Royal society of Canada working group on health research system

Source

Survey 1

Q1 Background

The Royal Society of Canada Working Group on Health Research System Recovery, in partnership with the Canadian Institutes of Health Research (CIHR), is holding a series of sessions that are part of an international knowledge exchange initiative. Given the impact of the COVID-19 pandemic on health research systems worldwide, the purpose of this initiative is to develop actionable recommendations to strengthen Canada’s health research system post-pandemic. Health research system can be defined as the people, institutions, and activities whose primary purpose is to generate high-quality knowledge that can be used to promote, restore, and/or maintain the health status of populations.

We will be holding sessions with leaders from health research funding agencies; health, public health, and social care policy-makers; leaders from research institutes; individual researchers; and members of the public.

In preparation for these meetings with representatives from organizations and sectors such as yours, we are requesting your completion of this survey to

Outline strategies within your organization that address any of the four themes from the WHO research system framework 1 (listed below)

Indicate whether these strategies have been modified to support pandemic recovery

Declare any competing interests

Themes from the WHO research system framework (Pang et al. 2003):

1.

Governance/stewardship including vision, priority setting, ethics, and monitoring/evaluation

3.

Capacity building encompassing capacity to conduct (including supporting the life cycle of the researcher), receive, and use research

4.

Producing and using research to improve health and strengthen the public, social, and health care systems

Q2 Terms of consent

Before beginning the survey, please review the terms of consent. If you have any questions please contact [email protected].

Your participation in this survey is voluntary.

You can choose to stop completing the survey at any time, though any responses up to that point may be used, as outlined below.

The responses will be synthesized by relevant members of the KT Program, Unity Health Toronto.

Prior to the sessions we will disseminate information on reported strategies collected from the survey and any supporting documents provided, to session participants.

The results of the survey will also help form the recommendations.

Results will be pooled and may be publicly reported in products summarizing the results (e.g., reports and publications), without any personal information, though we may include your organization type (e.g., “a provincial health research organization”). De-identified quotes may be used in reports and publications.

There is minimal risk associated with participation in this study; however, there is a risk that participants may later regret sharing some responses in the survey; however, participants are free to contact the study team and withdraw their data prior to the data analysis stage. As it is possible that participants may disclose identifying information, all such identifying information will be changed in any written reports or oral presentations so that participants’ privacy will be protected.

If you consent to the terms of the study you are welcome to begin. Your consent to participate will be implied by beginning the survey.

Q3 Name:

Q4 Email:

Q5 Organization name:

Q6 Department:

Q7 Job title:

Q8 Organization size:

◯ Small (1 to 99 employees)

◯ Medium (100 to 499 employees)

◯ Large (500 employees or more)

Q9 Age of organization:

◯ Greater than 30 years

Q10 Please select the term that best describes your organization as a stakeholder:

◯ Health research funding agency

◯ Research organization

◯ Other _______________________________________________

Display this question:

Please select the term that best describes your organization as a stakeholder: = Health research funding agency

Q11 Please select the type of health research funding agency:

◯ Other_______________________________________________

Display this question:

Please select the term that best describes your organization as a stakeholder: = Research organization

Q12 Please select the type of research organization:

◯ University-affiliated research institute

◯ Non-governmental organization

◯ Other_______________________________________________

Display this question:

Please select the term that best describes your organization as a stakeholder: = Research user

Q13 Please select the type of research user:

◯ Other _______________________________________________

Q14 Theme 1—governance/stewardship including vision, priority setting, ethics, and monitoring/evaluation.

Pang et al. (Pang et al. 2003) define governance/stewardship as being concerned with oversight of the entire health research system. It is primarily the responsibility of government, but others may have responsibility including national health research councils and professional associations. It includes four components: “definition and articulation of a vision for a national health research system; identification of appropriate health research priorities and coordination of adherence to them; setting and monitoring of ethical standards for health research and research partnerships; and monitoring and evaluation of the health research system itself”.Q15 With this definition in mind, please briefly list any strategies your organization implemented that address this theme (e.g., development of a plan with indicators to evaluate implementation of your organizations’ funded research) or provide links to any relevant material on your website describing these strategies or send them to [email protected]. Alternatively, feel free to contact us to set up a brief phone call to provide this information. We anticipate that some of the strategies might be at the initial implementation phases, while others may be in implementation planning stages.Q16 Have the strategies been modified to support pandemic recovery?

Display this question:

If Have the strategies been modified to support pandemic recovery? = Yes

Q17 If yes, how has your organization modified the strategies? Alternatively, feel free to send relevant links/information to [email protected] or contact us to set up a brief phone call to provide this information.Q18 Theme 2—financing According to Pang et al. (Pang et al. 2003) financing of health research systems refers to “securing of research funds and allocating these accountably” and subsequently monitoring these funds and allocation. This process should be efficient, transparent, and peer-review-based.Q19 With this definition in mind, please briefly list any strategies your organization implemented that address this theme (e.g., allocating research funds to COVID-related research) or provide links to any relevant material on your website describing these strategies or send them to [email protected]. Alternatively, feel free to contact us to set up a brief call to provide this information. We anticipate that some of the strategies might be at the initial implementation phases, while others may be in implementation planning stages.Q20 Have the strategies been modified to support pandemic recovery?

