research questions on health education

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• Published: 06 April 2020

The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015

• Viju Raghupathi 1 &
• Wullianallur Raghupathi 2  

Archives of Public Health volume  78 , Article number:  20 ( 2020 ) Cite this article

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A clear understanding of the macro-level contexts in which education impacts health is integral to improving national health administration and policy. In this research, we use a visual analytic approach to explore the association between education and health over a 20-year period for countries around the world.

Using empirical data from the OECD and the World Bank for 26 OECD countries for the years 1995–2015, we identify patterns/associations between education and health indicators. By incorporating pre- and post-educational attainment indicators, we highlight the dual role of education as both a driver of opportunity as well as of inequality.

Adults with higher educational attainment have better health and lifespans compared to their less-educated peers. We highlight that tertiary education, particularly, is critical in influencing infant mortality, life expectancy, child vaccination, and enrollment rates. In addition, an economy needs to consider potential years of life lost (premature mortality) as a measure of health quality.

Conclusions

We bring to light the health disparities across countries and suggest implications for governments to target educational interventions that can reduce inequalities and improve health. Our country-level findings on NEET (Not in Employment, Education or Training) rates offer implications for economies to address a broad array of vulnerabilities ranging from unemployment, school life expectancy, and labor market discouragement. The health effects of education are at the grass roots-creating better overall self-awareness on personal health and making healthcare more accessible.

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Introduction

Is education generally associated with good health? There is a growing body of research that has been exploring the influence of education on health. Even in highly developed countries like the United States, it has been observed that adults with lower educational attainment suffer from poor health when compared to other populations [ 36 ]. This pattern is attributed to the large health inequalities brought about by education. A clear understanding of the health benefits of education can therefore serve as the key to reducing health disparities and improving the well-being of future populations. Despite the growing attention, research in the education–health area does not offer definitive answers to some critical questions. Part of the reason is the fact that the two phenomena are interlinked through life spans within and across generations of populations [ 36 ], thereby involving a larger social context within which the association is embedded. To some extent, research has also not considered the variances in the education–health relationship through the course of life or across birth cohorts [ 20 ], or if there is causality in the same. There is therefore a growing need for new directions in education–health research.

The avenues through which education affects health are complex and interwoven. For one, at the very outset, the distribution and content of education changes over time [ 20 ]. Second, the relationship between the mediators and health may change over time, as healthcare becomes more expensive and/or industries become either more, or less hazardous. Third, some research has documented that even relative changes in socioeconomic status (SES) can affect health, and thus changes in the distribution of education implies potential changes in the relationship between education and health. The relative index of inequality summarizes the magnitude of SES as a source of inequalities in health [ 11 , 21 , 27 , 29 ]. Fourth, changes in the distribution of health and mortality imply that the paths to poor health may have changed, thereby affecting the association with education.

Research has proposed that the relationship between education and health is attributable to three general classes of mediators: economic; social, psychological, and interpersonal; and behavioral health [ 31 ]. Economic variables such as income and occupation mediate the relationship between education and health by controlling and determining access to acute and preventive medical care [ 1 , 2 , 19 ]. Social, psychological, and interpersonal resources allow people with different levels of education to access coping resources and strategies [ 10 , 34 ], social support [ 5 , 22 ], and problem-solving and cognitive abilities to handle ill-health consequences such as stress [ 16 ]. Healthy behaviors enable educated individuals to recognize symptoms of ill health in a timely manner and seek appropriate medical help [ 14 , 35 ].

While the positive association between education and health has been established, the explanations for this association are not [ 31 ]. People who are well educated experience better health as reflected in the high levels of self-reported health and low levels of morbidity, mortality, and disability. By extension, low educational attainment is associated with self-reported poor health, shorter life expectancy, and shorter survival when sick. Prior research has suggested that the association between education and health is a complicated one, with a range of potential indicators that include (but are not limited to) interrelationships between demographic and family background indicators [ 8 ] - effects of poor health in childhood, greater resources associated with higher levels of education, appreciation of good health behaviors, and access to social networks. Some evidence suggests that education is strongly linked to health determinants such as preventative care [ 9 ]. Education helps promote and sustain healthy lifestyles and positive choices, nurture relationships, and enhance personal, family, and community well-being. However, there are some adverse effects of education too [ 9 ]. Education may result in increased attention to preventive care, which, though beneficial in the long term, raises healthcare costs in the short term. Some studies have found a positive association between education and some forms of illicit drug and alcohol use. Finally, although education is said to be effective for depression, it has been found to have much less substantial impact in general happiness or well-being [ 9 ].

On a universal scale, it has been accepted that several social factors outside the realm of healthcare influence the health outcomes [ 37 ]. The differences in morbidity, mortality and risk factors in research, conducted within and between countries, are impacted by the characteristics of the physical and social environment, and the structural policies that shape them [ 37 ]. Among the developed countries, the United States reflects huge disparities in educational status over the last few decades [ 15 , 24 ]. Life expectancy, while increasing for all others, has decreased among white Americans without a high school diploma - particularly women [ 25 , 26 , 32 ]. The sources of inequality in educational opportunities for American youth include the neighborhood they live in, the color of their skin, the schools they attend, and the financial resources of their families. In addition, the adverse trends in mortality and morbidity brought on by opioids resulting in suicides and overdoses (referred to as deaths of despair) exacerbated the disparities [ 21 ]. Collectively, these trends have brought about large economic and social inequalities in society such that the people with more education are likely to have more health literacy, live longer, experience better health outcomes, practice health promoting behaviors, and obtain timely health checkups [ 21 , 17 ].

Education enables people to develop a broad range of skills and traits (including cognitive and problem-solving abilities, learned effectiveness, and personal control) that predispose them towards improved health outcomes [ 23 ], ultimately contributing to human capital. Over the years, education has paved the way for a country’s financial security, stable employment, and social success [ 3 ]. Countries that adopt policies for the improvement of education also reap the benefits of healthy behavior such as reducing the population rates of smoking and obesity. Reducing health disparities and improving citizen health can be accomplished only through a thorough understanding of the health benefits conferred by education.

There is an iterative relationship between education and health. While poor education is associated with poor health due to income, resources, healthy behaviors, healthy neighborhood, and other socioeconomic factors, poor health, in turn, is associated with educational setbacks and interference with schooling through difficulties with learning disabilities, absenteeism, or cognitive disorders [ 30 ]. Education is therefore considered an important social determinant of health. The influence of national education on health works through a variety of mechanisms. Generally, education shows a relationship with self-rated health, and thus those with the highest education may have the best health [ 30 ]. Also, health-risk behaviors seem to be reduced by higher expenditure into the publicly funded education system [ 18 ], and those with good education are likely to have better knowledge of diseases [ 33 ]. In general, the education–health gradients for individuals have been growing over time [ 38 ].

To inform future education and health policies effectively, one needs to observe and analyze the opportunities that education generates during the early life span of individuals. This necessitates the adoption of some fundamental premises in research. Research must go beyond pure educational attainment and consider the associated effects preceding and succeeding such attainment. Research should consider the variations brought about by the education–health association across place and time, including the drivers that influence such variations [ 36 ].

In the current research, we analyze the association between education and health indicators for various countries using empirical data from reliable sources such as the Organization for Economic Cooperation and Development (OECD) and World Bank. While many studies explore the relationship between education and health at a conceptual level, we deploy an empirical approach in investigating the patterns and relationships between the two sets of indicators. In addition, for the educational indicators, we not only incorporate the level of educational attainment, but also look at the potential socioeconomic benefits, such as enrollment rates (in each sector of educational level) and school life expectancy (at each educational level). We investigate the influences of educational indicators on national health indicators of infant mortality, child vaccinations, life expectancy at birth, premature mortality arising from lack of educational attainment, employment and training, and the level of national health expenditure. Our research question is:

What are some key influencers/drivers in the education-health relationship at a country level?

The current study is important because policy makers have an increasing concern on national health issues and on policies that support it. The effect of education is at the root level—creating better overall self-awareness on personal health and making healthcare more accessible. The paper is organized as follows: Section 2 discusses the background for the research. Section 3 discusses the research method; Section 4 offers the analysis and results; Section 5 provides a synthesis of the results and offers an integrated discussion; Section 6 contains the scope and limitations of the research; Section 7 offers conclusions with implications and directions for future research.

Research has traditionally drawn from three broad theoretical perspectives in conceptualizing the relationship between education and health. The majority of research over the past two decades has been grounded in the Fundamental Cause Theory (FCT) [ 28 ], which posits that factors such as education are fundamental social causes of health inequalities because they determine access to resources (such as income, safe neighborhoods, or healthier lifestyles) that can assist in protecting or enhancing health [ 36 ]. Some of the key social resources that contribute to socioeconomic status include education (knowledge), money, power, prestige, and social connections. As some of these undergo change, they will be associated with differentials in the health status of the population [ 12 ].

