Applying for, reviewing and funding public health research in Germany and beyond

Gerhardus et al. Health Research Policy and Systems (2016) 14:43 DOI 10.1186/s12961-016-0112-5 REVIEW Open Access Applying for, reviewing and funding public health research in Germany and beyond Ansgar Gerhardus1, Heiko Becher2, Peter Groenewegen3,4, Ulrich Mansmann5, Thorsten Meyer6, Holger Pfaff7, Milo Puhan8, Oliver Razum9, Eva Rehfuess5, Rainer Sauerborn10, Daniel Strech11, Frank Wissing12, Hajo Zeeb13 and Eva Hummers-Pradier14* Abstract Public health research is complex, involves various disciplines, epistemological perspectives and methods, and is rarely conducted in a controlled setting. Often, the added value of a research project lies in its inter- or trans-disciplinary interaction, reflecting the complexity of the research questions at hand. This creates specific challenges when writing and reviewing public health research grant applications. Therefore, the German Research Foundation (DFG), the largest independent research funding organization in Germany, organized a round table to discuss the process of writing, reviewing and funding public health research. The aim was to analyse the challenges of writing, reviewing and granting scientific public health projects and to improve the situation by offering guidance to applicants, reviewers and funding organizations. The DFG round table discussion brought together national and international public health researchers and representatives of funding organizations. Based on their presentations and discussions, a core group of the participants (the authors) wrote a first draft on the challenges of writing and reviewing public health research proposals and on possible solutions. Comments were discussed in the group of authors until consensus was reached. Public health research demands an epistemological openness and the integration of a broad range of specific skills and expertise. Applicants need to explicitly refer to theories as well as to methodological and ethical standards and elaborate on why certain combinations of theories and methods are required. Simultaneously, they must acknowledge and meet the practical and ethical challenges of conducting research in complex real life settings. Reviewers need to make the rationale for their judgments transparent, refer to the corresponding standards and be explicit about any limitations in their expertise towards the review boards. Grant review boards, funding organizations and research ethics committees need to be aware of the specific conditions of public health research, provide adequate guidance to applicants and reviewers, and ensure that processes and the expertise involved adequately reflect the topic under review. Keywords: Public health, Research, Grants peer review, Funding, Health systems research, Health services research Background When writing and reviewing research proposals in the area of health and the life sciences reviewers usually expect a clear-cut research question and/or hypothesis, a sound, straightforward, and well-proven methodology, well-defined outcome parameter(s) and a well-controlled setting which eliminates potentially interfering factors. Ethical review boards often expect informed consent or * Correspondence: 14 Department of General Practice, University Medical Center Göttingen, Göttingen, Germany Full list of author information is available at the end of the article measures for continuous monitoring of each individual study participant. Furthermore, the proposal should be based on one single established theory or model. Public health topics, instead, usually feature less controllable settings. They cover diverse populations, demand multifaceted observational approaches or interventions, and often involve different epistemological perspectives. For example, obesity, arguably one of today’s most important public health topics, is related to societal factors such as cultural norms, the natural and the built environment (transport facilities, walkability), the setting (school, workplace, unemployment), the availability of and advertising for foods, © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Gerhardus et al. Health Research Policy and Systems (2016) 14:43 as well as individual physical (calorie-intake, exercise), psychological (stress, coping behaviour) and social factors (income, educational level, family, friends), and genetic predispositions [1]. Cluster-randomized trials or pragmatic trials on public health interventions for obesity might include unique features that complicate the application of standard guidelines for ethics review [2, 3]. Depending on one’s epistemological viewpoint, obesity will be framed as an epidemic, a social construction, a symptom for a dysfunctional society, individual misbehaviour, a genetic condition, or all of these. According to the definition of WHO, public health “… refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases. Thus, public health is concerned with the total system and not only the eradication of a particular disease” [4]. For the purpose of this article we understand public health in the same broad way, i.e. referring to organized health-related measures that focus on populations, not on individual patients. Health systems research, health services research, health technology assessment, and similar research streams are thus explicitly included, as well as medical sociology or anthropology and applications of similar disciplines to health research. In contrast, clinical research, focusing on individual patients, is not considered here. In relation to the challenge of obesity, there has been a large array of projects comprising narrowly defined interventions, patient groups and outcomes, which were conducted in a highly controlled setting and used only one theory and one method. Dieting for weight loss in welldefined groups is one example. While some of these projects delivered valuable insights, others generated rather inconsequential results [5]. If, however, the reach and effectiveness of an intervention depend largely on its implementation in a specific context, public health research needs to take these factors and the complex interactions between them into account in order to be meaningfu (...truncated)