Display this question:

If Have the strategies been modified to support pandemic recovery? = Yes

Q21 If yes, how has your organization modified the strategies? Alternatively, feel free to send relevant links/information to [email protected] or contact us to set up a brief phone call to provide this information.

Q22 Theme 3—Capacity building

Capacity building can encompass capacity to conduct (including supporting the life cycle of the researcher), receive, and use research. Pang et al. (Pang et al. 2003) define this as bringing new researchers and institutions into the health research system, further developing and sustaining the existent human and physical capacity, maintaining good physical facilities to conduct research, an attractive career structure, good research management, availability of funding, opportunities to present and discuss data, rapid access to current research information, and addressing internal or external researcher migration and “brain drain”.Q23 With this definition in mind, please briefly list any strategies your organization implemented that address this theme (e.g., offering research staff trainings on novel research methods) or provide links to any relevant material on your website describing these strategies or send them to [email protected]. Alternatively, feel free to contact us to set up a brief call to provide this information. We anticipate that some of the strategies might be at the initial implementation phases, while others may be in implementation planning stages.Q24 Have the strategies been modified to support pandemic recovery?

Display this question:

If Have the strategies been modified to support pandemic recovery? = Yes

Q25 If yes, how has your organization modified the strategies? Alternatively, feel free to send relevant links/information to [email protected] or contact us to set up a brief phone call to provide this information.

Q26 Theme 4—producing and using research to improve health and strengthen the public, social, and health care systems

Pang et al. (Pang et al. 2003) define this as “producing scientifically valid research outputs, translating and communicating research to inform health policy, strategies, and practices, and public opinion, and promoting the use of research to develop new tools (drugs, vaccines, devices, and other applications) to improve health”.Q27 With this definition in mind, please briefly list any strategies your organization implemented that address this theme (e.g., holding knowledge exchange events with researchers and policy-makers who may use the research) or provide links to any relevant material on your website describing these strategies or send them to [email protected]. Alternatively, feel free to contact us to set up a brief call to provide this information. We anticipate that some of the strategies might be at the initial implementation phases, while others may be in implementation planning stages.Q28 Have the strategies been modified to support pandemic recovery?

Display this question:

If Have the strategies been modified to support pandemic recovery? = Yes

Q29 If yes, how has your organization modified the strategies? Alternatively, feel free to send relevant links/information to [email protected] or contact us to set up a brief phone call to provide this information.

Q30 Competing interests Competing interests can take several forms including financial, business/professional, intellectual, affiliations, or memberships in associations, research funding, payments, gifts, gratuities, honoraria, advocacy, consulting, and others.

Q31 Are you involved in any activities that could create real, potential, or apparent conflicts of interest that could affect your responses in this survey or in the upcoming session (if attending)? Please note that for transparency, your name along with your competing interests will be shared with session participants before the session.

Display this question:

If Are you involved in any activities that could create real, potential, or apparent conflicts of in… = Yes

Q32 If yes, please describe

Survey 2

Q1 Background

The Royal Society of Canada Working Group on Health Research System Recovery, along with the Canadian Institutes of Health Research (CIHR) held a series of sessions that were part of an international knowledge exchange initiative. Given the impact of the pandemic on health research systems worldwide, the purpose of this initiative was to develop actionable recommendations to strengthen Canada’s health research system post-pandemic.

The World Health Organization (WHO) defines a health research system as “the people, institutions, and activities whose primary purpose in relation to research is to generate high-quality knowledge that can be used to promote, restore, and/or maintain the health status of populations; it should include the mechanisms adopted to encourage the utilization of research” (Pang et al. 2003).The WHO Health Research Ecosystem Framework includes four components:

1.

Governance/stewardship, which includes coordination, priority setting, ethics, monitoring, evaluation, and accountability

2.

Financing, which includes securing and allocating funding with accountability and transparency

3.

Capacity building, which includes human and physical capacity to conduct, absorb, and use health research

4.

Producing and using research, which includes producing, promoting, disseminating, and implementing research in practice, policy, and public opinion

To develop these recommendations, we held sessions with national and international leaders from health research funding agencies; health, public health, and social care policy-makers; leaders from research institutes; individual researchers; and members of the public. We also contextualized the recommendations using input from the recently released report of the Advisory Panel on the Federal Research Support System.

Through this survey, we are requesting your feedback on these recommendations, which will then be disseminated broadly to all relevant organizations (e.g., funders, government, research organizations).

This survey will take 15–20 min to complete.

Q2 Terms of consent

Before beginning the survey, please review the terms of consent. If you have any questions please contact Robyn Beckett at [email protected].

Your participation in this survey is voluntary.

You can choose to stop completing the survey at any time, though any responses up to that point may be used, as outlined below.

No one other than the research team will know what you responded.

Your responses will be compiled by relevant members of the Knowledge Translation Program, Unity Health Toronto.