Education has also been conceptualized using the Human Capital Theory (HCT) that views it as a return on investment in the form of increased productivity [ 4 ]. Education improves knowledge, skills, reasoning, effectiveness, and a broad range of other abilities that can be applied to improving health. The third approach - the signaling or credentialing perspective [ 6 ] - is adopted to address the large discontinuities in health at 12 and 16 years of schooling, which are typically associated with the receipt of a high school diploma and a college degree, respectively. This perspective considers the earned credentials of a person as a potential source that warrants social and economic returns. All these theoretical perspectives postulate a strong association between education and health and identify mechanisms through which education influences health. While the HCT proposes the mechanisms as embodied skills and abilities, FCT emphasizes the dynamism and flexibility of mechanisms, and the credentialing perspective proposes educational attainment through social responses. It needs to be stated, however, that all these approaches focus on education solely in terms of attainment, without emphasizing other institutional factors such as quality or type of education that may independently influence health. Additionally, while these approaches highlight the individual factors (individual attainment, attainment effects, and mechanisms), they do not give much emphasis to the social context in which education and health processes are embedded.

In the current research while we acknowledge the tenets of these theoretical perspectives, we incorporate the social mechanisms in education such as level of education, skills and abilities brought about by enrollment, school life expectancy, and the potential loss brought about by premature mortality. In this manner, we highlight the relevance of the social context in which the education and health domains are situated. We also study the dynamism of the mechanisms over countries and over time and incorporate the influences that precede and succeed educational attainment.

We analyze country level education and health data from the OECD and World Bank for a period of 21 years (1995–2015). Our variables include the education indicators of adult education level; enrollment rates at various educational levels; NEET (Not in Employment, Education or Training) rates; school life expectancy; and the health indicators of infant mortality, child vaccination rates, deaths from cancer, life expectancy at birth, potential years of life lost and smoking rates (Table 1 ). The data was processed using the tools of Tableau for visualization, and SAS for correlation and descriptive statistics. Approaches for analysis include ranking, association, and data visualization of the health and education data.

Analyses and results

In this section we identify and analyze patterns and associations between education and health indicators and discuss the results. Since countries vary in population sizes and other criteria, we use the estimated averages in all our analyses.

Comparison of health outcomes for countries by GDP per capita

We first analyzed to see if our data reflected the expectation that countries with higher GDP per capita have better health status (Fig. 1 ). We compared the average life expectancy at birth, average infant mortality, average deaths from cancer and average potential year of life lost, for different levels of GDP per capita (Fig. 1 ).

Associations between Average Life Expectancy (years) and Average Infant Mortality rate (per 1000), and between Deaths from Cancer (rates per 100,000) and Average Potential Years of Life Lost (years), by GDP per capita (for all countries for years 1995–2015)

Figure 1 depicts two charts with the estimated averages of variables for all countries in the sample. The X-axis of the first chart depicts average infant mortality rate (per 1000), while that of the second chart depicts average potential years of life lost (years). The Y-axis for both charts depicts the GDP per capita shown in intervals of 10 K ranging from 0 K–110 K (US Dollars). The analysis is shown as an average for all the countries in the sample and for all the years (1995–2015). As seen in Fig. 1 , countries with lower GDP per capita have higher infant mortality rate and increased potential year of life lost (which represents the average years a person would have lived if he or she had not died prematurely - a measure of premature mortality). Life expectancy and deaths from cancer are not affected by GDP level. When studying infant mortality and potential year lost, in order to avoid the influence of a control variable, it was necessary to group the samples by their GDP per capita level.

Association of Infant Mortality Rates with enrollment rates and education levels

We explored the association of infant mortality rates with the enrollment rates and adult educational levels for all countries (Fig. 2 ). The expectation is that with higher education and employment the infant mortality rate decreases.

Association of Adult Education Levels (ratio) and Enrollment Rates (ratio) with Infant Mortality Rate (per 1000)

Figure 2 depicts the analysis for all countries in the sample. The figure shows the years from 1995 to 2015 on the X axis. It shows two Y-axes with one axis denoting average infant mortality rate (per 1000 live births), and the other showing the rates from 0 to 120 to depict enrollment rates (primary/secondary/tertiary) and education levels (below secondary/upper secondary/tertiary). Regarding the Y axis showing rates over 100, it is worth noting that the enrollment rates denote a ratio of the total enrollment (regardless of age) at a level of education to the official population of the age group in that education level. Therefore, it is possible for the number of children enrolled at a level to exceed the official population of students in the age group for that level (due to repetition or late entry). This can lead to ratios over 100%. The figure shows that in general, all education indicators tend to rise over time, except for adult education level below secondary, which decreases over time. Infant mortality shows a steep decreasing trend over time, which is favorable. In general, countries have increasing health status and education over time, along with decreasing infant mortality rates. This suggests a negative association of education and enrollment rates with mortality rates.

Association of Education Outcomes with life expectancy at birth

We explored if the education outcomes of adult education level (tertiary), school life expectancy (tertiary), and NEET (not in employment, education, or training) rates, affected life expectancy at birth (Fig. 3 ). Our expectation is that adult education and school life expectancy, particularly tertiary, have a positive influence, while NEET has an adverse influence, on life expectancy at birth.

Association of Adult Education Level (Tertiary), NEET rate, School Life Expectancy (Tertiary), with Life Expectancy at Birth

Figure 3 show the relationships between various education indicators (adult education level-tertiary, NEET rate, school life expectancy-tertiary) and life expectancy at birth for all countries in the sample. The figure suggests that life expectancy at birth rises as adult education level (tertiary) and tertiary school life expectancy go up. Life expectancy at birth drops as the NEET rate goes up. In order to extend people’s life expectancy, governments should try to improve tertiary education, and control the number of youths dropping out of school and ending up unemployed (the NEET rate).

Association of Tertiary Enrollment and Education with potential years of life lost

We wanted to explore if the potential years of life lost rates are affected by tertiary enrollment rates and tertiary adult education levels (Fig. 4 ).

Association of Enrollment rate-tertiary (top) and Adult Education Level-Tertiary (bottom) with Potential Years of Life Lost (Y axis)

The two sets of box plots in Fig. 4 compare the enrollment rates with potential years of life lost (above set) and the education level with potential years of life lost (below set). The analysis is for all countries in the sample. As mentioned earlier, the enrollment rates are expressed as ratios and can exceed 100% if the number of children enrolled at a level (regardless of age) exceed the official population of students in the age group for that level. Potential years of life lost represents the average years a person would have lived, had he/she not died prematurely. The results show that with the rise of tertiary adult education level and tertiary enrollment rate, there is a decrease in both value and variation of the potential years of life lost. We can conclude that lower levels in tertiary education adversely affect a country’s health situation in terms of premature mortality.

Association of Tertiary Enrollment and Education with child vaccination rates

We compared the performance of tertiary education level and enrollment rates with the child vaccination rates (Fig. 5 ) to assess if there was a positive impact of education on preventive healthcare.

Association of Adult Education Level-Tertiary and Enrollment Rate-Tertiary with Child Vaccination Rates

In this analysis (Fig. 5 ), we looked for associations of child vaccination rates with tertiary enrollment and tertiary education. The analysis is for all countries in the sample. The color of the bubble represents the tertiary enrollment rate such that the darker the color, the higher the enrollment rate, and the size of the bubble represents the level of tertiary education. The labels inside the bubbles denote the child vaccination rates. The figure shows a general positive association of high child vaccination rate with tertiary enrollment and tertiary education levels. This indicates that countries that have high child vaccination rates tend to be better at tertiary enrollment and have more adults educated in tertiary institutions. Therefore, countries that focus more on tertiary education and enrollment may confer more health awareness in the population, which can be reflected in improved child vaccination rates.

Association of NEET rates (15–19; 20–24) with infant mortality rates and deaths from Cancer

In the realm of child health, we also looked at the infant mortality rates. We explored if infant mortality rates are associated with the NEET rates in different age groups (Fig. 6 ).

Association of Infant Mortality rates with NEET Rates (15–19) and NEET Rates (20–24)

Figure 6 is a scatterplot that explores the correlation between infant mortality and NEET rates in the age groups 15–19 and 20–24. The data is for all countries in the sample. Most data points are clustered in the lower infant mortality and lower NEET rate range. Infant mortality and NEET rates move in the same direction—as infant mortality increases/decrease, the NEET rate goes up/down. The NEET rate for the age group 20–24 has a slightly higher infant mortality rate than the NEET rate for the age group 15–19. This implies that when people in the age group 20–24 are uneducated or unemployed, the implications on infant mortality are higher than in other age groups. This is a reasonable association, since there is the potential to have more people with children in this age group than in the teenage group. To reduce the risk of infant mortality, governments should decrease NEET rates through promotional programs that disseminate the benefits of being educated, employed, and trained [ 7 ]. Additionally, they can offer financial aid to public schools and companies to offer more resources to raise general health awareness in people.

We looked to see if the distribution of population without employment, education, or training (NEET) in various categories of high, medium, and low impacted the rate of deaths from cancer (Fig. 7 ). Our expectation is that high rates of NEET will positively influence deaths from cancer.

