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Credit: Johns Hopkins University

Study inspired by curious 15-year-old could advance search for novel antibiotics

New bacteria found in raw honey could benefit the fight against legionnaires' disease and antibiotic resistance, according to new johns hopkins medicine research.

By Alexandria Carolan

Equipped with a suitcase full of honey, high school sophomore Carson Shin contacted university after university, hoping to work with expert biochemists to investigate the sticky substance's antimicrobial properties.

The only problem? Scientists seemed wary of collaborating with a 15-year-old.

Image caption: Carson Shin

Shin couldn't have predicted that, five years later, he would co-author a Johns Hopkins Medicine report showing that dormant and previously undescribed bacteria found in raw honey produce antibiotics that can kill the bacterial pathogen Legionella . The pathogen can be found in potable water and causes Legionnaires' disease, a life-threatening pneumonia that kills one in 10 people infected with it.

The published report not only offers a first step in the development of new antibiotics for Legionella , but has the potential to aid in the fight against antibiotic resistance, says senior author Tamara O'Connor , assistant professor of biological chemistry at Johns Hopkins University School of Medicine.

Shin reached out to O'Connor in the spring of 2019, beginning a summer internship with the professor that he hoped would uncover a novel antimicrobial property of honey.

"Carson showed tremendous initiative and was very inquisitive," O'Connor says. "It's exciting to have any student join the lab who demonstrates this level of intellectual engagement in science."

Initially, Shin and O'Connor exposed Legionella to raw, unpasteurized honey, to test whether the natural substance could kill the bacteria. Surprisingly, honey had little effect on Legionella . However, in the course of these experiments, they identified several different bacteria in the honey that, in response to Legionella , produced and secreted antibiotics that were lethal to the pathogen.

"We found the right conditions for the honey bacteria to thrive, allowing us to tap into a resource we didn't know was there," Shin says.

In nature, O'Connor says, "bacteria figure out ways to outcompete one another, which often involves releasing toxic molecules that kill their competitors." The honey bacteria Shin and O'Connor isolated "recognize Legionella as competition and launch a deadly response."

The honey bacteria were identified as members of the Bacillus and Lysinibacillus genera of bacteria. This is not surprising, O'Connor says, because bacilli produce spores that are protected from the antimicrobial properties of honey. These bacteria are commonly found in raw honey, explaining why it is recommended to eat only pasteurized honey, she says.

Upon sequencing the genomes of two of the bacterial isolates, strain AHB2 and strain AHB11 , the researchers identified them as members of the species Bacillus safensis . Previously, the ability for this group of bacteria to produce antibacterial molecules was not well-documented.

Further experiments revealed how specific the response of honey bacteria to Legionella was.

"Remarkably, the bacteria in honey only produce these antibacterial molecules in response to Legionella species, as none of the other bacterial pathogens we exposed them to elicited this response," O'Connor says.

Image caption: Tamara O'Connor

While other pathogens did not cause honey bacteria to produce these antibiotics, many were susceptible to them, O'Connor says. These results suggest antibacterial molecules produced by honey could target other harmful pathogens and could be used as broad-spectrum antibiotics. While these preliminary findings offer the identification of new antibacterial molecules, more research is needed to determine their potential for developing viable therapeutics, O'Connor says.

Antimicrobial resistance is one of the largest threats to global public health, contributing to nearly 5 million deaths in 2019, according to the World Health Organization—creating a dire need for the development of new antibiotics to treat bacterial infections.

Similar studies of the biowarfare between microorganisms have led scientists to identify many antimicrobial molecules, says O'Connor. The vast majority of antibiotics prescribed by physicians originate from natural products, she says.

"The ability to tap into these resources by identifying new bacteria and the conditions that cause them to produce antibacterial molecules is critical in the fight against antibiotic resistance," she says.

Young scientists like Shin are crucial to combat antibiotic resistance, O'Connor says.

"Carson exemplifies how the curiosity of an aspiring young scientist can lead to exciting new discoveries," she says.