The results will help refine the recommendations. Results will be pooled and may be publicly reported in products summarizing the results (e.g., reports and publications), without any personal information, though we may include your organization type (e.g., “a provincial health research organization”). De-identified quotes may be used in reports and publications.

There is minimal risk associated with participation in this study. Minor risks include (1) participants may later regret sharing some responses in the survey; however, participants are free to contact the study team and withdraw their data prior to the data analysis stage; and (2) in the feedback section participants may disclose identifying information; however, all such identifying information will be changed in any written reports or oral presentations so that participants’ privacy will be protected.

If you consent to the terms of the study you are welcome to begin. Your consent to participate will be implied by beginning the survey.

Q3 Please select the term(s) that best describe your organization or you as a stakeholder (select all that apply):

□ Health research funding agency

□ Research organization

□ Research user (e.g., member of the public or patient, government employee, journal staff, and healthcare provider)

□ Other_______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (select all that apply): = Health research funding agency

Q4 Please select the type of health research funding agency (select all that apply):

□ Other_______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (select all that apply): = Research organization”.

Q5 Please select the type of research organization (select all that apply):

□ University-affiliated research institute

□ Non-governmental organization

□ Other_______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (select all that apply): = Research user (e.g., member of the public or patient, government employee, journal staff, and healthcare provider).

Q6 Please select the type of research user (select all that apply):

□ Clinician/healthcare provider

□ Member of the public or patient

□ Other_______________________________________________

Q7 The next several pages provide the recommendations organized by the four themes from the World Health Organization’s health research systems framework (governance/stewardship, financing, capacity building, and producing and using research). Please rate each recommendation on the importance for implementation in Canada on a scale from 1 to 9, with 1 being not at all important, 5 being moderately important, and 9 being extremely important. Please also provide any comments or suggestions for the recommendations in the open text boxes. These questions may be repetitive, but we appreciate your feedback across all the recommendations. Note that you can click on the hyperlinked terms in some of the statements to obtain definitions/more information.

Q8 Theme 1: governance/stewardship

Q9 Coordinate research efforts across local, provincial, national, and international entities. Specifically:

  1 2 3 4 5 6 7 8 9
Leverage and extend the use of the Canada Research Coordinating Committee (CRCC) across the TriCouncil Agencies and the Canada Foundation for Innovation (CFI) to provide research and innovation advice, oversight, coordination, and communication across the TriCouncil Agencies. Please click on the organization/project names to learn more.
Create a new entity, entitled the Canadian Knowledge and Science Foundation (CKSF) to rapidly address emerging research and innovation needs, deliver TriCouncil Agency programming, and enhance coordination, planning, and policy capacity across the research support system (as suggested in the recent report of the Advisory Panel on the Federal Research Support System)
Establish a health research funding agency in each province/territory through which the provincial/territorial health ministry and public health agency can connect on research priorities and evidence needs
Establish a structure whereby the Public Health Agency of Canada and Health Canada connect with provincial/territorial health research agencies and provincial/territorial ministries responsible for health and public health on research priorities and evidence needs

Q10 Please provide any comments or suggestions for the above set of recommendations.

Q11 Theme 1: Governance/stewardship

Q12 Create communications infrastructure. Specifically:

  1 2 3 4 5 6 7 8 9
Through regular and frequent meetings, promote coordination and communication between the Canadian Institutes of Health Research (CIHR) and Health Canada to facilitate research conduct, use, and funding
Through regular meetings, promote coordination and communication between federal and provincial/territorial funders and relevant federal and provincial policy-makers (e.g., the National Alliance of Provincial Health Research Organizations (NAPHRO)) to align and facilitate research conduct and use
Develop centralized processes to communicate and coordinate research priorities with knowledge users (such as researchers, academic institutions, charitable organizations, and patient/public organizations including equity-deserving groups)
Establish a communication platform to outline what research questions/priorities different funders (e.g., provincial/territorial, TriCouncil Agencies) are responsible for to limit duplication and support replication
Encourage the use of communication platforms between TriCouncil Agencies and international funding agencies to align research priorities in pandemics/health emergencies to coordinate research (e.g., Global Research Collaboration for Infectious Disease Preparedness (GloPID-R))
Develop principles of transparent communication around what research is funded
Develop and publicly report data on research impact and overall impact of research funding

Q13 Please provide any comments or suggestions for the above set of recommendations.

Q14 Theme 1: governance/stewardship.

Q15 Outline research logistics as a part of emergency preparedness. Specifically:

  1 2 3 4 5 6 7 8 9
Create an emergency preparedness research plan that includes data sharing, cybersecurity, research ethics board (REB) approvals, and supply chain procedures
Ensure the emergency preparedness research plan includes the coordination of research questions with international research funders to prioritize based on capacity, expertise, and infrastructure
Develop data sharing agreements within and across provinces/territories and between provinces/territories and national partners (e.g., Canadian Institute for Health Information (CIHI)) for sharing data including health research, health services, and registry data
Centralize and harmonize research ethics board (REB) processes nationally with a single online form, standardized training, and tracking of timelines
Prioritize REB for relevant studies during health/public health emergencies
Harmonize processes (including data collection, privacy, and REB) for biobanks and data sharing within provinces/territories and across provinces/territories to facilitate rapid research

Q16 Please provide any comments or suggestions for the above set of recommendations.

