Setting global research priorities for child protection in humanitarian action: Results from an adapted CHNRI exercise
Setting global research priorities for child protection in humanitarian action: Results from an adapted CHNRI exercise
Laura Gauer Bermudez 0 1
Katharine Williamson 1
Lindsay Stark 1
0 Columbia University School of Social Work , New York , New York, United States of America, 2 Save the Children , London , United Kingdom , 3 Department of Population and Family Health, Columbia University Mailman School of Public Health , New York , New York, United States of America, 4 George Warren Brown School of Social Work, Washington University in Saint Louis , St. Louis, Missouri , United States of America
1 Editor: Emma Sacks, Johns Hopkins School of Public Health , UNITED STATES
Data Availability Statement: All relevant data are
within the paper and its supporting information
Funding: The study was made possible with funds
from Save the Children provided to the Alliance for
Child Protection in Humanitarian Action, https://
www.savethechildren.net. Co-author, Katharine
Williamson, is a co-leader of the Alliance's AME
task force and is also an employee of Save the
Children, serving as their Senior Humanitarian
Child Protection Advisor.
Armed conflict, natural disaster, and forced displacement affect millions of children each
year. Such humanitarian crises increase the risk of family separation, erode existing support
networks, and often result in economic loss, increasing children's vulnerability to violence,
exploitation, neglect, and abuse. Research is needed to understand these risks and
vulnerabilities and guide donor investment towards the most effective interventions for improving
the well-being of children in humanitarian contexts.
The Assessment, Measurement & Evidence (AME) Working Group of the Alliance for Child
Protection in Humanitarian Action (ACPHA) identified experts to participate in a research
priority setting exercise adapted from the Child Health and Nutrition Research Initiative
(CHNRI). Experts individually identified key areas for research investment which were
subsequently ranked by participants using a Likert scale. Research Priority Scores (RPS) and
Average Expert Agreement (AEA) were calculated for each identified research topic, the top
fifteen of which are presented within this paper.
Intervention research, which aims to rigorously evaluate the effectiveness of standard child
protection activities in humanitarian settings, ranked highly. Child labor was a key area of
sector research with two of the top ten priorities examining the practice. Respondents also
prioritized research efforts to understand how best to bridge humanitarian and development
efforts for child protection as well as identifying most effective way to build the capacity of
local systems in order to sustain child protection gains after a crisis.
Competing interests: The authors have declared
that no competing interests exist.
Abbreviations: ACPHA, Alliance for Child
Protection in Humanitarian Action; AEA, Average
Expert Agreement; AME, Assessment,
Measurement & Evaluation Working Group;
CHNRI, Child Health and Nutrition Research
Initiative; CP AoR, Child Protection Area of
Responsibility; RPS, Research Priority Scores;
UNHCR, United Nations High Commissioner for
Refugees; NGO, Non-Governmental Organizations;
UN, United Nations; UNICEF, United Nation
Rigorous, scientific research that assesses the scope of child protection risks, examines the
effectiveness of interventions to improve child well-being, and translates evidence to
practice is critical. Findings from this research priority setting exercise offer guidance for a global
research agenda on child protection in humanitarian settings, encouraging cooperation
among donors, implementers, and academics to pursue a coordinated approach to
The number of people affected by humanitarian crises is on the rise, perpetuated by armed
conflict and natural disasters [
]. In 2017, there were over 65 million forcibly displaced people,
over half of whom were under the age of 18 [
]. In addition, over one billion children live in
countries affected by armed conflict [
]. Environmental factors, including climate change, are
likely to increase the number of conflicts and intensify the severity of natural disasters [4±5].
Armed conflicts and large-scale disasters increase the potential for family separation and the
erosion of existing support systems, putting children at risk of abuse, exploitation, violence,
and neglect. The widespread economic shocks that often accompany humanitarian crises
create further vulnerabilities for children when households employ negative coping strategies to
manage economic stress. In Lebanon, where over one million Syrian refugees have been
registered with the United Nations High Commissioner for Refugees (UNHCR), child marriage
and child labor have been reported as families struggle financially [6±7]. Children in
circumstances of economic and physical insecurity are also at risk of child trafficking, sexual
exploitation, and recruitment by armed forces and extremist groups.
