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How to write a research proposal in public health
The development of new medical treatments and cures would not happen without health research and the active role of research volunteers. Behind every discovery of a new medicine and treatment are thousands of people who were involved in health research. Thanks to the advances in medical care and public health, we now live on average 10 years longer than in the 1960's and 20 years longer than in the 1930's. Without research, many diseases that can now be treated would cripple people or result in early death. New drugs, new ways to treat old and new illnesses, and new ways to prevent diseases in people at risk of developing them, can only result from health research. The research proposal is an important step in developing a research project. In the first instance it helps you to further define your research question and enables you to demonstrate how you intend to go about answering that question. Secondly, the research proposal is able to give an overview of the research project so that other people understand the scope of the research, the significance of the research. This Paper attempts to provide the researchers, the various steps involved in formulating a health research protocol.
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How to prepare a Research Proposal
Health research, medical education and clinical practice form the three pillars of modern day medical practice. As one authority rightly put it: ‘Health research is not a luxury, but an essential need that no nation can afford to ignore’. Health research can and should be pursued by a broad range of people. Even if they do not conduct research themselves, they need to grasp the principles of the scientific method to understand the value and limitations of science and to be able to assess and evaluate results of research before applying them. This review paper aims to highlight the essential concepts to the students and beginning researchers and sensitize and motivate the readers to access the vast literature available on research methodologies.
Most students and beginning researchers do not fully understand what a research proposal means, nor do they understand its importance. 1 A research proposal is a detailed description of a proposed study designed to investigate a given problem. 2
A research proposal is intended to convince others that you have a worthwhile research project and that you have the competence and the work-plan to complete it. Broadly the research proposal must address the following questions regardless of your research area and the methodology you choose: What you plan to accomplish, why do you want to do it and how are you going to do it. 1 The aim of this article is to highlight the essential concepts and not to provide extensive details about this topic.
The elements of a research proposal are highlighted below:
1. Title: It should be concise and descriptive. It must be informative and catchy. An effective title not only prick’s the readers interest, but also predisposes him/her favorably towards the proposal. Often titles are stated in terms of a functional relationship, because such titles clearly indicate the independent and dependent variables. 1 The title may need to be revised after completion of writing of the protocol to reflect more closely the sense of the study. 3
2. Abstract: It is a brief summary of approximately 300 words. It should include the main research question, the rationale for the study, the hypothesis (if any) and the method. Descriptions of the method may include the design, procedures, the sample and any instruments that will be used. 1 It should stand on its own, and not refer the reader to points in the project description. 3
3. Introduction: The introduction provides the readers with the background information. Its purpose is to establish a framework for the research, so that readers can understand how it relates to other research. 4 It should answer the question of why the research needs to be done and what will be its relevance. It puts the proposal in context. 3
The introduction typically begins with a statement of the research problem in precise and clear terms. 1
The importance of the statement of the research problem 5 : The statement of the problem is the essential basis for the construction of a research proposal (research objectives, hypotheses, methodology, work plan and budget etc). It is an integral part of selecting a research topic. It will guide and put into sharper focus the research design being considered for solving the problem. It allows the investigator to describe the problem systematically, to reflect on its importance, its priority in the country and region and to point out why the proposed research on the problem should be undertaken. It also facilitates peer review of the research proposal by the funding agencies.
Then it is necessary to provide the context and set the stage for the research question in such a way as to show its necessity and importance. 1 This step is necessary for the investigators to familiarize themselves with existing knowledge about the research problem and to find out whether or not others have investigated the same or similar problems. This step is accomplished by a thorough and critical review of the literature and by personal communication with experts. 5 It helps further understanding of the problem proposed for research and may lead to refining the statement of the problem, to identify the study variables and conceptualize their relationships, and in formulation and selection of a research hypothesis. 5 It ensures that you are not "re-inventing the wheel" and demonstrates your understanding of the research problem. It gives due credit to those who have laid the groundwork for your proposed research. 1 In a proposal, the literature review is generally brief and to the point. The literature selected should be pertinent and relevant. 6
Against this background, you then present the rationale of the proposed study and clearly indicate why it is worth doing.
4. Objectives: Research objectives are the goals to be achieved by conducting the research. 5 They may be stated as ‘general’ and ‘specific’.
The general objective of the research is what is to be accomplished by the research project, for example, to determine whether or not a new vaccine should be incorporated in a public health program.
The specific objectives relate to the specific research questions the investigator wants to answer through the proposed study and may be presented as primary and secondary objectives, for example, primary: To determine the degree of protection that is attributable to the new vaccine in a study population by comparing the vaccinated and unvaccinated groups. 5 Secondary: To study the cost-effectiveness of this programme.
Young investigators are advised to resist the temptation to put too many objectives or over-ambitious objectives that cannot be adequately achieved by the implementation of the protocol. 3
5. Variables: During the planning stage, it is necessary to identify the key variables of the study and their method of measurement and unit of measurement must be clearly indicated. Four types of variables are important in research 5 :
a. Independent variables: variables that are manipulated or treated in a study in order to see what effect differences in them will have on those variables proposed as being dependent on them. The different synonyms for the term ‘independent variable’ which are used in literature are: cause, input, predisposing factor, risk factor, determinant, antecedent, characteristic and attribute.
b. Dependent variables: variables in which changes are results of the level or amount of the independent variable or variables.
Synonyms: effect, outcome, consequence, result, condition, disease.
c. Confounding or intervening variables: variables that should be studied because they may influence or ‘mix’ the effect of the independent variables. For instance, in a study of the effect of measles (independent variable) on child mortality (dependent variable), the nutritional status of the child may play an intervening (confounding) role.
d. Background variables: variables that are so often of relevance in investigations of groups or populations that they should be considered for possible inclusion in the study. For example sex, age, ethnic origin, education, marital status, social status etc.
The objective of research is usually to determine the effect of changes in one or more independent variables on one or more dependent variables. For example, a study may ask "Will alcohol intake (independent variable) have an effect on development of gastric ulcer (dependent variable)?"
Certain variables may not be easy to identify. The characteristics that define these variables must be clearly identified for the purpose of the study.