Q17 Theme 1: governance/stewardship

Q18 Prioritize equity in research processes. Specifically:

  1 2 3 4 5 6 7 8 9
Use equity and anti-oppression principles in all governance decision making and actions aligned with the TriCouncil Agency’s Dimensions Charter and the rights of First Nations, Inuit, and Métis Peoples
Include patients/public at all governance levels in the health research ecosystem using an open, transparent recruitment process and publicly report on their inclusion
Sustain Indigenous-led biobanks and data sharing
Create national database of ongoing studies for patients to engage with as research partners and research leads

Q19 Please provide any comments or suggestions for the above set of recommendations.

Q20 Theme 1: governance/stewardship

Q21 Facilitate streamlined, inclusive grant review process. Specifically:

  1 2 3 4 5 6 7 8 9
Monitor grant application and success rates by applicants’ PROGRESS PLUS factors (an acronym used to identify characteristics that stratify health opportunities and outcomes) and report on this information publicly
Ensure equity and diversity principles are embedded within all grant applications, including the consideration that research team and patient partners should reflect the diversity of relevant population
Reimburse peer reviewers for any caregiving support required for their dependents, to enable the peer reviewers to attend meetings
Mandate that principal investigators with peer-reviewed grants must participate in grant peer review for the duration of their grant support
Use the grant application and success data to revise grant competitions (e.g., to prioritize specific research areas, researchers from equity-deserving groups, etc.)
Standardize virtual and hybrid processes for grant peer review
Include patients in grant peer review process
Use Public Health Agency of Canada’s Strengthening the Integration of Intersectionality Theory in Health Inequality Checklist when reviewing grants to assess if and how they adhere to equity considerations
Create multidisciplinary grant review panels and provide peer review training for multidisciplinary research
Create iterative grant peer review process with opportunity for interviews with applicants and peer review panel to clarify questions/responses
Streamline the grants application process for patients such as reducing requirements for patients to complete letters of support, CVs and sex- and gender-based analysis plus (GBA+) modules (e.g., Women’s College Research Institute’s (WCRI) GBA+)
Conduct peer review of the grant peer review process (including peer reviewers) and make results of this peer review transparent

Q22 Please provide any comments or suggestions for the above set of recommendations.

Q23 Theme 2: financing

Q24 Reimagine funding of research. Specifically:

  1 2 3 4 5 6 7 8 9
Embed equity considerations in decision making on all research investments
Ensure long-term funding for successful research enterprises and develop strategies for defunding initiatives that aren’t achieving relevant impact
Assess extent to which research infrastructure and research infrastructure funding exists for therapeutics, vaccine, diagnostic testing development and implementation
Establish funding for provincial/territorial health research hubs with linkages to health, public health, social care, education and cross-disciplinary collaborations (e.g., National Institute for Health and Care Research (NIHR) Clinical Research Networks, Applied Research Collaborations, National Health and Medical Research Council (NHMRC) Translational Research Centres, National Institutes of Health (NIH) Implementation/translation Research Centres)
Develop strategies for sustainability of networks/platforms/hubs through partnerships with national/provincial/territorial funders
Increase overhead/indirect cost allowance (cost of doing research including space, human resources, contracts support) for research institutes to 50% to completely cover cost of research operations
Engage with industry to contribute to funding for health research hubs/networks/platforms
Work with industry to provide unrestricted funds for project research grants and infrastructure grants
Make research funding allocations transparent, and report on the distribution of funding by applicants’ PROGRESS PLUS factors (e.g., gender, race)
Make a clear separation between knowledge user-driven versus researcher-driven research; have separate funding for both groups
Support mechanisms for crowdfunding research

Q25 Please provide any comments or suggestions for the above set of recommendations.

Q26 Theme 2: financing

Q27 Support researchers. Specifically:

  1 2 3 4 5 6 7 8 9
Develop collaborative grants across the TriCouncil Agencies that support cross-disciplinary training of PhD students and post-doctoral fellows
Create salary support pathways for scientists (such as salary support awards or embedding salary into grants) throughout their career trajectories from early career to mid- and senior-career
Create similar salary support pathways for clinician scientists throughout their career trajectories from early career to mid- and senior-career
Expand joint industry/academic and PhD/post-doctoral training opportunities
Expand joint government/academic training opportunities for PhD/post-doctoral trainees
Establish and maintain living wage standards for salaries for graduate students and post-doctoral fellows

Q28 Please provide any comments or suggestions for the above set of recommendations.