Association of Deaths from Cancer and different NEET Rates

The three pie charts in Fig. 7 show the distribution of deaths from cancer in groups of countries with different NEET rates (high, medium, and low). The analysis includes all countries in the sample. The expectation was that high rates of NEET would be associated with high rates of cancer deaths. Our results, however, show that countries with medium NEET rates tend to have the highest deaths from cancer. Countries with high NEET rates have the lowest deaths from cancer among the three groups. Contrary to expectations, countries with low NEET rates do not show the lowest death rates from cancer. A possible explanation for this can be attributed to the fact that in this group, the people in the labor force may be suffering from work-related hazards including stress, that endanger their health.

Association between adult education levels and health expenditure

It is interesting to note the relationship between health expenditure and adult education levels (Fig. 8 ). We expect them to be positively associated.

Association of Health Expenditure and Adult Education Level-Tertiary & Upper Secondary

Figure 8 shows a heat map with the number of countries in different combinations of groups between tertiary and upper-secondary adult education level. We emphasize the higher levels of adult education. The color of the square shows the average of health expenditure. The plot shows that most of the countries are divided into two clusters. One cluster has a high tertiary education level as well as a high upper-secondary education level and it has high average health expenditure. The other cluster has relatively low tertiary and upper secondary education level with low average health expenditure. Overall, the figure shows a positive correlation between adult education level and compulsory health expenditure. Governments of countries with low levels of education should allocate more health expenditure, which will have an influence on the educational levels. Alternatively, to improve public health, governments can frame educational policies to improve the overall national education level, which then produces more health awareness, contributing to national healthcare.

Association of Compulsory Health Expenditure with NEET rates by country and region

Having explored the relationship between health expenditure and adult education, we then explored the relationship between health expenditure and NEET rates of different countries (Fig. 9 ). We expect compulsory health expenditure to be negatively associated with NEET rates.

Association between Compulsory Health Expenditure and NEET Rate by Country and Region

In Fig. 9 , each box represents a country or region; the size of the box indicates the extent of compulsory health expenditure such that a larger box implies that the country has greater compulsory health expenditure. The intensity of the color of the box represents the NEET rate such that the darker color implies a higher NEET rate. Turkey has the highest NEET rate with low health expenditure. Most European countries such as France, Belgium, Sweden, and Norway have low NEET rates and high health expenditure. The chart shows a general association between low compulsory health expenditure and high NEET rates. The relationship, however, is not consistent, as there are countries with high NEET and high health expenditures. Our suggestion is for most countries to improve the social education for the youth through free training programs and other means to effectively improve the public health while they attempt to raise the compulsory expenditure.

Distribution of life expectancy at birth and tertiary enrollment rate

The distribution of enrollment rate (tertiary) and life expectancy of all the countries in the sample can give an idea of the current status of both education and health (Fig. 10 ). We expect these to be positively associated.

Distribution of Life Expectancy at Birth (years) and Tertiary Enrollment Rate

Figure 10 shows two histograms with the lines representing the distribution of life expectancy at birth and the tertiary enrollment rate of all the countries. The distribution of life expectancy at birth is skewed right, which means most of the countries have quite a high life expectancy and there are few countries with a very low life expectancy. The tertiary enrollment rate has a good distribution, which is closer to a normal distribution. Governments of countries with an extremely low life expectancy should try to identify the cause of this problem and take actions in time to improve the overall national health.

Comparison of adult education levels and deaths from Cancer at various levels of GDP per capita

We wanted to see if various levels of GDP per capita influence the levels of adult education and deaths from cancer in countries (Fig. 11 ).

Comparison of Adult Education Levels and Deaths from Cancer at various levels of GDP per capita

Figure 11 shows the distribution of various adult education levels for countries by groups of GDP per capita. The plot shows that as GDP grows, the level of below-secondary adult education becomes lower, and the level of tertiary education gets higher. The upper-secondary education level is constant among all the groups. The implication is that tertiary education is the most important factor among all the education levels for a country to improve its economic power and health level. Countries should therefore focus on tertiary education as a driver of economic development. As for deaths from cancer, countries with lower GDP have higher death rates, indicating the negative association between economic development and deaths from cancer.

Distribution of infant mortality rates by continent

Infant mortality is an important indicator of a country’s health status. Figure 12 shows the distribution of infant mortality for the continents of Asia, Europe, Oceania, North and South America. We grouped the countries in each continent into high, medium, and low, based on infant mortality rates.

Distribution of Infant Mortality rates by Continent

In Fig. 12 , each bar represents a continent. All countries fall into three groups (high, medium, and low) based on infant mortality rates. South America has the highest infant mortality, followed by Asia, Europe, and Oceania. North America falls in the medium range of infant mortality. South American countries, in general, should strive to improve infant mortality. While Europe, in general, has the lowest infant mortality rates, there are some countries that have high rates as depicted.

Association between child vaccination rates and NEET rates

We looked at the association between child vaccination rates and NEET rates in various countries (Fig. 13 ). We expect countries that have high NEET rates to have low child vaccination rates.

Association between Child Vaccination Rates and NEET rates

Figure 13 displays the child vaccination rates in the first map and the NEET rates in the second map, for all countries. The darker green color shows countries with higher rates of vaccination and the darker red represents those with higher NEET rates. It can be seen that in general, the countries with lower NEET also have better vaccination rates. Examples are USA, UK, Iceland, France, and North European countries. Countries should therefore strive to reduce NEET rates by enrolling a good proportion of the youth into initiatives or programs that will help them be more productive in the future, and be able to afford preventive healthcare for the families, particularly, the children.

Average smoking rate in different continents over time

We compared the trend of average smoking rate for the years 1995–201 for the continents in the sample (Fig. 14 ).

Trend of average smoking rate in different continents from 1995 to 2015

Figure 14 depicts the line charts of average smoking rates for the continents of Asia, Europe, Oceania, North and South America. All the lines show an overall downward trend, which indicates that the average smoking rate decreases with time. The trend illustrates that people have become more health conscious and realize the harmful effects of smoking over time. However, the smoking rate in Europe (EU) is consistently higher than that in other continents, while the smoking rate in North America (NA) is consistently lower over the years. Governments in Europe should pay attention to the usage of tobacco and increase health consciousness among the public.

Association between adult education levels and deaths from Cancer

We explored if adult education levels (below-secondary, upper-secondary, and tertiary) are associated with deaths from cancer (Fig. 15 ) such that higher levels of education will mitigate the rates of deaths from cancer, due to increased awareness and proactive health behavior.

Association of deaths from cancer with adult education levels

Figure 15 shows the correlations of deaths from cancer among the three adult education levels, for all countries in the sample. It is obvious that below-secondary and tertiary adult education levels have a negative correlation with deaths from cancer, while the upper-secondary adult education level shows a positive correlation. Barring upper-secondary results, we can surmise that in general, as education level goes higher, the deaths from cancer will decrease. The rationale for this could be that education fosters more health awareness and encourages people to adopt healthy behavioral practices. Governments should therefore pay attention to frame policies that promote education. However, the counterintuitive result of the positive correlation between upper-secondary levels of adult education with the deaths from cancer warrants more investigation.

We drilled down further into the correlation between the upper-secondary education level and deaths from cancer. Figure 16 shows this correlation, along with a breakdown of the total number of records for each continent, to see if there is an explanation for the unique result.

Association between deaths from cancer and adult education level-upper secondary

Figure 16 shows a dashboard containing two graphs - a scatterplot of the correlation between deaths from cancer and education level, and a bar graph showing the breakdown of the total sample by continent. We included a breakdown by continent in order to explore variances that may clarify or explain the positive association for deaths from cancer with the upper-secondary education level. The scatterplot shows that for the European Union (EU) the points are much more scattered than for the other continents. Also, the correlation between deaths and education level for the EU is positive. The bottom bar graph depicts how the sample contains a disproportionately high number of records for the EU than for other continents. It is possible that this may have influenced the results of the correlation. The governments in the EU should investigate the reasons behind this phenomenon. Also, we defer to future research to explore this in greater detail by incorporating other socioeconomic parameters that may have to be factored into the relationship.

Association between average tertiary school life expectancy and health expenditure

We moved our focus to the trends of tertiary school life expectancy and health expenditure from 1995 to 2015 (Fig. 17 ) to check for positive associations.

Association between Average Tertiary School Life Expectancy and Health Expenditure

Figure 17 is a combination chart explaining the trends of tertiary school life expectancy and health expenditure, for all countries in the sample. The rationale is that if there is a positive association between the two, it would be worthwhile for the government to allocate more resources towards health expenditure. Both tertiary school life expectancy and health expenditure show an increase over the years from 1995 to 2015. Our additional analysis shows that they continue to increase even after 2015. Hence, governments are encouraged to increase the health expenditure in order to see gains in tertiary school life expectancy, which will have positive implications for national health. Given that the measured effects of education are large, investments in education might prove to be a cost-effective means of achieving better health.