Shin, who is beginning his senior year of college this fall at the University of Pennsylvania, said his experience at Johns Hopkins influenced his decision to study anthropology. Before reaching out to O'Connor, Shin had looked into raw honey's historic and ancient role in traditional medicines of the Egyptians, Greeks, and Islamic countries over thousands of years.

"Our research stems from studying culture. You can learn valuable information about medicine from cultures across the world and across time," Shin says.

The research was supported independently by the Department of Biological Chemistry and the Johns Hopkins University School of Medicine .

Posted in Health

Tagged antibiotics , department of biological chemistry , bacteria

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• Open access
• Published: 31 August 2024

Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023

• Xianru Shang   ORCID: orcid.org/0009-0000-8906-3216 1 ,
• Zijian Liu 1 ,
• Chen Gong 1 ,
• Zhigang Hu 1 ,
• Yuexuan Wu 1 &
• Chengliang Wang   ORCID: orcid.org/0000-0003-2208-3508 2  

Humanities and Social Sciences Communications volume  11 , Article number:  1115 ( 2024 ) Cite this article

Metrics details

• Science, technology and society

The rapid expansion of information technology and the intensification of population aging are two prominent features of contemporary societal development. Investigating older adults’ acceptance and use of technology is key to facilitating their integration into an information-driven society. Given this context, the technology acceptance of older adults has emerged as a prioritized research topic, attracting widespread attention in the academic community. However, existing research remains fragmented and lacks a systematic framework. To address this gap, we employed bibliometric methods, utilizing the Web of Science Core Collection to conduct a comprehensive review of literature on older adults’ technology acceptance from 2013 to 2023. Utilizing VOSviewer and CiteSpace for data assessment and visualization, we created knowledge mappings of research on older adults’ technology acceptance. Our study employed multidimensional methods such as co-occurrence analysis, clustering, and burst analysis to: (1) reveal research dynamics, key journals, and domains in this field; (2) identify leading countries, their collaborative networks, and core research institutions and authors; (3) recognize the foundational knowledge system centered on theoretical model deepening, emerging technology applications, and research methods and evaluation, uncovering seminal literature and observing a shift from early theoretical and influential factor analyses to empirical studies focusing on individual factors and emerging technologies; (4) moreover, current research hotspots are primarily in the areas of factors influencing technology adoption, human-robot interaction experiences, mobile health management, and aging-in-place technology, highlighting the evolutionary context and quality distribution of research themes. Finally, we recommend that future research should deeply explore improvements in theoretical models, long-term usage, and user experience evaluation. Overall, this study presents a clear framework of existing research in the field of older adults’ technology acceptance, providing an important reference for future theoretical exploration and innovative applications.

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Introduction.

In contemporary society, the rapid development of information technology has been intricately intertwined with the intensifying trend of population aging. According to the latest United Nations forecast, by 2050, the global population aged 65 and above is expected to reach 1.6 billion, representing about 16% of the total global population (UN 2023 ). Given the significant challenges of global aging, there is increasing evidence that emerging technologies have significant potential to maintain health and independence for older adults in their home and healthcare environments (Barnard et al. 2013 ; Soar 2010 ; Vancea and Solé-Casals 2016 ). This includes, but is not limited to, enhancing residential safety with smart home technologies (Touqeer et al. 2021 ; Wang et al. 2022 ), improving living independence through wearable technologies (Perez et al. 2023 ), and increasing medical accessibility via telehealth services (Kruse et al. 2020 ). Technological innovations are redefining the lifestyles of older adults, encouraging a shift from passive to active participation (González et al. 2012 ; Mostaghel 2016 ). Nevertheless, the effective application and dissemination of technology still depends on user acceptance and usage intentions (Naseri et al. 2023 ; Wang et al. 2023a ; Xia et al. 2024 ; Yu et al. 2023 ). Particularly, older adults face numerous challenges in accepting and using new technologies. These challenges include not only physical and cognitive limitations but also a lack of technological experience, along with the influences of social and economic factors (Valk et al. 2018 ; Wilson et al. 2021 ).