6. Questions and/ or hypotheses: If you as a researcher know enough to make prediction concerning what you are studying, then the hypothesis may be formulated. A hypothesis can be defined as a tentative prediction or explanation of the relationship between two or more variables. In other words, the hypothesis translates the problem statement into a precise, unambiguous prediction of expected outcomes. Hypotheses are not meant to be haphazard guesses, but should reflect the depth of knowledge, imagination and experience of the investigator. 5 In the process of formulating the hypotheses, all variables relevant to the study must be identified. For example: "Health education involving active participation by mothers will produce more positive changes in child feeding than health education based on lectures". Here the independent variable is types of health education and the dependent variable is changes in child feeding.
A research question poses a relationship between two or more variables but phrases the relationship as a question; a hypothesis represents a declarative statement of the relations between two or more variables. 7
For exploratory or phenomenological research, you may not have any hypothesis (please do not confuse the hypothesis with the statistical null hypothesis). 1 Questions are relevant to normative or census type research (How many of them are there? Is there a relationship between them?). Deciding whether to use questions or hypotheses depends on factors such as the purpose of the study, the nature of the design and methodology, and the audience of the research (at times even the outlook and preference of the committee members, particularly the Chair). 6
7. Methodology: The method section is very important because it tells your research Committee how you plan to tackle your research problem. The guiding principle for writing the Methods section is that it should contain sufficient information for the reader to determine whether the methodology is sound. Some even argue that a good proposal should contain sufficient details for another qualified researcher to implement the study. 1 Indicate the methodological steps you will take to answer every question or to test every hypothesis illustrated in the Questions/hypotheses section. 6 It is vital that you consult a biostatistician during the planning stage of your study, 8 to resolve the methodological issues before submitting the proposal.
This section should include:
Research design: The selection of the research strategy is the core of research design and is probably the single most important decision the investigator has to make. The choice of the strategy, whether descriptive, analytical, experimental, operational or a combination of these depend on a number of considerations, 5 but this choice must be explained in relation to the study objectives. 3
Research subjects or participants: Depending on the type of your study, the following questions should be answered 3 , 5
- - What are the criteria for inclusion or selection?
- - What are the criteria for exclusion?
- - What is the sampling procedure you will use so as to ensure representativeness and reliability of the sample and to minimize sampling errors? The key reason for being concerned with sampling is the issue of validity-both internal and external of the study results. 9
- - Will there be use of controls in your study? Controls or comparison groups are used in scientific research in order to increase the validity of the conclusions. Control groups are necessary in all analytical epidemiological studies, in experimental studies of drug trials, in research on effects of intervention programmes and disease control measures and in many other investigations. Some descriptive studies (studies of existing data, surveys) may not require control groups.
- - What are the criteria for discontinuation?
Sample size: The proposal should provide information and justification (basis on which the sample size is calculated) about sample size in the methodology section. 3 A larger sample size than needed to test the research hypothesis increases the cost and duration of the study and will be unethical if it exposes human subjects to any potential unnecessary risk without additional benefit. A smaller sample size than needed can also be unethical as it exposes human subjects to risk with no benefit to scientific knowledge. Calculation of sample size has been made easy by computer software programmes, but the principles underlying the estimation should be well understood.
Interventions: If an intervention is introduced, a description must be given of the drugs or devices (proprietary names, manufacturer, chemical composition, dose, frequency of administration) if they are already commercially available. If they are in phases of experimentation or are already commercially available but used for other indications, information must be provided on available pre-clinical investigations in animals and/or results of studies already conducted in humans (in such cases, approval of the drug regulatory agency in the country is needed before the study). 3
Ethical issues 3 : Ethical considerations apply to all types of health research. Before the proposal is submitted to the Ethics Committee for approval, two important documents mentioned below (where appropriate) must be appended to the proposal. In additions, there is another vital issue of Conflict of Interest, wherein the researchers should furnish a statement regarding the same.
The Informed consent form (informed decision-making): A consent form, where appropriate, must be developed and attached to the proposal. It should be written in the prospective subjects’ mother tongue and in simple language which can be easily understood by the subject. The use of medical terminology should be avoided as far as possible. Special care is needed when subjects are illiterate. It should explain why the study is being done and why the subject has been asked to participate. It should describe, in sequence, what will happen in the course of the study, giving enough detail for the subject to gain a clear idea of what to expect. It should clarify whether or not the study procedures offer any benefits to the subject or to others, and explain the nature, likelihood and treatment of anticipated discomfort or adverse effects, including psychological and social risks, if any. Where relevant, a comparison with risks posed by standard drugs or treatment must be included. If the risks are unknown or a comparative risk cannot be given it should be so stated. It should indicate that the subject has the right to withdraw from the study at any time without, in any way, affecting his/her further medical care. It should assure the participant of confidentiality of the findings.
Ethics checklist: The proposal must describe the measures that will be undertaken to ensure that the proposed research is carried out in accordance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical research involving Human Subjects. 10 It must answer the following questions:
- • Is the research design adequate to provide answers to the research question? It is unethical to expose subjects to research that will have no value.
- • Is the method of selection of research subjects justified? The use of vulnerable subjects as research participants needs special justification. Vulnerable subjects include those in prison, minors and persons with mental disability. In international research it is important to mention that the population in which the study is conducted will benefit from any potential outcome of the research and the research is not being conducted solely for the benefit of some other population. Justification is needed for any inducement, financial or otherwise, for the participants to be enrolled in the study.
- • Are the interventions justified, in terms of risk/benefit ratio? Risks are not limited to physical harm. Psychological and social risks must also be considered.
- • For observations made, have measures been taken to ensure confidentiality?
Research setting 5 : The research setting includes all the pertinent facets of the study, such as the population to be studied (sampling frame), the place and time of study.
Study instruments 3 , 5 : Instruments are the tools by which the data are collected. For validated questionnaires/interview schedules, reference to published work should be given and the instrument appended to the proposal. For new a questionnaire which is being designed specifically for your study the details about preparing, precoding and pretesting of questionnaire should be furnished and the document appended to the proposal. Descriptions of other methods of observations like medical examination, laboratory tests and screening procedures is necessary- for established procedures, reference of published work cited but for new or modified procedure, an adequate description is necessary with justification for the same.
