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The platform for funding health research in Canada is undergoing a revolution. With the establishment of the Canadian Institutes of Health Research, research communities, policy makers, health charities, and the general public can, for the first time, provide input into health research funding priorities. In this report we describe our efforts to obtain and distill input into the research priorities for the Institute of Nutrition, Metabolism and Diabetes (INMD). The INMD supports research to enhance health in relation to diet, digestion, excretion, and metabolism; and to address causes, prevention, screening, diagnosis, treatment, support systems, and palliation for a wide range of conditions and problems associated with hormone, digestive system, kidney, and liver function.
Response to our request for input was enthusiastic and came from across the research themes and disciplines under the INMD's umbrella. As one might expect we received a wide variety of suggestions for research priorities from respondents. While partisan suggestions were common, one area emerged as a priority through the frequency of its suggestion, in particular by people whose work is focused in other areas.
I am pleased to have this opportunity to help guide the INMD through the strategic planning process and I look forward to advancing our research agenda with the help of the many members, partners and stakeholders with an interest in the INMD. We will strive to obtain regular input from, and provide feedback to, the community as we chart our course over the next several years.
Sincerely,
Dr. Diane Finegood, PhD
Message from the Scientific Director
INMD's Strategic Direction Defined
Priorities for INMD's Funding: Program Types
Criteria for Guiding INMD's Strategic Initiatives
Services to the Health Research Community
In September 2001, the Institute of Nutrition, Metabolism and Diabetes (INMD) initiated an environmental scan of its stakeholder and potential partners. Through this environmental scan we sought input into the strategic directions to be undertaken by the Institute over the next few years. We sought responses to various aspects of INMD's strategic plan - including research and funding program priorities, partnerships and collaborations, and the services the Institute should provide.
Called Charting Our Course: A national consultation on strategic directions, this consultation will influence the goals and objectives for strategic initiatives developed by the INMD over the next several years. CIHR remains committed to spending the majority of its funds on investigator-initiated applications for health
We sought input on various research. Through the Institutes and their aspects of INMD's strategic efforts to consult, develop partnerships and direction - from research and direct funding into priority areas, we hope to program funding priorities to accelerate progress towards improving the partnerships and collaborations within the health of Canadians. research community, and the potential services of the Institute.
Included in the scan were researchers, health charities, nongovernmental organizations, and policy makers at the provincial and federal level. All four of CIHR's research themes: basic/biomedical; clinical; health systems and services; and social/cultural/environmental factors affecting health were represented, as were all areas of research relevant to INMD's mandate.
The selection for each respondent group is provided in Figure 1:Figure 1: Selection Criteria for Respondent Groups
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Respondent Group |
Selection Criteria |
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Research Community |
Who Selected for Interview:
How Selected:
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Who Selected for Broadcast Email:
How Selected:
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Policy Makers |
Who Selected:
How Selected:
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Organizations |
Who Selected:
How Selected:
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Over 2,500 people and 100 organizations were contacted. In depth interviews with researchers and policy makers were conducted. An email invitation to contribute was sent to individual scientists identified as working in areas under the INMD umbrella. Health charities, professional associations and other research organizations were asked to provide input either by fax, email or a web-based survey instrument. Over 300 responses were received. An overview of the environmental scan process is provided in Figure 2.
Figure 2: Overview of INMD's Environmental Scan Process
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Researchers Phone Interviews
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Organization Mail/Fax Survey
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Research Community Broadcast Email Website
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Policy Makers Phone Interviews
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Researchers' areas of investigation are identified by CIHR research themes (Figure 3), areas of research interest relevant to INMD's mandate (Figure 4), and by research themes and areas combined (Figure 5).
Over 2,500 researchers were contacted. We talked to 40 researchers and heard from more than 200 via our web site.
A total of 159 policy makers, organizations, research groups and funding agencies were contacted. We talked with over 20 policy makers and to date have heard from 35 organizations.
It is evident from both the number of responses and the comments received that Canada's health research community is pleased to have an opportunity for input and is excited about INMD's potential and direction.
INMD's Institute Advisory Board met in Ottawa October 26 -28 to review the results of the scan, and set the strategic directions for the Institute.
Over 500 responses to the question, "What priorities would you include in INMD's research agenda?" were received. Responses were transcribed verbatim, and then subjected to content analysis for common themes. Generally, responses fell into three categories: 1) content areas for research, 2) techniques and approaches to research, and 3) recommended strategies for CIHR (Figure 9).
Techniques, approahces and recommended strategies were also investigated with more direct questions in the survey (see Figures 6,7,10 and 11).
Content areas for research were differentiated by theme using the areas of research identified as relevant to the Institute. In quantifying the strength of responses, all responses were considered as discrete (no overlap was counted). The three areas most commonly cited were nutrition (100 responses), diabetes (90 responses) and obesity (60 responses). When the strength of the responses was considered relative to the number of people self-identified as working in that area (from Figure 4), obesity emerged as the most non-partisan research priority suggested (Figure 8).