Our results reveal how interlinked education and health can be. We show how a country can improve its health scenario by focusing on appropriate indicators of education. Countries with higher education levels are more likely to have better national health conditions. Among the adult education levels, tertiary education is the most critical indicator influencing healthcare in terms of infant mortality, life expectancy, child vaccination rates, and enrollment rates. Our results emphasize the role that education plays in the potential years of life lost, which is a measure that represents the average years a person would have lived had he/she not died prematurely. In addition to mortality rate, an economy needs to consider this indicator as a measure of health quality.

Other educational indicators that are major drivers of health include school life expectancy, particularly at the tertiary level. In order to improve the school life expectancy of the population, governments should control the number of youths ending up unemployed, dropping out of school, and without skills or training (the NEET rate). Education allows people to gain skills/abilities and knowledge on general health, enhancing their awareness of healthy behaviors and preventive care. By targeting promotions and campaigns that emphasize the importance of skills and employment, governments can reduce the NEET rates. And, by reducing the NEET rates, governments have the potential to address a broad array of vulnerabilities among youth, ranging from unemployment, early school dropouts, and labor market discouragement, which are all social issues that warrant attention in a growing economy.

We also bring to light the health disparities across countries and suggest implications for governments to target educational interventions that can reduce inequalities and improve health, at a macro level. The health effects of education are at the grass roots level - creating better overall self-awareness on personal health and making healthcare more accessible.

Scope and limitations

Our research suffers from a few limitations. For one, the number of countries is limited, and being that the data are primarily drawn from OECD, they pertain to the continent of Europe. We also considered a limited set of variables. A more extensive study can encompass a larger range of variables drawn from heterogeneous sources. With the objective of acquiring a macro perspective on the education–health association, we incorporated some dependent variables that may not traditionally be viewed as pure health parameters. For example, the variable potential years of life lost is affected by premature deaths that may be caused by non-health related factors too. Also there may be some intervening variables in the education–health relationship that need to be considered. Lastly, while our study explores associations and relationships between variables, it does not investigate causality.

Conclusions and future research

Both education and health are at the center of individual and population health and well-being. Conceptualizations of both phenomena should go beyond the individual focus to incorporate and consider the social context and structure within which the education–health relationship is embedded. Such an approach calls for a combination of interdisciplinary research, novel conceptual models, and rich data sources. As health differences are widening across the world, there is need for new directions in research and policy on health returns on education and vice versa. In developing interventions and policies, governments would do well to keep in mind the dual role played by education—as a driver of opportunity as well as a reproducer of inequality [ 36 ]. Reducing these macro-level inequalities requires interventions directed at a macro level. Researchers and policy makers have mutual responsibilities in this endeavor, with researchers investigating and communicating the insights and recommendations to policy makers, and policy makers conveying the challenges and needs of health and educational practices to researchers. Researchers can leverage national differences in the political system to study the impact of various welfare systems on the education–health association. In terms of investment in education, we make a call for governments to focus on education in the early stages of life course so as to prevent the reproduction of social inequalities and change upcoming educational trajectories; we also urge governments to make efforts to mitigate the rising dropout rate in postsecondary enrollment that often leads to detrimental health (e.g., due to stress or rising student debt). There is a need to look into the circumstances that can modify the postsecondary experience of youth so as to improve their health.

Our study offers several prospects for future research. Future research can incorporate geographic and environmental variables—such as the quality of air level or latitude—for additional analysis. Also, we can incorporate data from other sources to include more countries and more variables, especially non-European ones, so as to increase the breadth of analysis. In terms of methodology, future studies can deploy meta-regression analysis to compare the relationships between health and some macro-level socioeconomic indicators [ 13 ]. Future research should also expand beyond the individual to the social context in which education and health are situated. Such an approach will help generate findings that will inform effective educational and health policies and interventions to reduce disparities.

Availability of data and materials

The dataset analyzed during the current study is available from the corresponding author on reasonable request.

Abbreviations

Fundamental Cause Theory

Human Capital Theory

Not in Employment, Education, or Training

Organization for Economic Cooperation and Development

Socio-economic status

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Using theory in health professions education research: a guide for early career researchers

• Koshila Kumar 1 ,
• Chris Roberts 2 ,
• Gabrielle M. Finn 3 &
• Yu-Che Chang 4  

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Theory provides complex and comprehensive explanations of a wide range of phenomena (i.e., things that we research), and using theory can enhance quality in health professions education (HPE) research [ 1 , 2 , 3 , 4 ]. However, those who are new to HPE research and early career researchers (ECRs) can find it challenging to use theory. In this paper, we outline key considerations (see Table 1 ) for using theory in HPE research, both in relation to theory as a subject or content area and the process of using it, including critically questioning which theories are priviledged in the HPE literature [ 5 , 6 ]. By providing this guidance, we hope to support new and early-career HPE researchers around the globe to enhance their capacity to appraise and improve theoretical quality, both in relation to their own work and the HPE literature. While theory is the focus of this paper, we acknowledge it is one of many aspects that researchers have to concurrently balance and integrate into their work [ 7 ].

Consider theory comprehensively and critically

There are many different definitions of theory articulated in the HPE literature. These include theory as: an organised, coherent, and systematic articulation of a set of issues that are communicated as a meaningful whole [ 1 ]; a means of better understanding the mechanics of the research phenomena [ 3 ], a system of ideas intended to explain a phenomenon [ 8 ]; or a ‘philosophical stance informing the methodology’ [ 9 ]. These multiple definitions highlight that there are different interpretations about what theory is. For example, some regard theory as the underpinning philosophy or paradigm of a discipline which are the assumptions which underpin what a researcher does and why (we cover this in more detail later). Others, including ourselves, regard theory as a specific set of ideas or a lens that can be applied to examining and explaining phenomena. Furthermore, there are many different terms associated with theory [ 2 ] and interchangeable use of terminology. Therefore, we advise those new to HPE research to take time in the early stages of their research to clarify interpretations and terminology associated with theory and their own understandings of theory, through discussion with their supervisors/mentors, and research colleagues.

Given the range of theories available for use, we suggest ECRs seek guidance from supervisors/mentors and colleagues about what theories they use and see which theories are being discussed in their professional networks and social media. Once there is an initial level of familiarity, we advise ECRs to note which theories are being used in the primary HPE research literature (peer-reviewed journal articles) and grey literature (e.g., reports, conference presentations etc.) in the HPE field. To reduce the reliance on others’ interpretations of theory, it will also be important to engage with original sources of a chosen theory (or theories). To enhance inclusivity and diversity of theory [ 5 , 6 ], we advise ECRs to engage with theories from other disciplines (e.g., social psychology, sociology, education, philosophy, organisational, and economics etc.), cultures and geographical settings, and with theories that are less well-known in the HPE field. We also recommend ECRs collate, deconstruct, and discuss peer-reviewed examples of theory use. To demonstrate how to deconstruct theory use, we have taken a small sample of papers published in this journal and identified how theory is used in relation to paradigm, methodology, unit of analysis, timing of theory use, and write up of theory (See Table 2 ). Collectively, these strategies will help ECRs to identify and choose a theory (or multiple theories) that is fit for purpose.

As ECRs engage with theory, they will need to adopt a critical stance and ask questions both about theory as a subject/content area and the process of theory use. Questions that can be asked about theory as a subject/content area include: what are the origins of a particular theory; how has that theory evolved over time; and who is using that theory and how [ 14 ]? It is important to question theory because each theory: privileges a certain way of framing a research problem; is underpinned by certain assumptions; has different strengths and limitations [ 8 ]; and offers a different level of explanation and perspective [ 2 , 3 , 4 , 8 ]. Adopting a critical stance in relation to theory is also vital to decolonise and diversify research practices [ 5 , 6 ]. In order to effectively critique theory, we encourage ECRs to keep current with contemporary debates and discussions about theory and its use. So our first set of considerations (outlined in Table 1 ) relates to engaging comprehensively and critically with theory as a subject or content area.

Consider the alignment between paradigm and theory

A paradigm is a world view or a ‘philosophical way of thinking’ [ 15 ] which guides what a researcher does and why. It encompasses: values and assumptions about the nature of reality (ontology); how we come to know (epistemology); the research processes (methodology); and values (axiology) [ 16 , 17 ]. There is broad agreement that there are four main paradigms: positivism; post-positivism; constructivism/interpretivism; and critical theory [ 16 , 17 , 18 , 19 ]. Qualitative research is aligned with the post-positivist, constructivist/interpretivist, and critical paradigms, quantitative research corresponds to the positivst paradigm, and mixed methods research can involve a combination of all paradigms. A key element of HPE research relates to reflecting on and articulating one’s paradigm [ 17 ], ideally, at the time of designing a study.