Q29 Theme 3: capacity building

  1 2 3 4 5 6 7 8 9
Embed equity, diversity, and anti-racism principles in all research capacity-building activities
Create opportunities for Postdoctoral Fellowships across academia, industry, and government sectors
Create opportunities for Postdoctoral Fellows to work in more than one sector (academic, industry, or government) during a fellowship
Use provincial/territorial/national data to estimate needs for the health human workforce and the research workforce using dynamic modelling (e.g., align training opportunities while monitoring for burnout/lack of retention)
Create transdisciplinary research training networks for graduate students, fellows and early career researchers to facilitate research and research training in diverse methods and disciplines across all research pillars (e.g., implementation science, one health, artificial intelligence (AI))
Create support strategies for those disproportionately affected systematically and during the pandemic such as Black, Indigenous, and people of colour, women, non-binary people, and clinician scientists
Provide training for researchers on trauma-informed approaches to patient engagement; that is, approaches rooted in an understanding of how trauma impacts people, with the purpose of avoiding potential re-traumatization during the research process. These approaches also acknowledge broader social contexts and how systems of oppression (e.g., colonialism, white supremacy) cause trauma.
Ensure patient engagement in research uses trauma-informed approaches
Provide training for researchers, patient partners, and policy-makers on anti-oppression practices in research; that is, practices that name and seek to dismantle injustices and power imbalances in the broader social context and in the research processes (e.g., asking community members most impacted by the research to lead key research activities such as developing the project plan and the budget).
Provide training for researchers, patients, and policy-makers on knowledge mobilization

Q31 Please provide any comments or suggestions for the above set of recommendations.

Q32 Theme 4: producing and using research

Q33 Producing research

  1 2 3 4 5 6 7 8 9
Create a network of chief science advisors in each national/provincial/territorial government department Create opportunities for these advisors via knowledge exchange with researchers across Canada These advisors can interpret and communicate science to policy-makers including communication of evidence uncertainty
Create funding opportunities such as partnership grants between researchers and knowledge users to focus on research uptake
Further develop multidisciplinary, collaborative grants across the TriCouncil Agencies (leveraging New Frontiers in Research Fund) that support collaborations across research disciplines including those that range from developing the team/research project through to completion of research and its dissemination
Create health research hubs within provinces/territories to link health care delivery context with research across all Canadian Institutes of Health Research (CIHR) pillars; include patient/public engagement and commercialization
Create a national network of the provincial/territorial health research hubs and identify focused areas (e.g., methodological, clinical) that each may lead/co-lead nationally (for example, in areas such as pandemic preparedness, healthy aging, climate change, one health, health/social disparities, artificial intelligence (AI) innovation, patient/public engagement, implementation science/knowledge mobilization)
Embed clinical trials platform(s) within health care delivery/health research hubs

Q34 Please provide any comments or suggestions for the above set of recommendations.

Q35 Theme 4: producing and using research

Q36 Using research

  1 2 3 4 5 6 7 8 9
Enhance science to policy dissemination training for researchers (e.g., in plain language communication) through various approaches including modules and embedded training opportunities
Enhance science to policy dissemination training for policy-makers (e.g., in plain language communication) through various approaches including modules and embedded training opportunities
Co-create and deliver public education strategies for increasing health research literacy with members of the public
Co-create and deliver training for patients on engaging in research
Co-create and deliver training for patients on interacting with policy-makers
Create communication/knowledge exchange opportunities across funded networks/platforms/hubs

Q37 Please provide any comments or suggestions for the above set of recommendations.

Q38 Is there anything not captured in this list of recommendations that should be added?

Survey 3

Q1 Background

Thank you for your interest in the international knowledge exchange initiative led by the Royal Society of Canada Working Group on Health Research System Recovery, and in partnership with the Canadian Institutes of Health Research (CIHR). We held sessions with leaders from health research funding agencies; health, public health, and social care policy-makers; leaders from research institutes; individual researchers; and members of the public to develop a set of actionable recommendations to strengthen Canada’s health research system post-pandemic. After receiving public input, we developed and refined these recommendations. The updated version of the recommendations is provided in this survey.

There are reviews underway at the national and provincial/territorial levels into the COVID-19 research response and this work will feed into and benefit those reviews. The responses from this survey will be used to select one priority example across each category and present this to a wide range of executive decision-makers as a priority focus. We will be preparing a document with the list of recommendations and a description of some specific examples of what could be implemented and by whom. This document will be shared by the Canadian Institutes of Health Research (CIHR) and the Royal Society of Canada with relevant partners.

In this survey, there are 12 recommendations; each is followed by some specific examples of how these recommendations could be implemented and by whom. For each recommendation, we ask that you let us know which specific examples you think should be prioritized for implementation. For each of your selections, we ask you to specify who should be responsible for implementing it. We also invite you to provide any final suggestions to the wording of the 12 recommendations and examples.

This survey may take 15–20 min to complete; you may come back and resume the survey using the initial link.

Q2 Terms of consent

Before beginning the survey, please review the terms of consent. If you have any questions please contact Robyn Beckett at [email protected].

Your participation in this survey is voluntary.

You can choose to stop completing the survey at any time, though any responses up to that point may be used, as outlined below.

No one other than the research team will know what you responded.

Your responses will be compiled by relevant members of the Knowledge Translation Program, Unity Health Toronto.