Collection of data: A short description of the protocol of data collection. For example, in a study on blood pressure measurement: time of participant arrival, rest for 5p. 10 minutes, which apparatus (standard calibrated) to be used, in which room to take measurement, measurement in sitting or lying down position, how many measurements, measurement in which arm first (whether this is going to be randomized), details of cuff and its placement, who will take the measurement. This minimizes the possibility of confusion, delays and errors.
Data analysis: The description should include the design of the analysis form, plans for processing and coding the data and the choice of the statistical method to be applied to each data. What will be the procedures for accounting for missing, unused or spurious data?
Monitoring, supervision and quality control: Detailed statement about the all logistical issues to satisfy the requirements of Good Clinical Practices (GCP), protocol procedures, responsibilities of each member of the research team, training of study investigators, steps taken to assure quality control (laboratory procedures, equipment calibration etc)
Gantt chart: A Gantt chart is an overview of tasks/proposed activities and a time frame for the same. You put weeks, days or months at one side, and the tasks at the other. You draw fat lines to indicate the period the task will be performed to give a timeline for your research study (take help of tutorial on youtube). 11
Significance of the study: Indicate how your research will refine, revise or extend existing knowledge in the area under investigation. How will it benefit the concerned stakeholders? What could be the larger implications of your research study?
Dissemination of the study results: How do you propose to share the findings of your study with professional peers, practitioners, participants and the funding agency?
Budget: A proposal budget with item wise/activity wise breakdown and justification for the same. Indicate how will the study be financed.
References: The proposal should end with relevant references on the subject. For web based search include the date of access for the cited website, for example: add the sentence "accessed on June 10, 2008".
Appendixes: Include the appropriate appendixes in the proposal. For example: Interview protocols, sample of informed consent forms, cover letters sent to appropriate stakeholders, official letters for permission to conduct research. Regarding original scales or questionnaires, if the instrument is copyrighted then permission in writing to reproduce the instrument from the copyright holder or proof of purchase of the instrument must be submitted.
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Sample Masters Public Health Dissertation Proposal
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Critical Analysis of Factors Affecting Public Health Promotion: A Case Study of Saudi Arabia
This research will be conducted to fulfil the study’s aim to analyse the influence of public health on health promotion intervention within the case of Saudi Arabia as a developing country. To fulfil the research’s aim and objectives, the researcher will use a qualitative approach and secondary data sources regarding public health promotion intervention in Saudi Arabia.
The researcher will examine relevant secondary sources and then present a systematic overview of the literature to understand the impact of public health on the public health promotion intervention in the region of Saudi Arabia.
From the overview of past literature, it can be found that there is an increased interest of researchers and practitioners concerning public health and its promotion (Baum, 2016). The information and know-how regarding public health are important because public health programs and public health interventions are based on this knowledge and research (Boulware et al., 2016).
Now, several different elements tend to impact public health and programs related to public health. The governmental and health organisations have shifted their focus from removing and preventing the disease towards the socio-economic, behavioural, and environmental factors that significantly impact public health (Wiene et al., 2017).
From the research point of view, there have been very few researches in the past that have been carried out in this regard. Different countries aim to improve public health by introducing effective programs and interventions (Watts et al., 2015). The health sector continually works towards ensuring that their public health-related goals are met efficiently to make a significant mark.
The promotion of public health is undeniably an essential aspect of public health. Several types of research have been carried out in this regard (Rosenbaum, 2011). Health promotion is carried out to raise awareness among the public regarding the negative consequences of a disease or notify the public regarding living a healthy lifestyle.
Health promotion is an expression in practical terms as a source that lets the public lead a productive life regarding social, economic, and individual perspectives. Health is a source for a routine life, not an object that can be ignored easily (Anderson et al., 2005). According to WHO, public health is a fundamental human right, and all individuals should have the right to get rudimentary resources (WHO, 2018).
The interventions for the promotion of public health are carried out to ensure that public health is not at stake and that the public is aware of the importance of their health (Nutley, Smith, & Davies, 2000). Through public health intervention, the government can control several health problems.
Regarding Saudi Arabia’s public health, WHO has notified that more than 60% of the population is inactive, which is quite alarming concerning the individuals’ health (WHO, 2011). Physical activity is of great importance because it mainly decreases the many common diseases like diabetes, hypertension, cancer, and heart disease.
It also prevents one of the major problems regarding health, i.e., obesity (Frohlich & Potvin, 2008). It has been established that with time, the health sector of Saudi Arabia has been experiencing growth. However, there are still specific problems faced (Almalki, FitzGerald, & Clark, 2011).
One of the major problems of the health sector of Saudi Arabia is that there is a language barrier among physicians, doctors, and patients. Although some research has been carried out in the context of public health and its impact on health promotion intervention, there is still a need for more research to evaluate public health in terms of promotion.
Yet, according to Sharaf (2010), social media platforms, particularly Twitter, have inculcated new prospects for definitely influencing audiences’ health at large. As Saudi Arabia is coined to be the country with the highest number of Twitter users, practitioners believe that Twitter can contribute to the propagation of health promotion ideas.
According to Mckenzie (2016), with the help of developing different health intervention promotion programs, public health is improving daily. The researcher needs to carry out more research to ensure that public health is impacted efficiently. The country’s major goal is to ensure that the public is provided with high-quality healthcare services.
The well-being of society is promoted. According to Peltzer (2011), the health care promotional campaigns and interventions are focused more on developed nations than developing nations. Several different factors tend to have a significant impact on the health promotion intervention. Socio-economic factors play a critical role in people’s lives, affecting each individual’s health in many ways.
Every country has its characteristics that dominate other factors compared to other places according to specific policies and particular laws. But few general ones can be easily recognised in all parts of the world.
Aim and Objectives
The present research’s main aim is to analyse the influence of public health on the health promotion intervention within the case of Saudi Arabia as a developing country. The objectives of the study are as follows,
- To study the concept and significance of public health interventions.
- To identify factors affecting health promotion interventions concerning public health in the case of Saudi Arabia.
- To analyse the influence of public health on the health promotion intervention in the case of Saudi Arabia.
