a sub-committee looked at ACHNE’s vision and mission, “to be recognized as the premier leader in Community/Public Health (C/PHN) Nursing education, and to positively impact local to global population health. Advance population health through quality community/ public health nursing education, research and service” (ACHNE, 2016).

From there, we reviewed issues identified by the most recent work group, acknowledging that similar issues continue to impact public health nursing education and practice. Such issues include an aging population, chronic disease, health inequities, potential for natural disaster, threats of terrorism and global infectious disease pandemics (ACHNE Research Committee, 2010). We recognized the aging nursing workforce and continuing nursing shortage as added pressure for both nursing education and practice.

Process of Priority Revision

In 2014, the subcommittee performed an international literature review using a modified form of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (Moher, Liberati, Tetzlaff, and Altman, 2009). Publication years for English language literature spanned 2008 through 2015. At the ACHNE Annual Institute Research Pre-conference in 2014 and 2015, we facilitated discussion with attendees about research issues of interest. Conference calls were held among sub-committee members to plan and evaluate the literature review process, review of non-research literature sources, and concluded with a call to formulate proposed research priority revisions.

The CINAHL database was first accessed using the following search terms: Public health nursing education OR Community health nursing education OR Home health care nursing education OR Home health nursing education. 434 article abstracts were identified, dating from 2008 to 2014 and that was narrowed to 158 abstracts reviewed by sub-committee members.  Inter-rater reliability was addressed through overlap of the abstract reviews. Using the search terms, several non-research articles had been identified and were excluded.

During the Research Pre-conference in 2015, additional search terms were identified. A second literature search was performed using a research delimiter and the following terms: Service learning AND nursing; Inter-professional education AND community health OR public health; Social justice OR equality OR disparity AND nursing; Care coordination OR case management AND chronic disease AND community health OR public health; Chronic illness AND community health OR public health; Home health nursing OR home health care; Hospital readmission OR readmission AND community health nursing. From these terms, over 1,450 studies and dissertations were identified.

During this search, studies excluded from further review included those involving skilled nursing facilities and rehabilitation facilities, and literature captured by the research delimiter that was not actual research, such as articles about research methods in health disparities. In total, 456 research abstracts were reviewed, from 120 journals, published in the United States and internationally.  See Appendix A for a list of the journals accessed.

Literature Review Results

Three broad research themes were identified in the initial search; studies informing education, studies informing practice, and studies addressing workforce issues. In the search conducted in 2015, the broad themes continued to be dominant. In addition, six secondary themes emerged: education of nursing students (including inter-professional education research, simulation and pedagogical approaches); direct population and individual focused practice of community health nurses, continued education for practicing nurses; workforce issues (staffing, shortage, predictions of workforce needs); nursing history; and pure research (systematic literature reviews, integrative reviews).

Additional Resources

In addition to research literature, sub-committee members reviewed the Institute of Medicine’s report, Future of Nursing: Leading Change, Advancing Health (2011), literature related to the Affordable Care Act, and changes in the Centers for Medicare and Medicaid (CMS) reimbursement for services based on performance. In spring, 2016, subcommittee members were in contact with the Association of Public Health Nurses (APHN), as they embarked on a review of research priorities. We shared our strategy and basic results, and we plan to continue to communicate with those APHN members.

Recommendations

Based on the organization’s mission, the research literature review, issues in additional literature, changes in reimbursement by CMS, the Affordable Care Act, and active work by APHN, we submit these recommendations to the ACHNE Research Committee Chair.

  1. In its mission and vision, ACHNE is focused on education and should primarily fund research in the area of nursing education and staff development.
  2. Research about workforce issues is beyond the scope of current ACHNE funding resources, evidenced by few workforce research proposals received in past 8 years.
  3. Research funding in the area of practice would appear to be of interest to APHN and ACHNE is happy to collaborate in that area.
  4. The Research Committee should have the flexibility to support extraordinary proposals that may not easily fit into current research priorities.
  5. Revised research priorities for ACHNE in 2016:
    1. Community/public health nursing education as it is impacted by the Future of Nursing report.
    2. Advanced practice education for community/public health nursing.
    3. Educating the community/public health nursing workforce in light of innovations in Affordable Care Act and Centers for Medicare/Medicaid pay for performance initiatives.
    4. Extraordinary proposals that may not easily fit into the priorities listed above.

Thank you to Subcommittee Members:

Melanie Adams-Johnson
Barbara Braband (Research Committee Chair)
Rebecca Davis
Sheila A. Leander (Priorities sub-committee chair)
Carol Gaskamp
Susan Seibold-Simpson
Catherine Waters

References

Association of Community Health Nursing Educators (2016). Vision and Mission statement.

ACHNE Research Committee. (2010). Research Priorities for Public Health Nursing.  Position Paper.

Public Health Nursing, 1, pp. 94-100.

IOM (Institute of Medicine). (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

Moher, D., Liberati, A., Tetzlaff, J. and Altman, D. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med 6(6): e1000097.doi:10.1371/journal.pmed1000097.

Funding Grid dor Research (2016)

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