Results will be pooled and may be publicly reported in products summarizing the results (e.g., reports, publications), without any personal information, though we may include your organization type (e.g., “a provincial health research organization”). De-identified quotes may be used in reports and publications.

There is minimal risk associated with participation in this study. Minor risks include (1) participants may later regret sharing some responses in the survey; however, participants are free to contact the study team and withdraw their data prior to the data analysis stage; and (2) in the feedback section participants may disclose identifying information; however, all such identifying information will be changed in any written reports or oral presentations so that participants’ privacy will be protected.

If you consent to the terms of the study you are welcome to begin. Your consent to participate will be implied by beginning the survey.

Q3 Organization name (if applicable):

Q4 Department (if applicable):

Q5 Job title (if applicable)

Q6 Please select the term(s) that best describe your organization or you as a stakeholder (if applicable) (select all that apply):

□ Health research funding agency (includes foundations that fund health research (e.g., Health Research BC))

□ Government (e.g., Ministry of Health)

□ Research organization

□ Research user (e.g., member of the public or patient, government employee, journal staff, and healthcare provider)

□ Other _______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (if applic… = Health research funding agency (includes foundations that fund health research (e.g., Health Research BC))

Q7 Please select the type of health research funding agency (if applicable) (select all that apply):

□ Other _______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (if applic… = Research organization

Q8 Please select the type of research organization (if applicable) (select all that apply):

□ University-affiliated research institute

□ Non-governmental organization

□ Other _______________________________________________

Display this question:

Please select the term(s) that best describe your organization or you as a stakeholder (if applic… = Research user (e.g., member of the public or patient, government employee, journal staff, and healthcare provider)

Q9 Please select the type of research user (if applicable) (select all that apply):

□ Clinician/healthcare provider

□ Member of the public or patient

□ Other _______________________________________________

Q10 The next several pages provide the recommendations organized by the four themes from the World Health Organization’s health research systems framework (governance/stewardship, financing, capacity building, and producing and using research). There are 12 recommendations, each of which is followed by a number of specific examples on how these recommendations could be implemented. Please select the example that represents your highest priority as an implementation focus for each of the 12 recommendations. Next, please indicate who should be responsible for implementing it such as Health Canada, the Canadian Institute of Health Research (CIHR), the provincial/territorial governments, universities, research institutes, etc. Note that you can click on the hyperlinked terms in some of the statements to obtain definitions/more information.

Q11 Theme 1: governance/stewardship

Q12 Recommendation 1: Outline research logistics as a part of emergency preparedness.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Create an emergency preparedness research plan that includes data sharing (across provinces/territories and national partners), cybersecurity, research ethics boards (REB) approvals, protocols for key studies on health emergencies that are pre-cleared by REB, and supply chain procedures.

◯ b. Develop an emergency preparedness plan that coordinates research questions with international research funders to prioritize based on capacity, expertise, infrastructure, and ensure the emergency preparedness plan is fully integrated with existing research policies.

◯ c. Centralize, standardize, and harmonize REB processes nationally with a single online form and centralized intake with reviews distributed to regional REBs according to their wait times, standardized training, and tracking of timelines.

◯ d. Prioritize REB for relevant studies during health/public health emergencies, maintaining an equity focus in the research.

◯ e. Harmonize processes (including data collection, privacy, REB, and searchable database) for biobanks (a repository of biological samples that are used in research) and data sharing (the dissemination and exchange of data/research findings for the purpose of further research) within provinces/territories and across provinces/territories to facilitate rapid research.

Q13 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q14 Please provide any comments or suggestions for the above recommendation:

Q15 Recommendation 2: Prioritize equity and inclusion in research processes.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Use equity and anti-oppression principles in all governance decision making and actions aligned with the Tri-Council Agency’s Dimensions Charter and the rights of First Nations, Inuit, and Métis Peoples.

◯ b. Include patients/public at all governance levels in the health research ecosystem using an open, transparent recruitment process and publicly report on their inclusion.

◯ c. Create national database of ongoing studies for patients to engage with as research partners and research leads.

Q16 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q17 Please provide any comments or suggestions for the above recommendation:

Q18 Recommendation 3: Facilitate streamlined, inclusive, and rigorous application and grant review process.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Monitor grant application and success rates by applicants’ PROGRESS PLUS factors (an acronym used to identify characteristics that stratify health opportunities and outcomes) and sex- and gender-based analysis plus (GBA+), report on this information publicly, and use it to inform and revise grant competitions (e.g., prioritize specific research areas, researchers who are experiencing structural barriers, etc).

◯ b. Ensure equity and diversity principles are embedded within all requests for proposals and grant applications, including the consideration that research team and patient partners should reflect the diversity of relevant population and that study team and participant demographics are reported to granting agencies to ensure they are reflective of population.

◯ c. Reimburse peer reviewers for any caregiving support required for their dependents, to enable the peer reviewers to attend meetings (e.g., implemented at Canadian Institute of Health Research (CIHR)).

◯ d. Ensure peer reviewers are trained in anti-oppression in research, equity, and diversity principles.

◯ e. Mandate that principal investigators with peer-reviewed grants must participate in grant peer review for the duration of their grant support.