- To suggest effective recommendations for improving the health promotion intervention from the influence of public health in Saudi Arabia.
Based on the preliminary overview of the literature review on this topic, the research question that is going to be answered by this research is:
How can public health be determined through various factors affecting public health promotion in the context of Saudi Arabia?
This research will be carried out to analyse the impact of public health on public health promotion intervention, specifically in Saudi Arabia. In terms of the public health of Saudi Arabia, the company is experiencing significant improvement; however, they are still lacking in providing high-quality health care advice through public health promotion intervention. One of the important problems prevalent in the region is a language barrier among physicians, doctors, and patients.
The Rationale of the Research
The study has established that certain researches have been carried out concerning public health and its impact on evaluating the health promotion intervention. This particular research is significant because it focuses on analysing how public health in the region of Saudi Arabia impacts their health promotion intervention.
There are not many academic types of research carried out on Saudi Arabia’s public health. This research will contribute positively towards the existing body of literature mainly inclined towards Western countries’ general health (Glanz & Bishop, 2010). One of the significant hindrances with the effective provision of public health to a country’s citizens is that there is no consistent framework of public health that promotes the evaluation of public health promotion intervention (Frieden, 2010).
This research is particularly significant because it will look into different factors that combine to form the public health of Saudi Arabia. Moreover, it will also address the issues faced by the country regarding the implementation and evaluation of their health campaigns. The major rationale behind this research is that there are very few research studies carried out.
Structure of the Research
The following study comprises five significant sections: introduction, literature review, methodology, findings and conclusion, and recommendations. The first chapter of the study highlights the research study’s topic, the research problem, aims and objectives of the study, rationale, and significance. It provides a brief introduction to the analysis.
The second chapter of this study was a literature review. In this chapter, the researcher identifies the study variables and includes different theories and backgrounds concerning the view and opinions of various researchers. It consists of a theoretical framework and the development of a hypothesis.
The third chapter of the study was methodology. This section identified the methods and techniques used in a research study to examine the results. Data collection methods and techniques are described in this chapter, along with ethical considerations and limitations.
The fourth chapter of the study was findings and analysis. This chapter analyses and evaluates the data obtained from different sources based on other techniques and methods. A significant portion of this section includes an analysis of results and discussion.
The last chapter of the study is the conclusion and recommendations. It concludes the entire research along with summarised findings of the study.
Public health intervention and promotion.
Public Health is known for inhibiting the disease, health promotions, healthily improving lifestyle, and systematised society effort. The central focus is on the health betterment of the population and doing interventions to prevent disease. The protection, promotion, prolonging of public life, and betterment of society’s health are the main goals of public health (Brownson, 2017).
The progress in the social machinery by health promotions satisfies the people regarding maintenance and betterment of health. Better cure of advanced and severe diseases is required, specifically in developing countries. The interventions of Public health regarding the reduction in risk factors related to health are significant. The preventions are done of medicines to preserve or promote health and decrease the suffering when health is impaired (Gostin, 2016).
There are significant disciplines in which health sectors mostly perform to promote health. A healthy nutrient balances health and any disease, and reproductive health is taken care of the most because it includes mental, physical, and social health that should be healthy. In environmental health, the approach is to classify the particular biological or physical aspects that present all health risks.
It can be replaced and modified to protect people from it, like sanitisation of water, disposal of waste management, etc. (Frieden, 2010). The combination of health education and economics is beneficial for health promotions and their interventions. It helps in the substitution use of resources and their effective utilisation in the health service sector.
Many types of research have been done that focus on the distribution, frequency, biostatistics, and causes of disease. Such researches are an action to attain more information about the technical or scientific overview of public health. The health service sector management tries to work together and utilise the available resources to achieve the goal (Fleming, 2014).
Health promotion is the central part of public health, defined as the betterment of health in the population. It presents wide-ranging environmental and social conditions directed towards changing the negative aspects of such states to ease their effect on individual and public health. It enables individuals to elevate control over the factors of health and thus improve their health.
Contribution in health promotion is vital to endure promotions’ actions and efforts (Naidoo, 2016). Health promotion is an expression in practical terms as a source which let public to lead a productive life regarding social, economic and individual prospective because health is a source for a routine life, not an object that can be ignored easily.
It emphasises the physical capabilities of a person. WHO has recognised public health as a fundamental human right, and all individuals should have the right to get rudimentary resources (Lupton, 2014). The prospective health concept applies that the organisations that rule social, physical, and economic conditions should take responsibility for their activities in terms of their effect on the public and health (Leischik, 2016).
After the research many years, health promotion is now getting in trend. It became clear that health promotion interventions should be seen in the framework of difficult interrelationships encircling the public, societies, and health care sectors (Duplaga, 2015) and (Sitko, 2016). The approaches have found out that the effective interventions and consequent promotions that are in practice.
The interventions of health promotions should be for the betterment of local practice. The advanced interventions in public health lead to many issues and challenges regarding promotions. Interventions are commonly recognised by combining factors of a supplied intervention like theory and all with factors present in the local context such as funding etc. Interventions help a lot in controlling and preventing health problems (Kok, 2012).
Overview of Saudi Arabia’s Public Health Intervention and Promotion
The WHO reports show that 60% of the overall population of Saudi Arabia is physically inactive, which is not suitable for health at all. According to recent studies, physical activity is one of the significant health-promoting practices (Kraus, 2015). Physical activity mainly decreases the many common diseases like diabetes, hypertension, cancer, and heart disease.
It also prevents one of the major problems regarding health, i.e., obesity. It improves an individual’s mental health by decreasing depression and anxiety, showing the inverse relation of health outcomes with the amount of physical activity performed (Alahmed, 2017).
The health sector of Saudi Arabia has ranked the growth of health care services at the overall rate of care, due to which betterment has been seen in the health range of Saudi Arabia (Almalki, 2011). Besides such improvements, the major issue in Saudi Arabia’s health sector is the language hurdle among the physician and their patients. Many interventions have been taken to solve this issue by health promotions using posters, leaflets, or other ways (Vyas, 2012).
