PH C117/IB C195: Global Health Research: Start

What causes disease?
For any "disease" or condition, you could start by considering interactions among environmental and social factors:

Poor diet, resulting from food choices, "causes" nutritional deficiency or obesity in a population.

But consider:

• Is it "caused" by historical distribution of land use (redlining and racism in the US; colonialism in some other countries)?
• Or by the regulatory environment, including crop subsidies, food inspections, etc.?
• What about the role of NGOs, IGOs, aid networks?
• What about infrastructure, such as food distribution networks, transportation, etc.?
• Is the status of women/girls a factor?
• What about mental health issues?
• What is the role of commercial activity?
• What about the healthcare and health insurance system?

. . . Keep moving upstream!

Also, consider that how issues are framed is influenced by our assumptions and biases.

It may be useful to have a structure to help guide you when searching. 

When you formulate a research question, consider these elements:

• Phenomenon: What happened?
• Subject or Population: Who did it?
• Time: When did it happen?
• Location: Where did it happen?
• Cause or Motivation: Why did it happen?
• Process: How did it happen?

Note: It is possible that not all of the above elements will be appropriate for your search topic.
This worksheet (docx) will take you through the process of formulating a search.

PICO is another popular way to structure a search.
PICO stands for:

• Patient or Population;
• Intervention;
• Comparison or Control;
• Outcome.

Worksheet: Developing an Efficient Search Strategy Using PICO (docx): A  fillable form that provides a PICO example and prompts you to document synonyms and MeSH headings.

Embase has a PICO search form to guide you.

SPIDER is a search structure used in qualitative research. SPIDER stands for:

• Sample;
• Phenomenon of Interest;
• Design;
• Evaluation;
• Research Type.

Once you have a search strategy, you can try the Polyglot Search tool, which helps to translate a PubMed search into the correct syntax for several other databases, including Embase, Scopus, Web of Science, and more.

Below are some examples of questions or lines of inquiry.
Considering what question a research article addresses may help you determine if it is relevant to your needs:

• Are their racial or ethnic disparities in type 1 diabetes mellitus prevalence?
• Compare and contrast personal versus "upstream" factors relevant to these disparities.
• Describe examples of things that could reduce these disparities, differentiating between personal and upstream factors. 
• If a policy or program increases disparities, what are possible reasons for this? Differentiate between personal and systemic factors.
• Describe a plan/program/policy to reduce these disparities.
• Justify why systemic or upstream factors contribute more to these disparities than personal factors.

What is a good Research Question? It is a question that:

• identifies a relevant issue in your field;
• pursues relatively uncharted research territories to address the problem;
• piques the interest of others.

This blog post has tips on how to write a good research question, including examples of bad, good, and great questions.

To reduce bias, it may be best to pose your question in a neutral manner. Examples:

• Neutral question: What is the impact of school-based physical activity interventions on time spent engaged in moderate to vigorous physical activity among children, in comparison to children not exposed to school-based interventions?
• Non-neutral question: Which school-based interventions are effective in increasing the amount of time children engage in moderate to vigorous physical activity?

What is the question being addressed in the study you are reading? Compare:

• "Our intervention worked toward fixing Problem X."
• "The most effective interventions for fixing Problem X are: ..."
• "The effects of our intervention on Problem X are: ..."

When you read an article, answer (briefly) the following (source):

• What question are the authors addressing?
• What did they do to answer the question?
• What was their rationale for doing what they did to address their question?
• What were the findings?
• How were the authors think their findings mean?

Finding a systematic review that addresses the question you are interested in can be very helpful: take a look at the search strategy and databases used in the systematic review for tips on your search.

Primary research presents original research methods or findings for the first time. A primary source is a document (or object) which was written or created during the time under study, by someone who was present during an experiment or experience, and offers an firsthand view of a particular event. Especially in the sciences, an "experience" or "event" includes a research study or process.

In science, primary literature is the original publication of a scientist's new data, results, and theories.

A good way to evaluate whether or not a scientific article is a primary source is whether the article has a Materials and Methods (or similar) section.  If the article discusses methods, it is likely primary literature.

Secondary literature does not report new findings, and includes review articles and most scholarly or academic books, including textbooks.