◯ f. Standardize virtual and hybrid processes for grant peer review.

◯ g. Include patients in grant peer review process.

◯ h. Use Public Health Agency of Canada’s Strengthening the Integration of Intersectionality Theory in Health Inequality Checklist when reviewing grants to assess if and how research applicants adhere to equity considerations.

◯ i. Create multidisciplinary (e.g., Canadian Institutes of Health Research (CIHR) pillars 1 to 4) grant review panels and provide peer review training for multidisciplinary research.

◯ j. Create iterative grant peer review process with opportunity for interviews with applicants and peer review panel to clarify questions/responses.

◯ k. Streamline the grants application process for patients such as reducing requirements for patients to complete letters of support, CVs, and sex- and gender-based analysis plus (GBA+) modules, include patient-friendly instructions and modules.

◯ l. Conduct peer review of the grant peer review process (including peer reviewers) and make results of this peer review transparent.

◯ m. Ensure patients are adequately compensated to ensure they have capacity to participate as peer reviewers

Q19 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q20 Please provide any comments or suggestions for the above recommendation:

Q21 Recommendation 4: Create communications infrastructure.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Develop centralized processes to communicate and coordinate research priorities with knowledge users (such as researchers, academic institutions, charitable organizations, and patient/public organizations including equity-deserving groups).

◯ b. Develop protocols and processes for rapid funding calls (e.g., ensuring they include focus on populations that may be at highest risk of health inequities).

◯ c. Encourage the use of communication platforms between Tri-Council Agencies and international funding agencies to facilitate alignment of research priorities in pandemics/health emergencies to coordinate communication around research (e.g., Global Research Collaboration for Infectious Disease Preparedness (GloPID-R)).

◯ d. Develop principles of transparent communication around what research is funded, including publicly reporting data on research impact and overall impact of research funding.

Q22 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q23 Please provide any comments or suggestions for the above recommendation:

Q24 Recommendation 5: Coordinate research efforts across local, provincial, national, and international entities.

Please select your prioritized example for implementing the above recommendation from the following list:◯ a. Leverage and extend the use of the Canada Research Coordinating Committee (CRCC) across the Tri-Council Agencies and the Canada Foundation for Innovation (CFI) to provide research and innovation advice, oversight, democratic decision-making, and coordination, prioritization, and communication across the Tri-Council Agencies and among international funding agencies.

 Membership of the CRCC should include national (e.g., Canadian Institutes of health Research (CIHR), Health Canada, Public Health Agency of Canada (PHAC)) and provincial/territorial funding agencies (e.g., National Alliance of Provincial Health Research Organisations (NAPHRO)).

 This could be achieved, for example, through strategies to create better coordination, as suggested in the recent report of the Advisory Panel on the Federal Research Support System. This report suggested creating a new entity, entitled the Canadian Knowledge and Science Foundation (CKSF) to rapidly address emerging research and innovation needs, deliver Tri-Council Agency programming, and enhance coordination, planning, and policy capacity across the research support system.

◯ b. Establish a health research funding agency in each province/territory where these do not currently exist and through which the provincial/territorial health ministry and public health agency can connect on research priorities and evidence needs.

Q25 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q26 Please provide any comments or suggestions for the above recommendation:

Q27 Theme 2: financing

Q28 Recommendation 6: reimagine funding of research.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Embed equity considerations in decision making on all research investments, such as making funding contingent on meaningful actions to address inequities.

◯ b. Ensure long-term funding for successful research enterprises and develop strategies that balance defunding low impact initiatives and exploratory research.

◯ c. Assess extent to which research infrastructure and research infrastructure funding exists for therapeutics, vaccine, diagnostic testing development and implementation and develop metrics for appropriate allocation.

◯ d. Establish funding and sustainability strategies for provincial/territorial health research hubs with linkages to health, public health, social care, education, and cross-disciplinary collaborations (e.g., National Institute for Health and Care Research (NIHR) Clinical Research Networks, Applied Research Collaborations, National Health and Medical Research Council (NHMRC) Translational Research Centres, and National Institutes of Health (NIH) Implementation/translation Research Centres).

◯ e. Increase overhead/indirect cost allowance (cost of doing research including space, human resources, and contracts support) for research institutes to 50% to completely cover cost of research operations.

◯ f. Engage with industry to transparently contribute to funding and communications for health research authorities/hubs/networks/platforms.

◯ g. Work with industry to provide unrestricted funds for project research grants and infrastructure grants, with transparency protocols.

◯ h. Ensure separate funding for knowledge user-driven and researcher-driven research.

◯ i. Support mechanisms for crowdfunding research.

◯ j. Provide more support for researcher success (e.g., increase funding pool and/or support increased application quality).

◯ k. Increase access for non-academic organizations (e.g., local health authorities) to research funding pools.

◯ l. Include funding requirements and fund access to support patient involvement as research partners (e.g., honoraria, translation, and childcare), while considering patients’ circumstances (e.g., disability income and tax implications).