Critically, ECRs are advised that although not every published study will explicitly name a paradigm, each study is situated within a specific philosophical milieu [ 20 ]. Furthermore, ECRs also need to understand that each theory itself is also underpinned by certain assumptions based not only on its disciplinary roots, but also its cultural roots [ 5 , 6 ]. For example, theories derived from psychology will differ from sociological theories in terms of their fundamental philosophical assumptions about phenomena and focus on understanding individuals and/or groups (psychological theories) and social groups, communities, and cultures (sociological theories). Similarly, theories from Western cultures may priviledge certain kinds of knowledge and perspectives over others [ 5 , 6 ]. Finally, although theory use is more prevalent in qualitative research, it can also be used in quantitative and mixed methods research as illustrated in the examples we have currated in Table 2 . This reinforces the importance of all HPE researchers having some understanding of theory and how to use it. Thus, our second set of considerations relate to considering the interplay between theory and paradigm (summarised in Table 1 ).

Consider the interplay between methodology and theory

Methodology refers to the research processes used in a study, encompassing methods of recruitment, data collection and data analysis. An important relationship exists between paradigm and methodology [ 17 ], and therefore between methodology and theory. As identified earlier, theory can be used in both qualitative and quantitative HPE research and different methodologies interact differently with theory. For example, traditional grounded theory as a methodology actively rejects pre-existing theory and regards theory development as an endpoint of the research [ 21 ]. In contrast, contemporary variants of grounded theory use pre-existing theory to inform the research [ 22 ]. Other qualitative methodologies such as hermeneutic phenomenology also use theory to focus the inquiry and explain findings [ 23 ]. So, in this context, we encourage ECRs to develop their awareness of the underpinning philosophical foundations of their chosen methodology and its stance on theory, and to engage with examples of published research to identify how others utilising a similar methodology have used theory. Therefore, our third set of considerations (summarised in Table 1 ) relates to engaging with theory in the context of methodology.

Consider the fit between theory and unit of analysis

There are two elements relating to the unit of analysis. Firstly, the unit of analysis pertains to the level at which a researcher is intending to examine a research phenomenon. Crotty’s [ 9 ] multi-level framework is a useful way to frame the different levels at which a phenomenon can be explored, which is at the level of the: individual or groups (micro-level); organisations/workplaces or medium sized networks (meso-level); or systems or large networks (macro-system). At the micro or individual level, the focus is mainly on the individual and their motivations, learning, performance, and development etc., and theories used at this level include mainly psychological and educational theories. At the micro-level, there can also be a focus on groups or small networks and their interactions, processes, social practices, identity etc., with social psychology, socio-cultural, sociological, social network theories being used. At the meso or organisational level, the focus is on structures and systems within organisations and mid-level networks, and organisational, cultural, socio-cultural, and ecological theories are commonly used at this level. At the macro level, there is a broader focus on systems and large networks, and theories used at this level can include activity theory, systems theory, and complexity theory etc.

Secondly, the unit of analysis can also pertain to whether a researcher is specifically seeking to unravel the impact of power, race, gender, politics, history and culture on phenomena (across micro, meso or macro levels). This would require the use of theories which are critical or emancipatory in nature, such as critical, feminist, intersectional, or postcolonial theory. As discussed earlier, using a critical or emancipatory lens can decolonise and diversify the theoretical knowledge and perspectives represented in the HPE literature [ 5 , 6 ]. By critically and deeply reflecting on their motivations and values with regards to a research study [ 17 ] ECRs can clarify their unit of analysis. As such, our fourth set of considerations (listed in Table 1 ) relates to identifying the alignment between unit of analysis and theory.

Consider when theory is used and associated implications

Theory can be used deductively or inductively [ 2 ]. When used deductively, theory guides all parts of the process, including conceptualisation, planning and execution of the research [ 2 ]. Using theory deductively requires ECRs to outline how the chosen theory has informed the framing of their research problem, the wording of the research aims and questions, and the methods of data collection and analysis. It is important for ECRs to understand that while the deductive approach implies there is a logical and linear way to use theory, initial theoretical understandings are often extended and adjusted as researchers engage in the research process. This includes the processes of collecting and analysing data, applying a theory, critically reflecting on the use of theory, writing up their work [ 2 ], and considering the interplay between pre-existing theory and emergent theory [ 21 ].

Theory can also be used inductively which involves applying it in the latter stages of data analysis [ 2 ]. With this approach, data is first interpreted in an open and exploratory manner using approaches like thematic analysis [ 24 ] or framework analysis [ 25 ] enabling the identification of preliminary themes. Then a theory-informed analysis is undertaken using a theory that is chosen based on preliminary impressions of the data and engagement with the literature. This inductive approach is also common in secondary analyses where researchers apply theory to interpret research data that has already been collected. With both deductive and inductive approaches, it is important for HPE researchers to show they have engaged critically and comprehensively with theory in justifying their choice of theory (or theories). As such, our fifth set of considerations (outlined in Table 1 ) relates to considering when theory is used in the research process and associated implications.

Consider the complexities of how theory is written up

In the HPE research manuscript, theory can be presented in three different ways. In some papers, theory is introduced and described in the Background/Introduction section as a way of framing the research, revisited in the Methods as part of the data collection and analysis, and explained further in the Discussion in terms of the contributions and implications of using theory. This approach is common in both studies where theory is used deductively or inductively, highlighting the complexities of balancing what was done in the research process (which is highly flexible and non-linear) and the reporting of a research study (which demands a logical and linear approach). We discuss this aspect later. In other papers, theory is first presented in the Methods section as a lens for data interpretation and then in the Discussion section as a way of considering the significance of findings and implications. This is common in studies using an inductive approach but may run the risk of reviewers critiquing the transparency and consistency of a paper [ 26 ]. Finally, entry-level research mostly only refers to theory in the Discussion section as a way of highlighting the implications of a study, but this approach does not fully leverage the possibilities offered by the use of theory [ 1 , 2 , 3 , 4 ].

In reporting their work, researchers need to balance between what they have done in the research process (logic-in-use) with how they ‘formulate, articulate, analyse, or evaluate’ what they have done (reconstructed logic) [ 27 ]. Logic-in-use is a highly flexible and non-linear process involving juggling between the interrelated elements of ontology, epistemology, methodology, and axiology across the entire research process [ 9 ]. In contrast, reconstructed logic involves researchers developing linear and logical narratives about their work in which theory is often presented earlier as part of the framing of a study and separated from methodology and paradigm. Reconstructed logic means that even in studies where theory may have been used inductively and applied at the stage of data collection, a linear narrative can create an impression that the theory was known all along [ 28 ]. This highlights the complexities of balancing logic-in-use and reconstructed logic in the write-up phase. As advised earlier, consulting examples of original research articles can help ECRs to discern the different ways in which theory is presented in a research manuscript and how to report theory in a way that is fit for purpose for their research. So, our last set of considerations (outlined in Table 1 ) relates to considering the complexities of how theory is written up.

Using theory in HPE research holds significant benefits for the individual researcher, research teams and communities, and the discipline of HPE. Therefore upskilling in theory use is vital for all HPE researchers. We hope the guidance provided here supports new and emerging researchers across the globe to enhance their capacity to discern, enhance, and critique theoretical quality in HPE research.

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Kumar, K., Roberts, C., Finn, G.M. et al. Using theory in health professions education research: a guide for early career researchers. BMC Med Educ 22 , 601 (2022). https://doi.org/10.1186/s12909-022-03660-9

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Editorial by Kelly Henning;  Health Education Research , Volume 33, Issue 1, February 2018, Pages 1–3

Reducing 30-day readmission rates in a high-risk population using a lay-health worker model in Appalachia Kentucky by Roberto Cardarelli; Mary Horsley; Lisa Ray; et al.;  Health Education Research , Volume 33, Issue 1, February 2018, Pages 73–80

Using graphic warning labels to counter effects of social cues and brand imagery in cigarette advertising  by J Niederdeppe; D Kemp; E Jesch; et al.;  Health Education Research , Volume 34, Issue 1, February 2019, Pages 38–49

Exposure to fictional medical television and health: a systematic review  by Beth L. Hoffman; Ariel Shensa; Charles Wessel; et al.;  Health Education Research , Volume 32, Issue 2, April 2017, Pages 107–123

* All articles have been made freely available online until December 31, 2019 or have been published under an open access license.

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• Frontiers in Public Health
• Public Health Education and Promotion
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Insights in Public Health Education and Promotion: 2021

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Research Topics & Ideas: Healthcare

100+ Healthcare Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Tops & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your healthcare dissertation or thesis, check out Topic Kickstarter service below.

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15 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

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U.S. journalists’ beats vary widely by gender and other factors

The beats American journalists cover vary widely by gender and other factors, according to a new analysis of a Pew Research Center survey of nearly 12,000 working U.S.-based journalists conducted in 2022. The analysis comes amid continued discussion about the demographic composition of U.S. newsrooms .

The survey asked reporting journalists to identify up to three topic areas or beats that they cover regularly, 11 of which had large enough sample sizes to study. Men are far more likely than women to cover certain beats – especially sports – while journalists who are women are more likely than men to cover news about social issues, education and health.

Men account for 83% of the surveyed journalists who indicated that they cover sports, far higher than the 15% who are women. Men also account for majorities of those who cover political news (60%) and news about science and technology (58%).

By comparison, women are more likely than men to cover three of the 11 news beats studied: health, education and families, and social issues and policy. For instance, women account for nearly two-thirds (64%) of surveyed journalists who cover news about health, while only about a third (34%) are men.