After facing constant failure, alternative techniques have been applied, i.e., spreading awareness by using promotional items in health promotions, which was beneficial to give important messages to the public (Al Aboud, 2013). It succeeds whenever implemented correctly, which was also seen in TB patients (Alahmed, 2017).
Factors Affecting Public Health Promotion Intervention
Public Health revolves around the study of highlighting the issues that affect human health. It focuses on the preventive measures of diseases and prolonging humans’ lives by bringing awareness through different campaigns and promotions that could improve the public’s health. The research has been done to work on the public health sector as it is one of the significant elements that influence any country’s environment.
It is also essential to look out for the reasons that can affect the promotions and interventions to maintain public health stability. Social determinants include the status and affiliations that determine health (Shaw, 2008). In socio-economic factors, social attributes play a critical role in people’s lives, affecting each individual’s health in many ways.
The socio-economic factors are one of the major influences for public health in any country, whereas; cultural factors are based on the thoughts and behaviours shared by a group of people in any country. Culture always has a significant impact on all aspects of life. It contributes to every individual in an integrated pattern of values and morals.
In political factors, government policies and programs also profoundly affect health interventions in many ways (Mackenbach, 2014). At the same time, national health factors are about taking account of public health to local needs and includes the development level for the entire health sector.
Income is one of the main features that can affect public health promotion. It is directly proportional to individuals’ health related to the amount of money that a person is earning. When the making is high, the health is automatically influenced better, but if it is low, it can affect the quality of the food you take or the health services that are not affordable (Abel-Smith, 2016).
It can also be described as an example that not everyone can afford to see experienced doctors of sickness or other major health issues due to their high fees. It also goes in a way that they cannot purchase better foods to remain healthy. Income also influences the location one chose to live in as the surrounding influences health at a higher level. It can be perceived as lower earnings can lead to poorer health choices and increased health risks (Stoddart, 2017).
It is a crucial element that determines people’s social and economic position related to health outcomes. Education helps learn about the positive and negative aspects of health classified as better or poor health status. It elaborates the benefits of a healthy diet, increases the knowledge, and guides in making good choices compared to those who are not well educated or more aware of effective food products (Rosen, 2015).
The factor of employment contributes to health promotion intervention to enhance social status and self-esteem, leading to community life participation by bringing more opportunities that improve health and well-being. Career also surrounds being physically active or getting exhausted and tired due to long work hours that affect an individual’s health. The nature of the job is considered in this sector that can be classified as working at a farm, factory, chemicals or radiology, sports, and a proper organisation (Garthwaite, 2014).
There can be many cultures within a society, and it differs in views and norms that affect health in various ways. One major factor that developing countries face is social inequality which means all the people do not meet human needs. The lack of food, water, shelter, and clothing influences the health of the individuals. It affects the lifestyle and causes serious health problems as well. The easy access to these factors does create a difference in human beings’ lives as these are the most critical elements to survive (Berkman, 2014).
Developing countries like India, Pakistan, Bangladesh, and others have some of the most disturbing factors that destroy a person’s health: early marriages. Children are forced to marry at the early stages in many rural areas in these developing countries, which is not suitable for their future health (García-Moreno, 2015). Since the people in rural areas are not so educated or aware of these things, it results in early pregnancies, labour complications, and severe infections that could lead to life-ending diseases.
Another factor that comes under the cultural environment is family. It means the number of people in a family that does make a difference at a greater rate. People in rural areas in developing countries usually have many children with very few gaps. They do not know the preventive measures or the effect of such fast pregnancies on health. Moreover, they also face financial issues due to less income, which cannot provide quality food and daily life necessities.
Poverty has been a critical factor in health determinants as it is directly linked with poor health. The less fortunate people are affected at so many levels that destroy their health. They are deprived of basic knowledge, money, and access to the services of health. Poor people cannot get treatment for diseases or see doctors due to a lack of money (Poverty and Health, 2014). Usually, only one member earns for the family that brings too much of a burden. Therefore, when everyday life’s basic needs are not easy for them to get, health is mostly the last thing to be given attention to for poor people.
The physical environment plays a great role in affecting people’s health positively or negatively. Clean air and water are two substantial means towards a healthy lifestyle. Lack of access to clean water and sanitation as well as polluted air develops major health issues. It also includes noise pollution, access to green and open space, transportation, housing, and food. Moreover, climate seasons influence the health of infants. They all are of equal importance in environmental conditions that directly affect health. Developing countries face air and noise pollution and the limited amount of clean water, which creates trouble for them, if not right away then in the future (Lü, 2015).
The living area of a person or improper untidy housing develops certain health conditions. Poor housing is associated with significant diseases like respiratory and skin infection, morbidity and mortality, and psychological effects. The overcrowded places usually do not consider a healthy lifestyle, whereas; homelessness develops sleep deprivation, mental health disorders, chronic stress, nutritional and psychic disorders.
Age and Gender
This has a significant part, like other factors, in determining health. People develop various health problems at different stages of life. For example, the diseases found in infants like pneumonia, diarrhoea, and skin rashes would not be quickly adopted by elders. In this manner, gender differences like men and women rarely have the same types of diseases. There are few common diseases found in women, like thyroid or kidney issues, whereas; men are mostly heart problems. This variance is the reason for distinctive lifestyles acquired by both of them.
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Influence of Public Health on the Health Promotion Intervention
Health Promotions has progressed a lot in the past years, but some of its procedures are limited due to the assessment methods (Peltzer, 2011). Research is much needed in the evaluation of health importance and interventions. Health promotions focus on developing more significant results that create demanding and expensive interventions for both the physician and the patient.
Such interventions are being studied deeply using a high level of standardised protocols (McKenzie, 2016). The effectiveness of health promotions does not show the positive or negative outcomes of busy, understaffed public health clinics and huge health sectors (Baum, 2016).
The medical trend focuses on the surgical interference that gives instant outcomes. As compared to the health promotions, less research is done on their interventions. There is little research on interventions that report the population. The interventions that show adequate randomised trials results are not effective when applied to the common public (Schmidt 2015).
According to the RE-AIM model, the intellectualising is done on the general population’s health that affects the applied interventions in health promotions as five elements that include efficacy, implementation, learning, reach, and management (Ward, 2018).