Within these contexts, child protection experts in non-governmental organizations (NGO),
multilateral institutions such as the UN Children's Fund and the United Nations High
Commissioner for Refugees, work to prevent and respond to incidents of abuse, neglect,
exploitation, and violence against children. These efforts can take the form of broader
systemsstrengthening interventions that seek to build the capacity of national actors to implement
effective social support systems that care for children and families, both in formal and informal
spheres. As a complement to systems strengthening, child protection initiatives may also take
the form of direct implementation, such as the establishment of ªChild Friendly Spaces (CFS)º
that allow children safe zones to play, parenting trainings that emphasize alternatives to
physical punishment, or family tracing and reunification for unaccompanied or separated children.
Yet, the assumptions that drive such child protection efforts in humanitarian practice have not
yet been fully based on scientific evidence. Protection risks are often estimated and prioritized
based on anecdotal accounts [
], definitions of child protection concepts are often not
], and there is scant evidence on the effectiveness of many of the sector's universally
agreed upon standard interventions [10±12].
To begin addressing these gaps in empirical research within the sector of child protection
in humanitarian contexts, a research priority setting exercise, adapted from the Child Health
and Nutrition Research Initiative (CHNRI), was undertaken to identify and rank research
priorities. This manuscript presents the process and results of this participatory ranking
methodology designed to guide future research investment.
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The Child Health and Nutrition Research Initiative (CHNRI) was designed as a tool to help
guide policy and investment in global health research, specifically children's health. CHNRI
has since been used to establish research priorities across a broad array of global health
disciplines [13±20]. The method is comprised of four stages (i) determining the boundaries of
investigation and creating evaluation criteria; (ii) obtaining and systematically listing input
from key stakeholders on critical priorities/tasks (referred to as ªresearch questionsº) to
address gaps in sectoral evidence or knowledge; (iii) enlisting stakeholders to rank the research
questions based on a pre-defined set of evaluation criteria; (iv) calculation of research priority
scores and agreement between experts (Fig 1]. A more detailed explanation of the CHNRI
method has been published elsewhere [21±23].
The present study was commissioned by the Assessment, Measurement and Evidence
Working Group of the Alliance for Child Protecton in Humanitarian Action (ACPHA) and
was informed by prior consensus-building efforts in the sector [24±25]. In collaboration with a
Lead Researcher, the CHNRI method was adapted to prioritize research topics in the sector of
child protection in humanitarian settings. For the purposes of this exercise, a `humanitarian
setting' was defined as ªacute or chronic situations of conflict, war or civil disturbance, natural
disaster, food insecurity or other crises that affect large civilian populations and result in
significant excess mortalityº [
]. The goal of `child protection' efforts are ªto protect children from
abuse, neglect, exploitation, and violenceº [
]. And `children' were defined as ªindividuals
under the age of 18º [
Experts working on issues of child protection in humanitarian settings were then invited to
take part in semi-structured interviews to discuss the gaps in knowledge and evidence that
Fig 1. Research priorities setting exercise flow diagram.
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existed within the sector and to generate research priorities to address these gaps. Forty-seven
experts participated in this first round of evidence generation with representatives from
NonGovernmental Organizations (NGOs), United Nations (UN) agencies, donor agencies, and
research institutions. Experts were initially identified through three coordination bodies±the
Alliance for Child Protection in Humanitarian Action (ACPHA), the Child Protection Area of
Responsibility (CP AoR), and UNHCR with the network extended through snowball sampling.
Respondents were strategically diversified to include inputs from those involved in various
child protection job functions including implementation, coordination, policy development,
and academia from a range of geographic locations (Table 1]. Recruitment continued on a
rolling basis and ended once data saturation, defined as the point at which no new data were
being generated, was achieved. The final sample was consistent with previous research that
identified 45±55 as the number of experts at which collective opinion stabilizes [
Aligned with prior CHNRI studies in humanitarian contexts [
], interviews were held via
Skype with experts notified in advance that they would be requested to provide their opinions
on the most important areas for investment to improve the state of evidence in the field of
child protection in humanitarian settings in the next 3±5 years. Participants were encouraged
to follow up by email in the event they were able to generate further ideas after the interview
Through an iterative process, the Lead Researcher then collated 24 hours of interview notes
to identify 90 unique research priorities, condensing interrelated research ideas and
simplifying concepts for use in the ranking exercise. The priorities were then thematically organized
into the following pre-determined themesÐEpidemiological Research; Policy and Systems
Research; and Intervention Research (Table 2]. The research team provided review and
consensus on the themes and categorization after which the areas for research were listed within
the online survey. The survey was pilot tested by individuals who were not involved in the
development of research questions but who had general knowledge of humanitarian concepts
and survey design. Further, to ensure that question order did not bias results, we implemented
a page randomization that shuffled page order within the survey for each new respondent.