The source of data for this analysis is a Pew Research Center survey of 11,889 U.S.-based journalists who are currently working in the news industry and say that they report, edit or create original news stories in their current job. The survey was conducted online between Feb. 16 and March 17, 2022.

Because there is no readily available list of all U.S. journalists, Center researchers relied on commercial databases of journalists based in the U.S., as well as supplemental lists of news organizations to create a broad and diverse sample of over 160,000 journalists from as many types of outlets and areas of reporting as possible. Although it is impossible to be certain every segment of the journalism profession in the U.S. is covered by the sample, the use of multiple databases and supplemental lists ensured that journalists from a variety of different reporting areas, news platform types, as well as outlet sizes and types – such as those who work for organizations that are intended to primarily reach a particular demographic group – were represented.

Propensity weighting was used to ensure that the responses of the 11,889 respondents aligned with the full sample of over 160,000 journalists with respect to job titles, media outlet type, freelance status and geographic location.

This analysis looks at the journalists who cover 11 topic areas or beats. In the survey, reporting journalists were asked to write down up to three topic areas they report on in a typical month. In the survey, reporting journalists are those who indicated that they have one of the following job titles: reporter, columnist, writer, correspondent, photojournalist, video journalist, data visualization journalist, host, anchor, commentator or blogger. About three-quarters of all journalists surveyed (76%) are reporting journalists.

Researchers coded these open-ended responses into distinct categories. Eleven of the coded topic areas (or beats) had enough reporting journalists in our sample to reliably study: crime and law, economy and business, education and family, entertainment and travel, environment and energy, government and politics, health, local and state, science and technology, social issues and policy, and sports. 

Refer to the topline  for the questions asked in the survey. For more information on the development of the sample of journalists or the survey weighting., please read the methodology .

This is the latest analysis in Pew Research Center’s ongoing investigation of the state of news, information and journalism in the digital age, a research program funded by The Pew Charitable Trusts, with generous support from the John S. and James L. Knight Foundation.

The remaining five beats studied – economy, crime and law, local and state, environment and energy, and entertainment and travel – are more evenly split between men and women journalists.

Overall, 51% of the reporting journalists surveyed are men and 46% are women. In the survey, reporting journalists are those who indicated that they have one of the following job titles: reporter, columnist, writer, correspondent, photojournalist, video journalist, data visualization journalist, host, anchor, commentator or blogger. About three-quarters of all journalists surveyed (76%) are reporting journalists.

Majority of journalists who cover entertainment, travel are freelancers or self-employed

Journalists’ beats also vary by their employment status – that is, whether they are freelance or self-employed journalists, or full- or part-time journalists at a news organization.

Entertainment and travel stands out as the only topic area in which a majority of those who cover it (57%) are freelance or self-employed journalists. Nearly half of journalists who cover science and technology (46%) are also freelancers or self-employed.

On the other hand, some beats are overwhelmingly covered by either full- or part-time employees of news organizations. For instance, 87% of reporting journalists who cover crime and law fall into this category.

Overall, about a third of the reporting journalists surveyed (34%) indicated that they are freelance or self-employed, compared with about two-thirds (65%) who are full- or part-time employees of a news organization.

Journalists’ beats vary somewhat by race, ethnicity

Journalists’ beats also differ modestly by other demographic factors, including race and ethnicity.

One reporting area particularly stands out by the race and ethnicity of the journalists who cover it: social issues and policy. Hispanic and Black journalists make up a greater portion of those who cover this beat (20% and 15%, respectively) than any other studied.

White journalists make up about half (53%) of those who report on social issues and policy, but they make up large majorities of the other 10 beats studied, including 84% of those who cover environment and energy. Asian journalists account for no more than 7% of those who cover any of the 11 beats studied.

Overall, 76% of all reporting journalists surveyed indicated that they are White, while 8% are Hispanic, 6% are Black and 3% are Asian. These figures align closely with previous research showing that a large portion of newsrooms’ employees are White , higher than the share of U.S. workers overall who are White.

Note: Here are  the questions used for the report , along with responses, and the survey  methodology .

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About one-in-six U.S. journalists at news outlets are part of a union; many more would join one if they could

U.s. journalists differ from the public in their views of ‘bothsidesism’ in journalism, twitter is the go-to social media site for u.s. journalists, but not for the public, journalists sense turmoil in their industry amid continued passion for their work, q&a: how and why pew research center surveyed almost 12,000 u.s. journalists, most popular.

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People think 'old age' starts later than it used to, study finds

Increases in life expectancy, later retirement could explain shift in public perception of when old age begins.

Middle-aged and older adults believe that old age begins later in life than their peers did decades ago, according to a study published by the American Psychological Association.

"Life expectancy has increased, which might contribute to a later perceived onset of old age. Also, some aspects of health have improved over time, so that people of a certain age who were regarded as old in the past may no longer be considered old nowadays," said study author Markus Wettstein, PhD, of Humboldt University in Berlin, Germany.

However, the study, which was published in the journal Psychology and Aging , also found evidence that the trend of later perceived old age has slowed in the past two decades.

Wettstein, along with colleagues at Stanford University, the University of Luxembourg and the University of Greifswald, Germany, examined data from 14,056 participants in the German Ageing Survey, a longitudinal study that includes people living in Germany born between 1911 and 1974. Participants responded to survey questions up to eight times over 25 years (1996-2021), when they were between 40 and 100 years old. Additional participants (40 to 85 years old) were recruited throughout the study period as later generations entered midlife and old age. Among the many questions survey participants answered was, "At what age would you describe someone as old?"

The researchers found that compared with the earliest-born participants, later-born participants reported a later perceived onset of old age. For example, when participants born in 1911 were 65 years old, they set the beginning of old age at age 71. In contrast, participants born in 1956 said old age begins at age 74, on average, when they were 65.

However, the researchers also found that the trend toward a later perceived onset of old age has slowed in recent years.

"The trend toward postponing old age is not linear and might not necessarily continue in the future," Wettstein said.

The researchers also looked at how individual participants' perceptions of old age changed as they got older. They found that as individuals aged, their perception of the onset of old age was pushed further out. At age 64, the average participant said old age started at 74.7. At age 74, they said old age started at 76.8. On average, the perceived onset of old age increased by about one year for every four to five years of actual aging.

Finally, the researchers examined how individual characteristics such as gender and health status contributed to differences in perceived onset of old age. They found that women, on average, said that old age started two years later than men -- and that the difference between men and women had increased over time. They also found that people who reported being more lonely, in worse health, and feeling older said old age began earlier, on average, than those who were less lonely, in better health, and felt younger.

The results may have implications for when and how people prepare for their own aging, as well as how people think about older adults in general, Wettstein said.

"It is unclear to what extent the trend towards postponing old age reflects a trend towards more positive views on older people and aging, or rather the opposite -- perhaps the onset of old age is postponed because people consider being old to be an undesirable state," Wettstein said.

Future research should examine whether the trend toward a "postponement" of old age continues and investigate more diverse populations in other countries, including non-Western countries, to understand how perceptions of aging vary by country and culture, according to the researchers.

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Materials provided by American Psychological Association . Note: Content may be edited for style and length.

Journal Reference :

• Markus Wettstein, Rinseo Park, Anna E. Kornadt, Susanne Wurm, Nilam Ram, Denis Gerstorf. Postponing old age: Evidence for historical change toward a later perceived onset of old age. . Psychology and Aging , 2024; DOI: 10.1037/pag0000812

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Development and Validation of Health Education Tools and Evaluation Questionnaires for Improving Patient Care in Lifestyle Related Diseases

Charu arora.

1 PhD Scholar, Department of Home Science, University of Delhi and Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Bipin Sinha

2 Senior Resident, Department of Medicine, Patliputra Medical College, Dhanbad, Jharkhand, India.

Anita Malhotra

3 Associate Professor, Department of Home Science, Lakshmibai College, University of Delhi, India.

Piyush Ranjan

4 Associate Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Lifestyle related diseases continue to be a significant burden on the health care system. Health education is a combination of educational strategies that promote voluntary adoption of healthy lifestyle choices and dietary behaviour. The use of simple and validated education and evaluation tools is now increasing in routine clinical practice to aid health status evaluation and communication between the patient, dietitian and the health care provider. Development of effective health education materials is a systematic process which starts with setting up the goals for education, followed by literature review and focus group discussion, content selection, designing the rough draft, seeking expert comments and validation. Questionnaire development should follow a logical and structured approach. Item generation should be based on extensive literature search and target group participation. Validation by the experts makes the questionnaire more meaningful, trustworthy and applicable. Considerable effort goes into designing and testing of these tools in order to ensure that they are effective. For enhancing clinical, dietetic and educational practice, it is pertinent to learn the process of developing these tools scientifically.