Content areas were further differentiated by sub-theme (Figure 9). There was significant overlap among sub-themes, specifically with respect to nutrition in prevention of disease, prevention, treatment and management of Type 2 Diabetes, and obesity. When considering relevant responses from the nutrition and diabetes themes, obesity clearly arose as the most cross-cutting theme identified with one third of the content areas related to obesity.
Policy makers also identified obesity and related areas such as diabetes prevention, diabetes in aboriginal populations, nutrition labeling, nutrition surveillance, food security, traditional foods, healthy eating, and behaviour modification for healthy lifestyles, as areas where there are significant gaps in knowledge on which to base policy. A number of the organizations surveyed also identified these areas as a priority for the development of partnerships with INMD.
Obesity emerged as the most non-partisan research priority suggested and as the most cross-cutting theme identified.
Figure 9: Content Analysis of Responses
| Theme | Sub-themes | No. of responses |
| Nutrition |
Prevention/ health promotion, chronic disease |
33 |
| Maternal/ infant/ child, miscellaneous diseases, nutraceuticals/ functional foods, diet-gene interactions, surveillance, poverty/ food security, immunity, foods/ safety, aging | 67 | |
| Diabetes | Prevention, treatment/ management, etiology & pathogenesis of type 2 | 34 |
| Complications/ etiology & pathogenesis of type 1, cure for type 1, aboriginal, care delivery, quality of life | 56 | |
| Obesity | Prevention/ health promotion, causes, management, complications, vulnerable populations | 60 |
| Metabolism | Lipids, drugs/ drug-gene interaction, anti-oxidants, environmental determinants, metals | 36 |
| Kidney | Renal failure/ transplantation, dialysis, diabetic nephropathy, prevention, transport | 36 |
| Endocrine | Mechanisms of hormone action, insulin signaling, androgens, hormonal control of gene expression, steroid hormones | 26 |
| GI | Functions GI Disorders, inflammatory bowel disease, neuroendocrine control, colorectal cancer, intestinal microflora | 24 |
| Liver | Hepatitis C, transplantation, liver cancers | 19 |
| Other | 4 | |
| Resear techniques/ approaches | Basic science, clinical science, health systems, social/ population, cross pillar, genetics/ genomics, bioinformatics, knowledge transfer, pharmacology | 110 |
| CIHR Strategies | Training, investigator-initiated, career awards, seed funding | 24 |
| Total | 525 |
Support for investigator-initiated work, training of Canada's next generation of researchers, and for interdisciplinary and multidisciplinary research networks are deemed essential components of INMD's strategic direction (Figure 10).
The importance of continued funding for investigator-initiated work is underscored by respondents. Calls to fund excellence in research and use a balanced approach to program funding are key messages.
Funding for training of Canada's next generation of researchers, and to attract, retain and build capacity in Canada's health research community is a high priority and deemed essential.
Support for interdisciplinary and also multidisciplinary research through collaborative networks and partnerships is also deemed essential, both for increasing research power and enhancing the ability to address strategic research initiatives.
Respondents rated eight proposed criteria to guide the work of the Institute as low, medium or high in importance (Figure 11).
Potential for significant scientific advance rates high as a criteria for guiding the selection of INMD's strategic research and funding initiatives. This is backed by a rationale signaling the need for risk and leading edge work over confirmatory research and conservative approaches.
Potential reduction in the "burden of suffering" is another highly rated criteria for guiding the strategic initiatives of the Institute. Rationale for support of this criteria cites the need to address relevance to Canadian public health concerns and disseminate research results to the general public.
These responses suggest the following framework to guide INMD's strategic initiatives.
Environmental scan respondents were asked to identify services they would like to see INMD provide to the health research community in Canada.
Specific services identified for supporting the Institute's research community include providing assistance with grant applications, providing incentives and training for the next generation of researchers, linking researchers with industry and other institutes, and lobbying for health research at all levels of government.
Responses also indicate that communication with the research community is an important Institute function. INMD is widely viewed as an appropriate agency to act as a "clearing house" of information - for Requests for Applications (RFAs); on a variety of research areas; for workshop notices; about accessing request journals; on best practices; and on the allocation of grant monies and funds.
More specifically, respondents request emphasis be placed on facilitating greater information sharing within the research community, by providing lists of potential collaborators and supporting venues for discussion and idea exchange, either through forums or on the internet.
INMD is also called upon to serve as an interface between the research community and the public. Several suggestions relate to heightening public awareness of INMD, CIHR, and Canadian researchers. Translation of research results for public consumption is emphasized, as is transparency regarding the allocation of taxpayer dollars to health research projects.
The internet, in particular CIHR and INMD's website, is widely regarded as one of the most effective potential means of communicating with stakeholders and the health research community. Conferences, workshops and newsletters are also suggested as ways to facilitate communication both with the research community and the public.
As the Institute continues to chart its course, the following are some of the activities planned for the near future.