When health sector interventions have been taken in health promotions, their main focus is constantly developing countries. Like in Malawi, it has been applied, and their outcome was good. Health promotions are also designed specifically for children and young people. It depends on the requirement of public health. It helps in dealing with the mortality or morbidity issue and others also (Eldredge, 2016).
Overall, developing countries show the interventions in health promotions, and their applications differ a lot according to sustainability and effectiveness. If the government supports health promotions rightfully, it puts a high level of impact on public health.
In Ethiopia, hygiene practices are very poor, and the sanitary situation is insufficient, resulting in the elevation of transmissible diseases in the population and worsen public health. Health promotion interventions are done to spread knowledge and apply hygiene practices in rural schools of Ethiopia and improve their hygiene characteristics (Vivas, 2010).
Children were targeted for promotions because they are more approachable for adopting healthy attitudes by them it will spread among the families and community (Lopez-Quintero, 2009).
Brazil is also considered a developing country, in which health promotions have been implemented many times in the past and present. Currently, the major concern is heart diseases, hygiene, and unhealthy lifestyle issue. The health promotions did interventions for the betterment of living and unhealthy situation of people.
The infectious disease in Brazil was a high level of public health issue in the country before. Still, after many interventions regarding health promotions, including campaigns, such disease decreased from the government. Now circulatory diseases are the main reason for mortality. All of the issues needed basin sanitation awareness and health education.
The particular activities of health promotions include improving physical activity practices, reducing smoking, decreasing death and morbidity rate due to any disease or accident, reducing alcohol intake, adopting healthy habits, and inhibiting violence (Horta, 2017). Health promotion was also done in schools, leading to positive outcomes and a lot of betterment. The growth of the Brazilian Unified Health System has been influenced by Brazil’s public health sector (Ramos, 2014).
Research philosophy describes the set of beliefs that the researcher has while carrying out the research. It provides the significance of how the data will be analysed and used in the research. The research philosophies are categorised into different types that can be used according to the researcher’s analysis and feasibility. The research philosophies that are commonly used in the study are positivism, interpretivism, and realism (Merriam and Tisdell, 2015)
The study in hand has used the interpretivism philosophy for conducting the research. This philosophy is based on the social sciences and focuses on the disciplines and the school of thought that the respondents carry out in the research. On the other hand, the positivism philosophy is based on realistic data and carries out the information found in reality.
The realism philosophy is commonly observed in scientific research and collects data based on experiments and scientific tests. The researcher may face problems with interpretivism philosophy because the respondents are not observed to provide justified opinions for theirs. The problems may also be faced in interpreting views carried out by the researcher (Teherani et al., 2015). Concerning the attitudes and behaviours, interpretivism philosophy is highly suitable for the research that is being observed.
The following study will use interpretivism to identify the impact of public health on health promotion interventions within Saudi Arabia because the research is purely based on qualitative analysis; therefore, interpretivism philosophy helps to understand the in-depth information about variables.
According to the study of Sekaran and Bougie (2016) research approach is stated as the pattern that has been selected for conducting the research. The research approaches are mainly divided into inductive and deductive approaches that provide research patterns to get significant results.
Both the approaches have their existence and vary based on the hypothesis and models used in the research. The inductive approach provides the research pattern that starts with observation and tests conducted by the researcher. It moves on to the identification of patterns used in the research and finalises the theory.
On the other hand, the deductive approach is based on the theory that has been selected. The researcher carries out the hypothesis and develops observations and tests for accepting or rejecting the idea based on the theory. The statement and tests confirm and reject the hypothesis that carries out the result of the research carried out.
For the research in hand, the approach that has been used is the deductive approach as it has used the theory that has been used before and has developed. The researcher has also conducted tests and observations to identify whether the hypothesis can be accepted or rejected. The deductive approach justifies the research carried out and is correct (Silverman, 2016). Moreover, the researcher may not lead to falsification and gets the justified results of the approaches used.
The following study will use the inductive research approach because the underlying factors of public health promotions and their impact on health promotion interventions were analysed through systematic analysis of information. The deductive approach provides a structured way of examining Saudi Arabia’s case to assess the impact.
Type of Investigation
Marshall and Rossman (2014) have identified three types of research investigation under which the research is carried out. The types of investigation methods used in the researches are exploratory, explanatory, and descriptive research. The experimental research refers to the explore the new techniques and phenomenon that has not been used before.
As the name identifies, it provides the significance of starting the research from the groundwork. Exploratory research is aimed to find something new and carry out the research in a new direction. Descriptive research tends to explore and explain the phenomenon in detail. It provides additional information regarding the topic and fills the missing part of the research. It carries out the gap analysis and gets the work done until the gap is filled (Lewis, 2015).
Another type of investigation method followed by the researchers is explanatory research. It is also known as causal research and determines the identification of cause and effect relationships. The explanatory research is determined to explain the phenomenon that has been used before in previous researches.
It explains the description of topics and determines the causes and effects of the particular topic on another (McCusker and Gunaydin, 2015). The following research is based on the cause and effect relationship, and hence the type of investigation used in the next study is explanatory research. The cause and effect relationship used in the explanatory research has provided the best fit for the relationship between the variables.
For the following study, the researcher will use the descriptive method of investigation to examine the relationship between public health and health promotion interventions. The explanatory study will provide information about how public health impacts the various health promotion activities.
The studies of Choy, (2014) have determined the types of research design used in the following research. The design is categorised into three main types that are qualitative, quantitative, and mixed methods. All three types are used according to the needs and requirements of the selected topic. Qualitative research is dependent upon the collection of behavioural data.
The data is collected and analysed in the form of statements and descriptions used to carry out the results. Another commonly used research design is the quantitative method. The data is collected in numeric and numbers that are analysed using statistical tools and techniques. Another commonly used method is mixed (Merriam and Tisdell, 2015).
The following research will use qualitative research design methods to examine how public health affects health promotion intervention. Using the qualitative method, the researcher will shed light on the existing articles and journals collected by different researchers and scholars.