Introduction

Lifestyle related diseases such as diabetes; hypertension, obesity, Non Alcoholic Fatty Liver Disease (NAFLD) and coronary artery disease are on the rise worldwide and have now become the most important cause of disease related morbidity. The increasing prevalence of these diseases is attributed mainly to lack of physical activity, sedentary lifestyle and faulty dietary pattern including the consumption of fast food and sugar sweetened beverages [ 1 ]. Compliance to medical health practitioner’s prescription and dietitian’s advice for long lasting adoption of healthy lifestyle plays a central role in the management of lifestyle related diseases [ 2 ]. However, the patients often fail to follow the advice to make the necessary changes in their habits, which impedes the achievement of treatment goals [ 3 ]. To effectively impart such education, medical health practitioners and dietitians must understand and address the existing gaps in knowledge, attitudes, and practices of patients. Well designed and validated questionnaires can help them in this task. The purpose of this article is to give a comprehensive description of the process of construction and validation of health education tools as well as evaluation questionnaires. This article would be useful to general practitioners, dietitians and auxiliary health workers in improving compliance to and follow up of lifestyle related advice.

Health Education Tools and their Importance in Clinical Practice

Health education is a combination of educational strategies which promote voluntary adoption of healthy lifestyle choices and behaviour. Healthy lifestyle as defined by WHO is a lifestyle that involves eating lots of fruits and vegetables, reducing fat, sugar and salt intake and exercising [ 4 ]. Handbooks [ 4 , 5 ], guidelines [ 6 ], information leaflets/pamphlets [ 7 , 8 ] and booklets [ 9 - 11 ] are some of the traditional tools that provide health education to the masses. Websites [ 12 ], smart phone applications [ 13 ], blogs [ 14 ] and podcasts [ 15 , 16 ] are examples of newer methods which are popular in increasing health awareness among the youth.

These tools are useful in improving the overall knowledge of patients and their families about healthy lifestyle and their adherence to treatment. In clinical setting, these tools can be used as reinforcement by the physicians, dietitians and other auxillary health care workers during verbal communication with the patients [ 17 ]. Health education tools not only help in addressing the doubts and apprehensions of the patients [ 10 ] but also contribute immensely in teaching and research.

Health Education Tools - Basic Steps of Development

Education tool development is done in three steps [ Table/Fig-1 ]. First step is to define the purpose and goal of developing the education material. This can be done by conducting surveys, interviews and focus group discussions with a small group from the target population to identify the relevant items acceptable to the population [ 18 ]. All such sessions should be tape recorded and transcribed verbatim. The data so collected will guide in generation of the topics to be included in the tool. Literature review is important to justify the selection of the topics.

A schematic diagram showing stages of development of health education tool.

In second step, a preliminary draft is prepared by incorporating all essential items identified. The content of the draft should be easy to read and simple to understand. Interesting and relevant illustrations should be developed with the help of specialists to enhance the presentation and effectiveness [ 19 ]. This draft can be printed before sending it for expert opinion and validation.

The third step includes evaluation by independent experts from the selected field. The health education material needs proper validation before it is implemented on patients. Experts selected should have previous experience in health promotion activities and validation of education tools. These experts should comment on the adequacy and appropriateness of information and its presentation style, from the reader´s perspective. While evaluating the tool, they should also assess the flow and ease of understanding as well as simplicity of language. The Readability Index (RI), related to the level of schooling necessary to understand a given text, should be calculated using the Flesch reading ease formula [ 20 ]. If the score comes below 50, the text should be rewritten by reducing sentence size and replacing words. After this process the text should be proof read by a specialist. Conceptual mistakes (if any) should also be pointed out. Regarding illustrations, it is important to evaluate the appropriateness of the picture, graphs and charts and their placement with reference to the text. The recommendations given by experts at the end of validation process should be integrally accepted and incorporated in the education tool. The new version of the education material after corrections should be subjected to another edition, revision and layout process [ 17 ].

Besides, few subjects (usually 10-20) from the target group should be invited for pilot testing the tool and analysing it. They should be asked to review the vocabulary indicating the difficult terms, as well as the appropriateness of illustrations [ 21 ].

It is important to frequently revise the health education material according to the latest scientific innovations and new knowledge in that field [ 22 ].

Health Evaluation Questionnaires and their Importance in Clinical Practice

Evaluation is an important step in health care. It should be an integral part of the assessment process as it leads to quality improvement of clinical services. Questionnaire is a commonly used health evaluation instrument that helps in the measurement of a patient’s progress or lack of progress toward achievement of specified goals.

The use of questionnaires as a method of data collection in health-care research both at national and international level has increased in the past few years [ 23 ]. A questionnaire consists of a series of questions that help in gathering information from respondents. It has advantages over other methods of data collection as it is relatively quick to complete, economical and usually easy to analyse [ 24 ]. Self administered questionnaires can cover large sample size in a wide geographical area, access population which is sometimes difficult to reach and provide a good way to deal with sensitive topics, which are uncomfortable for many people to discuss face to face. A major drawback with questionnaires is that they are developed on the assumption that the researcher and respondents share similar understanding about language and interpret similar meaning from similar statements. Also, the response rate in a questionnaire may be low and they may only provide a snapshot of the situation rather than in-depth picture of the area of concern. Besides, questionnaires generate socially desirable responses at times [ 25 ].

Well-designed questionnaires can measure knowledge, attitudes, emotion, cognition, intention and behaviour. They capture the self-reported observations of the individual and are commonly used to measure patient perceptions of many aspects of health care. In a health care setup, questionnaires can be used in many ways such as describing a patient’s experiences with routine or new procedures, examining progress with the implementation of medical and dietary intervention and identifying areas for improvement by conducting periodic evaluations and identifying barriers to compliance to medical and dietary advice and prescriptions [ 26 ].

Basic Steps in Developing A Questionnaire

Questionnaires are commonly used in medical and nutrition education. Still there is not much clarity on how to design and construct these questionnaires for use in medical field [ 27 ]. As a result, many of these poorly designed questionnaires fail to achieve the purpose that they are designed for. Development of a questionnaire is a systematic process that involves following steps:

Step 1: Review of literature : One should start making the questionnaire only after reviewing all the existing literature on the selected topic. This will help to identify any already made questionnaire in that area, which can be modified or adapted for the desired purpose. This will also help in determining the construct of the questionnaire [ 27 ].

Step 2: Conducting interviews and focus group discussions : Knowing how well the target population understands and conceptualizes the disease and its treatment is instrumental in the development of a questionnaire. Therefore, it is important to understand the perspectives of the target group about the disease and its treatment. Interviews and focus group discussions are conducted for the purpose where active participation and interaction of the subjects is encouraged. The procedure should be repeated until no new ideas are available from the groups. All discussions should be recorded. The results of literature review and focus groups should be merged [ 27 ].

Step 3: Item generation : This step comprises of creating a list of items that adequately represent the construct of the questionnaire in a simple and lucid language. A lot of pilot work goes into creation of a list of items during a questionnaire development. Sequencing of words and content development should be given maximum attention. Questions should be formulated keeping in mind the characteristics of a good questionnaire [ Table/Fig-2 ]. Consideration should be given to the order in which items are presented. Begin the questionnaire with simple, non threatening questions to help capture the interest of the respondent [ 28 ]. This should be followed by transition questions that are used to make different areas flow well together. Skips include questions similar to “If yes, then answer question (A) If no, then continue to question (B).” Too many jumps will confuse the respondent and may discourage them from continuing with the questionnaire. Difficult questions should be put towards the end. Personal questions should be at the closing of the questionnaire as they may make the respondents uncomfortable and may deter them from finishing the questionnaire [ 29 ]. Deciding the number of items is also important. The ideal number of items is determined by several factors, depending on the complexity of the questionnaire design. The most crucial element in item generation is to revisit the research questions again and again, to ensure that items reflect these and remain relevant [ 30 ].

Characteristics of a good questionnaire.

Scales and ranges in a questionnaire: While developing a new item/question, it is important to establish which scale and response format is to be used. Different scales and response styles produce different types of data which influence the analysis options [ 23 ].

Frequency scales may be used when it is important to establish how often a target behaviour or event has occurred. The example of a food frequency questionnaire explains the frequency scale where the subject needs to answer his behaviour regarding food consumption in terms of frequencies such as daily, weekly, fortnightly, monthly, rarely etc. Knowledge questionnaires may be helpful when evaluating the outcome of a patient education programme. For example, the change in knowledge of subjects about ways to control blood pressure before and after a lifestyle counselling session can be analysed by administering a knowledge questionnaire.

Some questionnaires measure separate variables such as questions on preferences (food preferences), behaviours (exercise behaviours), and facts (knowledge about symptoms of a disease). Other questionnaires have questions that are aggregated into either a scale or index, include questions that measure traits, attitudes (attitude towards alcohol), etc.,

Four types of response scales [ 31 ] for closed-ended questions exist:

• Dichotomous: Here, the respondent has to choose between two options (yes and no, true and false, agree and disagree).
• Nominal-polytomous: In this case, the respondent is asked to select from more than two unordered options such as level of education (high school, intermediate, graduate, post graduate).
• Ordinal-polytomous: This scale asks the subject to choose between more than two ordered options such as ranking foods in order of preference (from best to worst).
• (Bounded) Continuous: Here, the respondent is presented with and is asked to choose from a continuous scale such as attitude towards exercise (strongly agree, agree, neither agree nor disagree, disagree and strongly disagree).