Experts who participated in the interview process were invited to take part in the online
ranking portion of the prioritizatio exercise. Two additional experts who were either not
previously available or who reached out to participate after the period for interviews had passed,
were also invited to take part in survey.
Each of the 90 research priorities were ranked on four criteria: (i) Relevance±research will
support learning that contributes to the prevention and response to abuse, neglect,
exploitation, or violence in humanitarian settings; (ii) Feasibility±research is feasible to conduct in an
ethical way; (iii) Originality±research will generate new findings or methods; and (iv)
Applicability±research will be readily applied to programs and policies. Relative weights were not
assigned to scoring criteria. For each research question, participants were offered six possible
responses: strongly agree (5 points); agree (4 points); undecided (3 points); disagree (2 points);
strong disagree (1 point); and insufficiently informed (considered non-applicable/no
response). The scoring matrix was a deviation from past CHNRI studies which typically
offered four possible responses±yes (1 point), no (0 points), undecided (0.5 points), and
insufficiently informed/no response. In the development of the present research design, the study
team elected to use a full Likert scale to allow for greater granularity when analyzing scores.
Aligned with the CHNRI methodology [13±20], every research question was provided a
priority score under each of the four judging criterion, calculated by taking the point totals and
dividing them by the maximum number of points available, after excluding from the
denominator those who did not answer the question or reported they were insufficiently informed, a
percentage was calculated [
]. For each question, the overall Research Priority Score (RPS)
was then calculated by taking the mean of the total priority scores for each judging criterion,
as calculated above. Research questions were then ranked from highest to lowest on overall
priority scores and the top fifteen presented in Table 3. Standard deviations for RPS are also
included to show the variation between total priority scores for each judging criterion
(Table 3, S1 Annex).
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Relevance Feasibility Originality Applicability
In addition, the Average Expert Agreement (AEA) was calculated for each research
question. In order to obtain AEA values, we consolidated ªstrongly agreeº and ªagreeº as well as
ªstrongly disagreeº and ªdisagreeº. For each judging criterion, the number of modal responses
was then divided by the total number of scorers for that question, again excluding those who
did not answer the question or who reported they were insufficiently informed on the research
question being assessed. Following this calculation, the ratios were then summed and divided
by the number of judging criteria.
Both RPS and AEA were calculated for the entire group of respondents as well as for
subgroups, in order to analyze differences in priorities for those located in field settings as
compared to those based in non-operational settings. Data were analyzed using Microsoft Excel.
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Formal ethics review is usually not requested for undertaking CHNRI exercises [13±20] as the
exercise does not involve personal or otherwise sensitive data. Participants were solicited via
established professional networks whose purpose is to facilitate and enable
information-sharing. Prior to participation in initial Skype interviews, all participants were informed on the
nature of the research and the anonymity of their feedback.
Of the 49 respondents invited to take part in the online ranking, 41 experts participated,
eliciting a response rate of 83.7 percent. Research questions from all three of the research domains
(epidemiological research; policy and systems research; and intervention research) featured in
the top 15 research priorities. Intervention research was the most predominant domain voted
upon by experts with 8 of the top 15 priorities identified falling within this realm. Policy and
systems research followed with 5 priorities and epidemiologic research with only 2 featured
priorities ranking in the top 15 (Table 3).
The range of overall RPS was 63.28 to 86.33, with the highest ranked priority being the
rigorous evaluation of the effectiveness of cash-based social safety nets to improve child
wellbeing. Within the top 15 priorities, RPS ranged from 80.70 to 86.33. Intervention research
which aims to rigorously evaluate the effectiveness of standard child protection activities
provided in humanitarian settings ranked highly. Two questions concerning child labor,
specifically estimating the prevalence and understanding the effectiveness of interventions to reduce
the practice, ranked in the top ten priorities. Respondents also prioritized research efforts to
understand how best to mobilize local systems, including the local social service workforce
and para-social work models, in order to sustain child protection gains after international
actors have departed a crisis.