Data Collection Method
The identified data collection methods used in the researches are categorised into primary and secondary research. The researcher collects data from the respondents based on the primary and secondary methods of collecting data. Both the methods have their ways of collecting data. The data collection for the primary research is interviews, questionnaires, experiments, and observation.
On the other hand, is the data collected from previous studies. The research, based on secondary data, uses the information available on the internet and carries out the data analysis (Mertens, 2014).
The study in hand has used the primary method of data collection. The data has been collected based on the qualitative methods and has gathered the information from the primary sources, including questionnaire surveys, interviews, and first-hand observation of the researcher. The researcher has faced some constraints while carrying out the primary data that is limited time and cost used for the research. Respondents are not ready to provide detailed information regarding their feelings and practices (Silverman, 2016).
The data collection method selected for this study is the secondary method of data collection. The researcher will use the second method to conduct a systematic review and answer the study’s research questions. The study will also select articles from 2010 to 2018, and a health-related database will be used for examining the information.
Inclusion and Exclusion Criteria
Inclusion criteria refer to the characteristics of the study’s characteristics that are included in particular research. On the other hand, exclusion criteria refer to specific characteristics or elements that disqualify the subjects from being included in the research. The inclusion criteria of this research are different studies related to public health and public health promotion.
Majorly the studies taken into account are those carried out in the region of Saudi Arabia and other parts of the Middle East. The exclusion criteria for the research are the studies that do not belong to credible journals and publishers.
Sampling Method, Technique, and Sample Size
Sampling is an integral part of the research and determines the population selected for carrying out the research. The selected population for collecting the data is known as the sample. The sampling method is further divided into non-probability and probability sampling. Probability sampling provides an equal chance to all the sample population for getting the responses. On the other hand is the non-probability sampling does not provide an equal chance to all the respondents (Silverman, 2016).
The following study is based on non-probability sampling. The technique that has been used in the study is convenience sampling. The researcher has carried out the respondents’ information based on convenience for gathering data through a systematic review of articles and journals. From 2010 to 2018, the articles will be selected for obtaining information about health promotions and interventions therefore, an article out from this domain will not be used.
Data Analysis Method
According to Smith, (2015), data analysis is a critical stage of the research process. The tool that has been used in the following research is thematic analysis because the study is based on qualitative techniques. The interviews gathered by the researcher and the observations have been analysed using the method of thematic analysis.
The thematic analysis is based on the pinpointing and examination of the patterns within the data that has been collected. On the other hand, the tool for quantitative analysis is SPSS. As the study is qualitative, so the data has been analysed using themes and defining them according to the research. The researcher will use content analysis to analyse the information obtained from different sources and critically examine the data about health promotion interventions, particularly in Saudi Arabia.
The researcher will conduct a systematic review through existing studies and with the help of a descriptive approach. A systematic literature review is going to be carried out in five steps (Khan et al. 2003). The research question has been framed in the first step, after which relevant publications regarding the research questions are identified. The next step covers the assessment of the quality of the study. The next step is related to summarising the evidence that has been collected. Lastly, the findings collected from different relevant articles are interpreted.
It is an integral part of the research and identifies the researcher’s ethical considerations while carrying out the research. For the following research, the researcher has ensured the respondents that the data collected is valid and authentic. The confidentiality of the respondent’s information has been considered. The researcher has avoided any sort of unethical activity while carrying out the research.
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Public Health Research Proposal Example
Type of paper: Research Proposal
Topic: Government , Information , Knowledge , Poverty , Family , Health , Disabilities , Medicine
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It goes without saying that life without good health and peace is of no relevance. The very purpose of living is defeated if there is an absence of good health that can sustain the need of life, learning, and future challenges. One of the challenges of modern times is deformities at the time of birth. According to Lannucci (2000), "Birth defects are abnormalities that are present in an infant at birth. They include visible, structural abnormalities as well as inherited disease" (P. 7).
Statement of research
The purpose of this study is to identify the elements and features of birth defects, and find solutions to this problem of health and physical deformities in future.
Significance and background of the study
In this modern day of information explosion and use of computer and internet, the case of growing problems of physical deformities at the time of birth is a cause of concern for the family, society, health departments, administrators, and planners not only in the United States but also in the entire world. This research demands the urgent need to examine the issues pragmatically and design a comprehensive plan for its solutions by involving all the stakeholders of family, society, health officials and researchers, and administrators. Using these comprehensive planning and strategy will enable us to find out the ways and means to mitigate the impact of the birth defects and ensure awareness for a quality health quotient level among the general public.
Characteristics of the research
As part of the description, interpretation and explanation of the research process, it has been decided to collect the sample data for an area which has remained ignored and isolated from the universal right of quality health management and protection system. The area selected for sample study is the region of Southern California which is mushrooming with the problems of poor health and homelessness. According to Mechanic and Tanner (2012), people are vulnerable and susceptible to the possible harm caused due to inefficient interaction resulting from developmental problems, personal incapacities, disadvantaged social status, and insufficient interpersonal networks. In this context, there is a need to think that birth defects due to poor health problems are external factors that result from our mental degradation of health machinery and inefficient approach of policy makers and planners.
Description of the area of research
The population of the southern Californian, which is chosen for this analysis, is 25000, especially the ghetto. This is located in the San Diego, El Centro and El Cajon area of California which is placed at the southern tip bordering Mexico. Of a total area of 411,048 square kilometers of the California, these areas cover around 278 square kilometers of the areas. The focus of the study is children’s birth defect, its causes and solutions, involvement of risk, preventive measures, budgetary assistance, and accountability of administrative and health machinery to implement the policy and program. In addition, special attention is being paid on the children below the age of 5 years, and among these, the most vulnerable lot is the female children who are generally ignored and discriminated. In the light of their poor plight of health, we cannot afford to have the two worlds where the children, especially the poor lot of the southern California, especially from the black racial origin, are divided on the basis of the race, poverty, and poor health. Although, we have enough resources that need to be judiciously managed to provide quality life to the poor lot, there is a lack of political, social, and financial will-power to root out this health menace.