Q29 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q30 Please provide any comments or suggestions for the above recommendation:

Q31 Theme 3: capacity building

Q32 Recommendation 7: Invest in formative training opportunities rooted in equity, diversity, and anti-racism.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Embed formative equity, diversity, and anti-racism components in all research capacity building activities.

◯ b. Provide training for researchers on trauma-informed approaches to patient engagement; that is, approaches rooted in an understanding of how trauma impacts people, with the purpose of avoiding potential re-traumatization during the research process. These approaches also acknowledge broader social contexts and how systems of oppression (e.g., colonialism and white supremacy) cause trauma.

◯ c. Provide training for researchers, patient partners, and policy-makers on anti-oppression practices in research; that is, practices that name and seek to dismantle injustices and power imbalances in the broader social context and in the research processes (e.g., asking community members most impacted by the research to lead key research activities such as developing the project plan and the budget).

◯ d. Provide training for researchers, patients, and policy-makers on patient engagement and knowledge mobilization.

◯ e. Establish a national standard for engaging patients as partners in research.

Q33 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q34 Please provide any comments or suggestions for the above recommendation:

Q35 Recommendation 8: support researchers.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Create support strategies for those disproportionately affected systematically and during the pandemic such as Black, Indigenous, and people of colour, women, non-binary people, and clinician scientists.

◯ b. Use provincial/territorial/national data to estimate needs for the health human workforce and the research workforce using dynamic modelling (e.g., align training opportunities while monitoring for burnout/lack of retention).

◯ c. Create salary support pathways for scientists/clinician scientists (such as salary support awards or embedding salary into grants) throughout their career trajectories from early career to mid- and senior-career.

◯ d. Provide sufficient funding for researchers for knowledge mobilization, including in communication, media, and graphic design.

Q36 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q37 Please provide any comments or suggestions for the above recommendation:

Q38 Recommendation 9: Support early career researchers.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Create opportunities for Postdoctoral Fellows to work in more than 1 sector (academic, industry, or government) during a fellowship.

◯ b. Create transdisciplinary research training networks for graduate students, fellows, and early career researchers to facilitate research and research training in diverse methods and disciplines across all research pillars (e.g., implementation science, One Health, artificial intelligence (AI)).

Q39 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q40 Please provide any comments or suggestions for the above recommendation:

Q41 Theme 4: producing and using research

Q42 Recommendation 10: further strengthen Indigenous health research and break down systemic barriers to its conduct.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Sustain Indigenous-led biobanks and data sharing.

◯ b. Incorporate guidance and knowledge to support respectful research engagement with Indigenous people including the OCAP Principles (Ownership, Control, Access, and Possession), the OCAS principles (Ownership, Control, Access, and Stewardship) and Inuit Qaujimajatuqangit (Inuit traditional knowledge).

◯ c. Ensure barriers are removed for Indigenous knowledge holders to be principal applicants.

Q43 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q44 Please provide any comments or suggestions for the above recommendation:

Q45 Recommendation 11: Produce innovative research.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Create partnership grants between researchers and knowledge users to focus on research uptake.

◯ b. Further develop multidisciplinary, collaborative grants across the Tri-Council Agencies (leveraging New Frontiers in Research Fund) that support collaborations across research disciplines including those that range from developing the team/research project through to completion of research and its dissemination.

◯ c. Create health research hubs within provinces/territories to link health care delivery context with research across all Canadian Institutes of Health Research (CIHR) pillars; include patient/public engagement and commercialization and facilitate a national network of these hubs (e.g., UK National Institute for Health and Care Research (NIHR) Applied Research Collaborations, National Health and Medical Research Council (NHMRC) Translational Research Centres).

◯ d. Embed clinical trials platform(s) within health care delivery/health research hubs (e.g., National Institute for Health and Care Research (NIHR)).

◯ e. Have funding calls for research areas prioritized by patients/the public.

Q46 Who do you think should implement your prioritized example? (select all that apply)

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q47 Please provide any comments or suggestions for the above recommendation:

Q48 Recommendation 12: enhance research use across the health research ecosystem.

Please select your prioritized example for implementing the above recommendation from the following list:

◯ a. Enhance science to policy dissemination training for researchers (e.g., in plain language communication) and policy-makers through various approaches including modules and embedded training opportunities.

◯ b. Create a network of chief science advisors in each national/provincial/territorial government department. Create opportunities for these advisors via knowledge exchange with researchers across Canada. These advisors can interpret and communicate science to policy-makers including communication of evidence uncertainty.

◯ c. Create knowledge exchange opportunities across funded networks/platforms/hubs.

◯ d. Co-create and deliver public education strategies for increasing health research literacy with members of the public.

◯ e. Co-create and deliver training for patients on engaging in research.

◯ f. Co-create and deliver training for patients on interacting with policy-makers.

Q49 Who do you think should implement your prioritized example? (select all that apply).

□ Public Health Agency Of Canada (PHAC)

□ Canadian Institutes of Health Research (CIHR)

□ Provincial/territorial governments

□ Provincial/territorial funding agencies

□ Health care professional organizations

□ Other_______________________________________________

Q50 Please provide any comments or suggestions for the above recommendation:

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