AEA scores ranged from 41.55 to 85.63, representing the percentage of respondents who
provided the same score on a research priority (averaged across four judging criteria). For the
top 15 research investment options, AEA ranged from 69.04 (to build the capacity of child
protection sector staff in empirical research design and data analysis planning) to 85.75 (to
evaluate the effectiveness of interventions to reduce child labor) (Table 3). We found higher levels
of respondent agreement among research questions with higher RPS rankings, demonstrating
that a certain level of consensus was attained in order for research topics to be prioritized in
the higher ranks (Fig 2).
Standard deviations (SD) were also analyzed in order to assess variation between the
judging criterion. Among the top 15 reserch priorities, SDs ranged between 2.5 and 5.4 with the
exception of the evaluation of psychosocial programming with an SD of 8.2 due to the
comparatively lower score provided on Originality. This is likely due to the recent work on this
particular topic that has been widely circulated [
] and therefore was deemed less original in the
When comparing all RPS scores among respondents who resided within an operational
setting versus those who did not, there was a correlation co-efficient of 0.32, indicating a weak
but positive association. The top ten research priorities differed between the two groups
(Table 4). With the exception of rigorously evaluating family strengthening programs, which
ranked highly for both groups of respondents, there were no other priorities that jointly
ranked among the top ten. For field-based respondents, the most important initiative was to
identify best practices for bridging humanitarian and development initiatives for child
protection system strengthening. Field-based respondents tended towards the identification of best
practices while also prioritizing capacity building for child protection sector staff in empirical
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Fig 2. Top ten research priorities comparing RPS & AEA.
research design and data analysis planning. In contrast, respondents who were not based in
operational settings showed greater enthusiasm for the rigorous evaluation of interventions,
with an examination of the effects of cash-based social safety nets on child well-being
outcomes ranking highest.
The limitations to rigorous research on child protection in humanitarian crises are notable,
with harsh operational conditions, short project cycles, and inadequate funding all considered
hindrances to scientific inquiry on child protection within these contexts [31±32]. However,
recent efforts have begun to demonstrate that robust social science methodologies within the
sector are both needed and possible [33±35]. This prioritization exercise, which is among the
first known systematic inquiries on research investments for child protection in humanitarian
contexts using the CHNRI methodology, offers initial insight on the research interests and
evidence needs of sector experts.
Intervention research comprised three of the top four research priorities, aligning with
many previous CHNRI studies that have similarly found intervention research to be of
importance to stakeholders [
]. As previously noted, there is a dearth of rigorous evaluation to
determine the effectiveness of common child protection interventions in humanitarian
settings. The lack of quantitative data to document intervention effectiveness inhibits the ability
of humanitarian actors to design evidence-based programs, a hindrance increasingly
problematic for funding appeals and policy advocacy. This prioritization suggests that understanding
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intervention effectiveness is of particular interest to the sector, ranging from examinations of
family-strengthening to capacity-building interventions to activities aimed at reducing child
labor. Because the sample more heavily represents individuals in technical advisory and other
operational capacities, the interest in intervention research most visibly highlights the needs of
practitioners to have their programming rigorously tested and evaluated with respect to child
As the top priority among both intervention research topics and the entire ranking exercise,
understanding the effects of cash-based social safety nets on child well-being outcomes has
emerged as highly importance for the sector. Cash transfers have gained prominence as
multiple studies have found them effective in improving the welfare of children, including through
improved health and nutrition outcomes as well as increased educational attainment [37±39].
The assumption driving the proliferation of cash-based social safety net interventions in
humanitarian contexts is that they are an effective way of mitigating crisis-induced economic
shocks, thereby preventing the use of coping strategies that may have negative effects on
children such as school drop-out, child labor, and family separation. Yet, these assumptions have
not been fully tested within disaster, conflict-affected, or displacement contexts, environments
where children face unique risks and vulnerabilities. Further, the majority of existing evidence
on the effects of cash transfers do not examine child protection outcomes such as reductions
in violence, abuse, and exploitation, information of great interest to sector experts.