Tentative questions of the research
The problems of birth defects highlight the need to understand the nuances and apply a concerted effort to deal with this issue. But, this raises many questions that deserve to be answered. Some of these questions are: a) What do you understand by the term “birth defect?” b) What are features and types of birth defects? c) What are the possible causes of the birth defects? d) What are the medical solutions for this problem? e) What are the suggestions recommended by the doctors? f) What are the procedures and investigations needed to root out this problem? g) What kind of public awareness is needed to mitigate the impact of the birth defects? h) What should be the role of the government administrative and health officials? i) How should the government devise the special plan, policy, and program for the poor and female children? j) What preventive measures are necessitated to counter this danger of birth defects?
Objective of the research
In view of these questions, the objective of the research is to find answers to these questions by collection some invaluable data, list out the problem areas, develop a strategy to deal with the problem areas of the birth defects, and finally define the process and procedures of effective management health hazard at the time of the birth.
Hypotheses of the research
It is being hypothesized that the efficient process of data collection, interpretation, analysis will pave the way finding out the root problems and take suitable measures to deal with the endangering challenges. All these analyses and preventive measures will play a key role to eradicating the problems of birth defects.
Method and procedure of data collection and analysis
In order to carry out the process of data collection, the specified region was divided in terms of class, economic status, race, education level, and health awareness quotient. Further, a questionnaire was prepared seek answers from each person or family. These questionnaires dealt with the nature of problems of birth defects, types of defects, and causes of defects. According to Sloss (1999), "Outcomes were classified into 24 categories - infant mortality, four related to prenatal development, and 19 for various of birth defects" (P. 29).With a view to ascertain the medical facts of problems, a qualified and competent medical professional accompanied during the data collection and helped in identifying the reasons of defects such as sensory, metabolic, degenerative, and nervous disorders. The collected data were sampled on various parameters of age, class, region, economic status, race, and gender, and finally analyzed in multiple permutation and combination of these defined parameters so as to arrive at the result flawlessly in future for finding the root reasons and the ultimate solutions of the stated problems.
Presentation of results
Based on the collection of data, analyses, results, some of the startling facts that came to the highlight are: a) 15% of people below the age of 5 years had either genetic or chromosomal problems. b) 30% pregnant women, especially from poor class and black did not undergo regular medical examination for any possible birth defects. c) 70% of the women, who were detected to have birth defects problems, had either consumed alcohol either during or before pregnancy. d) Body mass index (BMI) of the affected people were very low. e) 80% of the affected people were from either poor economic background or the black origin. f) Academic level of the affected people was low, and that resulted in lack of general and health awareness.
Suggestions for preventive measures
a) Medical department should carry the genetic or chromosomal analysis reports of every person and suggested health-oriented preventive measures in the initial stage. b) Government, especially the health department, should make obligatory to carry out regular medical examination of all the pregnant women for any possible birth defects with special focus being on the poor and the black people. c) Health awareness and motivation plan should be conducted for the pregnant women for desisting from consuming alcohol either during or before pregnancy. d) The local administration should check up the body mass index of the every individual and arrange healthy and nutritious food for having a standard physical fitness level. e) Government should envisage a special economic and health package in order to boost their level of health and economic status. f) Health machinery should exploit the application of electronic and print media, conduct of seminar, workshop, awakening programs, banners, posters, flyers, and many more in order to create awareness among the common and weakwr section of the societies.
Administrative and budgetary research
All these analyses and their effective implementation will benefit the common people immensely. For this, the role of the administrative and financial department of the federal, state, and local government plays a key role in overcoming the problems of birth defects. Presently, the federal and the state government have earmarked 5% of their funds for the health management but now they should allocate 10% extra funds to the health department in their budget plan. If necessary, the administrative department should establish a monitoring agency to ensure the use of allotted funds to needy people, the poor and the black people, for creating an health infrastructure and awareness program. Furthermore, the government should plan to initiate an extensive research programs in future for the establishment of quality health infrastructures in the backward regions of the state and also for finding out the co-relation between race, economic status, and the birth defects.
Credentials of the researcher and associated personnel
For this research work on the problems of birth defects in a specified locality, I owe special thanks to all the persons, teachers, local authority, friends, family members for their constant support and patient guidance during the process of data collection, sampling, analysis and findings. In addition, I would like to extend my special thanks to my teacher and family members in helping me in accomplishing this research assignment. Without their support, it could not have been possible to successfully complete this research analysis on birth defects.
In the light of the aforesaid facts and analyses on the birth defects, , it can be, undoubtedly, assumed that poor health due to lack of public healthcare system is really an unjustifiable and unacceptable. Blaming the poor or the underprivileged sections of the society for this type of dysfunctional problems during the time of birth is not logical. It is to be believed that education, awareness, economic development, health infrastructure by the government will create a positive difference in their life. So, time has come for us to discuss positive elements and remove a sense of differences faced due to poor planning of health. So, let us build a society or a world where there is no birth effects due to poor health and poverty to make our life happy, progressive, honest, and prosperous in a true sense.
1. Lannucci, Lisa (2000). Birth Defects: Disease and People, New Jersey, USA: Enslow Publishers. 2. MedicineNet.com (24 April 2012.) Article: Birth Defects. Retrieved from http://www.medicinenet.com/birth_defects/article.htm 3. Sloss M. Elizabeth (1999). Groundwater Recharge with Reclaimed Water: Birth Outcomes in Los Angeles County. Pennsylvania: RAND Corporation 4. Centers for Disease Control and Prevention (16 April 2012.) National Center on Birth Defects and Development Disabilities Retrieved from http://www.cdc.gov/ncbddd/index.html 5. Stephens Stephanie (July 21, 2011.) Medicaid Waiver Good News for L.A.'s Homeless. Retrieved from http://owl.english.purdue.edu/owl/resource/560/01/ 6. Mechanic, David and Tanner, Jennifer (2012.) Vulnerable People, Groups, And Populations: Societal View. Retrieved from http://content.healthaffairs.org/content/26/5/1220.full 7. California Advocacy Groups (2009.) Health Access. Retrieved from http://www.health-access.org/item.asp?id=120 8. Susan M. Barrow, Nicole D. Laborde (2008). Invisible Mothers: Parenting by Homeless Women Separated from Their Children. Retrieved from http://www.springerlink.com/content/742gu15730342t14/
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