In open-ended questions, the respondent’s answer is coded into a response scale afterwards. In clinical practice and research, Likert-type/frequency scales are most commonly used scales to measure attitudes and opinions. They offer fixed choice responses to the respondents. Agreement/disagreement can be measured using these ordinal scales. Generally the respondents have to choose between five, seven or nine already coded responses. These odd numbered scales provide a center point that is neutral, which means neither agree nor disagree [ 32 ].

Step 4: Demonstrating validity and reliability of a questionnaire: Validity refers to whether a questionnaire is measuring what it is supposed to measure [ 33 ]. Validity is of two types. Internal validity measures the extent to which questions within an instrument agree with each other. External validity measures the ability of the questionnaire to extrapolate the findings of the sample tested, to a large population. Internal validity confirms that a subject will respond to similar questions in a similar way and also affects the likelihood of producing false positives and false negatives.

Validation of a questionnaire is an important step before it can be used in population. It not only ensures its reliability but also improves it further in terms of usability and credibility. Usually, a validated questionnaire is better in terms of simplicity and precision. Besides, it is adequate for the problem intended to measure and capable of measuring the change [ 34 ].

In a questionnaire, certain aspects of validity should be ensured before its application. First is content validity (or face validity) i.e., whether the items or questions cover the full range of issues and topics relevant to the subject area. It ensures balanced coverage of different topics within the questionnaire. Second is criterion validity i.e., the extent to which a measure is related to an outcome. Another important one is construct validity i.e., extent to which a questionnaire can correctly measure the cause and effect link between a measure and some other factor [ 34 ] [ Table/Fig-3 ].

A schematic diagram to show types of validity.

To make sure that the content is valid, many different sources are utilized for item generation. First of all extensive literature review is done. This is followed by consultation with experts in that subject area. Also, a few respondents are involved in the whole process. Content Validity Ratio (CVR) is a method that is specifically designed to check the content validity of health based questionnaires [ 35 , 36 ]. This method helps to identify which items should remain in the questionnaire and which should be discarded. Content validation forms should be developed and given to the experts for this phase [ 37 ].

Criterion validity is often divided into concurrent and predictive validity. Concurrent validity refers to the ability of the questionnaire to measure current performance. This can be established by correlating the performance of the questionnaire with concurrent behaviour. Predictive validity refers to the ability of the questionnaire to measure future performance. To establish predictive validity of the tool, it is needed to correlate performance of the tool, with behaviour in future [ 38 ].

Construct validity, on the other hand, refers to expert opinion concerning whether the scale items represent the proposed domains and concepts the questionnaire is designed to measure. To establish construct validity, it is required to correlate the performance of the tool with the performance of a pre-existing established tool.

Every questionnaire may not have all kinds of validity. Therefore, no questionnaire can ever be fully “validated.” It can only be validated for a certain patient population, under certain conditions. Therefore, it is important to validate each questionnaire according to the target population and purpose of data collection [ 39 ].

Reliability is the degree to which a questionnaire produces similar results each time it is administered. It is essential that the reliability of a developing questionnaire can be demonstrated. Cronbach’s α statistic is the most common method used to demonstrate reliability. Explaining Cronbach’s α statistic is beyond the scope of this article. Authors advice readers to consult statistician for in-depth knowledge.

Administering a Questionnaire

Broadly, the questionnaires can be administered in the following ways:

• Interviewer administered questionnaires : There is face to face interaction between the interviewer and the respondent, where the interviewer asks oral questions one by one. These are expensive to conduct and involve direct interaction with the participant.
• Self administered questionnaires : Here the respondent himself/herself reads the questions and responds according to his/her understanding. This is a cheaper way of data collection.
• Computer administered questionniares : The questions are asked through the computer. These are restricted to participants who have access to a computer and this can become a bias in the data.

To conclude, effective health education tools and evaluation questionnaires can aid the medical and dietetic practitioners in developing a patient centered plan to implement and maintain management plan. These tools help in improving patient outcomes in terms of compliance to medical and dietetic advice. Development of individualized and tailor made health education tools and evaluation questionnaires can be a boon not only to improve patient care but also to promote voluntary adoption of healthy lifestyle choices and dietary behaviour.

Financial or other Competing Interests

Administrator Stem Cell and Regenerative Medicine Center

• Madison, Wisconsin
• SCHOOL OF MEDICINE AND PUBLIC HEALTH/CTR FOR STEM CELL REGENERATIVE MEDICINE
• Administration
• Partially Remote
• Staff-Full Time
• Opening at: Apr 23 2024 at 11:40 CDT
• Closing at: May 7 2024 at 23:55 CDT

Job Summary:

The UW Madison Stem Cell and Regenerative Medicine Center (SCRMC) operates under the School of Medicine and Public Health (SMPH) and the Office of the Vice Chancellor for Research and Graduate Education (OVCRGE). The SCRMC provides a central point of contact, information and facilitation for all stem cell research activities on campus. The Center's mission is to advance the science of stem cell biology and foster breakthroughs in regenerative medicine through faculty interactions, research support and education. Dr. Timothy Kamp (Department of Medicine) is director of the Center and directly supervises this position. The SCRMC Administrative Specialist will report to the SCRMC Director. This position will coordinate complex daily activities of the Center, SCRMC faculty, members and students, and will communicate effectively with external stakeholders. This position is responsible for the center's program administration and support activities, including maintaining and updating membership lists and communications with memberships, coordinating promotional/informational event announcements, program bulletins, educational seminars, courses, meetings and professional development opportunities. This position serves as the primary contact person for over 100 faculty and staff members of the Center. This position requires the ability to keep confidential information sensitive to the mission and work of the Center. This position also assists the SCRMC public communications and outreach specialist as needed.

Responsibilities:

• 25% Implements and executes established policies and procedures for a designated work unit to adhere to unit objectives and to align with established strategies
• 30% Schedules logistics and secures resources for a designated work unit to contribute to the day-to-day operational success
• 5% Analyzes data and trends, compiles progress reports, and provides appropriate recommendations or conclusions in support of the assigned operational work unit(s)
• 10% Assists, recommends, and advises staff on unit or program administrative issues, personnel matters, and budgetary problems
• 10% Serves on committees and attends meetings, representing the interests of the unit or program
• 10% Assist with weekly Campus Stem Cell Seminar, CRB 625, Fall Conference and Wisconsin Stem, Cell Symposium
• 5% Support regenerative medicine focus groups
• 5% Purchasing/P-Card use and documentation

Institutional Statement on Diversity:

Diversity is a source of strength, creativity, and innovation for UW-Madison. We value the contributions of each person and respect the profound ways their identity, culture, background, experience, status, abilities, and opinion enrich the university community. We commit ourselves to the pursuit of excellence in teaching, research, outreach, and diversity as inextricably linked goals. The University of Wisconsin-Madison fulfills its public mission by creating a welcoming and inclusive community for people from every background - people who as students, faculty, and staff serve Wisconsin and the world. For more information on diversity and inclusion on campus, please visit: Diversity and Inclusion

Preferred Bachelor's Degree

Qualifications:

- 2 years administrative and/or office experience required - Experience with Microsoft office, proficient in Microsoft Excel and Word preferred - Experience with computer software, specific experience in accounting database development, document production, print media, electronic publishing, page design, web development and web publishing (Photoshop; Acrobat) preferred

Full Time: 100% This position may require some work to be performed in-person, onsite, at a designated campus work location. Some work may be performed remotely, at an offsite, non-campus work location.

Appointment Type, Duration:

Ongoing/Renewable

Minimum $51,000 ANNUAL (12 months) Depending on Qualifications

Additional Information:

The position requires a person with the ability to work with general direction, excellent administrative, organizational and interpersonal skills as well as considerable independence in planning and implementation. Knowledge of University, State and Federal fiscal and administrative rules, regulations and procedures including purchasing and travel. University sponsorship is not available for this position. The selected applicant will be responsible for ensuring their continuous eligibility for employment in the United States on or before the effective date of the appointment. UW-Madison is not an E-Verify employer, and therefore, is not eligible to employ F1-OPT STEM Extension participants.

How to Apply:

To apply for this position, please click on the "Apply Now" button. You will be asked to upload a current resume/CV and a cover letter briefly describing your qualifications and experience. You will also be asked to provide contact information for three (3) references, including your current/most recent supervisor during the application process. References will not be contacted without prior notice.

Kassie Hefty [email protected] 608-262-2710 Relay Access (WTRS): 7-1-1. See RELAY_SERVICE for further information.

Official Title:

Administrative Specialist(AD006)

Department(s):

A53-MEDICAL SCHOOL/CTR STEM CELL REG MED/GEN

Employment Class:

Academic Staff-Renewable

Job Number:

The university of wisconsin-madison is an equal opportunity and affirmative action employer..

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