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In addition to understanding the effectiveness of singular child protection interventions on
child-well-being outcomes, experts indicated a need to also evaluate multi-sectoral
interventions, considering this one of the highest priorities for research. A relatively broad mandate,
this methodological research priority underscores the need for study designs that allow for the
rigorous evaluation of multiple components within increasingly complex program designs,
including analyses on how various components interact with one another. Such research
endeavors are inherently more complicated, yet recent guidance from the global health sector
has shown this to be a priority that spans disciplines within development and humanitarian
Similarly, as multi-sectoral and interdisciplinary interventions are prioritized by funders,
experts within this study have identified a need to quantitatively demonstrate the added value of
child protection interventions when mainstreamed within other sectors, such as health,
nutrition, or education. Prior research on the effects of nutrition supplementation and
play/stimulation on stunted children in Jamaica provides an example of how social scientists have captured
the additive effects of non-sector related interventions [
]. If protection interventions are
found to be effective in improving non-protection related outcomes for children, this type of
evidence would support an argument that child protection considerations and/or program
components are necessary to achieve desired results in other areas of humanitarian relief.
Child labor in humanitarian settings was also a common theme with both intervention
effectiveness and prevalence data among the top 10 priorities for research investment. Similar
to cash transfers, child labor has been examined across multiple development settings [44±46],
however, data from humanitarian contexts is extremely sparse and generally limited to
anecdotal information. As urban environments have become a more common setting for
humanitarian crises, there is an increased risk that children will be used for begging, street vending,
and other forms of exploitation [47±48]. There is a need to understand the prevalence,
dynamics, and effective interventions to reduce this protection risk for children who have been
displaced as well as children from affected host communities.
In order for child protection programming to be more responsive to current humanitarian
contexts, experts felt that there was value in 1) better understanding the protection risks of
children with disabilities (particularly non-observable disabilities) and 2) translating any
existing evidence on implementing humanitarian programs in urban settings into more tangible
guidance for CP practitioners. Disability inclusion has gained traction as a critical component
within humanitarian assistance, however, experts noted this work to primarily address
physical disabilities where programmatic accommodations are often tangible and straightforward,
such as the fitting and distribution of assistive devices. In contrast, many experts noted feeling
ill-equipped to properly serve children with cognitive and intellectual disabilities, agreeing that
an examination of the protection risks for children with disabilities, particularly
non-observable disabilities, should be prioritized.
Similarly, experts felt more guidance on child protection programming in urban
humanitarian crises would be beneficial. Indeed, as rapid urbanization has resulted in more densely
population cities and towns, the potential impacts of a humanitarian crisis increase,
particularly in areas with weak infrastructure and insufficient governance [
]. The Syrian refugee
crisis has seen over 5 million people flee to neighboring countries, seeking refuge predominately
in the cities and towns of Lebanon and Jordan with another 6 million internally displaced
within Syria, again primarily in urban and peri-urban settings [
]. This trend differs from
past decades of humanitarian assistance that was largely provided within camp-based settings,
requiring a new framework for understanding how best to support children in crisis. Other
actors within humanitarian response have begun to give this issue greater attention in the past
several years [51±52] enabling the identified priority of secondary literature review and as
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relevant, the translation and integration of evidence into child protection strategies and
Localization and sustainability were also key themes. Within the top 15 research priorities,
experts conveyed a need to identify best practices for both engaging the local social service
workforce in emergency settings and establishing sustainable para-social work models such
that structures will exist past the duration of humanitarian intervention. At the same time,
respondents would like to understand best practices for bridging humanitarian and
development initiatives for child protection systems strengthening. Taken together, these items
demonstrate a desire to understand how best to engage local social service structures (formal and
informal) and connect the work done during a crisis to a longer-term development agenda.
When scrutinizing the findings further, three trends emerged. First, among the top 15
research priorities, participants routinely scored research questions much higher for relevance
than originality. It is speculated that this score variation may be a result of recent efforts by the
sector to discuss and advocate for a more robust evidence base in humanitarian contexts [53±
55]. The relatively frequent discussion about these evidence needs may have made a number of
research questions appear unoriginal to participants yet still highly relevant because the
research had yet to be carried out. This finding highlights the readiness of child protection
experts to move forward an actionable research agenda for humanitarian settings.
Next, there were notable differences in the priorities of field and non-field based staff with
only one research topic ranking within the top ten for both sub-groups (rigorously evaluate
the effectiveness of family strengthening interventions to improve child well-being). As
compared to non-field based respondents, those residing within an operational setting were less
likely to identify rigorous evaluation within their top priorities. Instead, these respondents
tended towards the identification of best practices, a logical reaction given that such research
would presumably result in straight-forward guidance to program design. At the same time,
field-based staff highly ranked capacity building in empirical research design and data analysis
planning for the child protection sector, demonstrating a desire to build the skills required to
further evidence generation.
Lastly, our study explored research topics within the professional sector of ªchild protection
in humanitarian settingsº, which had a rather expansive purview. As such, some of the
research priorities identified by experts were similarly broad in scope. It is our hope that as the
sector progresses in the collection and translation of rigorous evidence that future priority
setting exercises on child protection in humanitarian settings will be able to focus on particular
needs within narrower sub-specialties.
The CHNRI method is based on purposive sampling where individuals are invited to
participate based on their expertise in a given field. This method relies on a non-representative
sample to aggregate knowledge and experiences. The findings are therefore limited to the
perceptions of a discrete group of individuals and it is possible that additional areas for research
investment may have emerged if a larger sample was recruited though, as earlier noted, prior
quantitative work has demonstrated collective opinion to stabilize with as few as 45±55
], however, this finding was based on binary ªyesº or ªnoº responses as opposed to
the Likert scale implemented in this project. Further, given the low-cost and replicability of the
procedure, it is attractive to a variety of sectors as a means of fostering transparency and
enhancing systematization in the creation of a research agenda.
In our study. non-field based staff were more likely to respond to requests for interviews
and as such, had greater representation within the study (Table 1). This created a certain level
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of bias towards the insights and experiences of child protection experts currently based in
non-operational settings. When secondarily analyzing results based on whether respondents
resided in operational or non-operational settings, we did find variation in the prioritization
of research items (Table 4). These findings indicate that even when saturation appears to have
been reached, the rank ordering of priorities can be influenced by the characteristics of the
Deviating from standard CHNRI procedure, we requested that participants rank research
priorities against pre-determined criteria using a Likert scale as opposed to binary ªyesº or
ªnoº responses. This decision was informed by the lack of existing evidence within the sector
of child protection in humanitarian action and the anticipation that a large majority of
research items would be affirmatively ranked by respondents, making it difficult to discern
which were of highest priority. While Likert scales have been used extensively in other
crowdsourcing methods [56±58], more research is needed to examine the benefits and drawbacks of
using a Likert scale within an adapted CHNRI framework.
Lastly, our study did not include ªimpactº as a ranking criterion. Such a criterion would
have participants rank research based on the likelihood it would result in a reduction of
protection risks or improved responses to child protection violations. While our research criterion
of ªrelevanceº included similar language, it did not explicitly request input on the ability of a
research question, once answered, to impact the lives of children. Further research priority
setting exercises on child protection may wish to include ªimpactº as a ranking criterion separate
from ªrelevanceº in order to further ascertain the merit of a research idea.
Rigorous, scientific research that assesses the scope of child protection risks, examines the
effectiveness of existing child protection interventions, and translates evidence to practice is
critical to move the sector forward and respond to donor calls for programming that is
evidence-based. This CHNRI adaptation solicited inputs from a range of sector experts with
variation across geographic location and job function. It is our hope that findings can guide a
global research agenda, facilitating cooperation among donors, implementers, and academics
to pursue a coordinated approach to evidence generation.
S1 Annex. Full ranking.
Conceptualization: Katharine Williamson, Lindsay Stark.
Data curation: Laura Gauer Bermudez.
Formal analysis: Laura Gauer Bermudez.
Methodology: Laura Gauer Bermudez.
Supervision: Katharine Williamson, Lindsay Stark.
The authors express gratitude to the participants who took time from their busy schedules to
generate and rank research priorities for this exercise.
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Writing ± original draft: Laura Gauer Bermudez.
Writing ± review & editing: Katharine Williamson, Lindsay Stark.
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