User acceptance of technology is a significant focus within information systems (IS) research (Dai et al. 2024 ), with several models developed to explain and predict user behavior towards technology usage, including the Technology Acceptance Model (TAM) (Davis 1989 ), TAM2, TAM3, and the Unified Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh et al. 2003 ). Older adults, as a group with unique needs, exhibit different behavioral patterns during technology acceptance than other user groups, and these uniquenesses include changes in cognitive abilities, as well as motivations, attitudes, and perceptions of the use of new technologies (Chen and Chan 2011 ). The continual expansion of technology introduces considerable challenges for older adults, rendering the understanding of their technology acceptance a research priority. Thus, conducting in-depth research into older adults’ acceptance of technology is critically important for enhancing their integration into the information society and improving their quality of life through technological advancements.

Reviewing relevant literature to identify research gaps helps further solidify the theoretical foundation of the research topic. However, many existing literature reviews primarily focus on the factors influencing older adults’ acceptance or intentions to use technology. For instance, Ma et al. ( 2021 ) conducted a comprehensive analysis of the determinants of older adults’ behavioral intentions to use technology; Liu et al. ( 2022 ) categorized key variables in studies of older adults’ technology acceptance, noting a shift in focus towards social and emotional factors; Yap et al. ( 2022 ) identified seven categories of antecedents affecting older adults’ use of technology from an analysis of 26 articles, including technological, psychological, social, personal, cost, behavioral, and environmental factors; Schroeder et al. ( 2023 ) extracted 119 influencing factors from 59 articles and further categorized these into six themes covering demographics, health status, and emotional awareness. Additionally, some studies focus on the application of specific technologies, such as Ferguson et al. ( 2021 ), who explored barriers and facilitators to older adults using wearable devices for heart monitoring, and He et al. ( 2022 ) and Baer et al. ( 2022 ), who each conducted in-depth investigations into the acceptance of social assistive robots and mobile nutrition and fitness apps, respectively. In summary, current literature reviews on older adults’ technology acceptance exhibit certain limitations. Due to the interdisciplinary nature and complex knowledge structure of this field, traditional literature reviews often rely on qualitative analysis, based on literature analysis and periodic summaries, which lack sufficient objectivity and comprehensiveness. Additionally, systematic research is relatively limited, lacking a macroscopic description of the research trajectory from a holistic perspective. Over the past decade, research on older adults’ technology acceptance has experienced rapid growth, with a significant increase in literature, necessitating the adoption of new methods to review and examine the developmental trends in this field (Chen 2006 ; Van Eck and Waltman 2010 ). Bibliometric analysis, as an effective quantitative research method, analyzes published literature through visualization, offering a viable approach to extracting patterns and insights from a large volume of papers, and has been widely applied in numerous scientific research fields (Achuthan et al. 2023 ; Liu and Duffy 2023 ). Therefore, this study will employ bibliometric methods to systematically analyze research articles related to older adults’ technology acceptance published in the Web of Science Core Collection from 2013 to 2023, aiming to understand the core issues and evolutionary trends in the field, and to provide valuable references for future related research. Specifically, this study aims to explore and answer the following questions:

RQ1: What are the research dynamics in the field of older adults’ technology acceptance over the past decade? What are the main academic journals and fields that publish studies related to older adults’ technology acceptance?

RQ2: How is the productivity in older adults’ technology acceptance research distributed among countries, institutions, and authors?

RQ3: What are the knowledge base and seminal literature in older adults’ technology acceptance research? How has the research theme progressed?

RQ4: What are the current hot topics and their evolutionary trajectories in older adults’ technology acceptance research? How is the quality of research distributed?

Methodology and materials

Research method.

In recent years, bibliometrics has become one of the crucial methods for analyzing literature reviews and is widely used in disciplinary and industrial intelligence analysis (Jing et al. 2023 ; Lin and Yu 2024a ; Wang et al. 2024a ; Xu et al. 2021 ). Bibliometric software facilitates the visualization analysis of extensive literature data, intuitively displaying the network relationships and evolutionary processes between knowledge units, and revealing the underlying knowledge structure and potential information (Chen et al. 2024 ; López-Robles et al. 2018 ; Wang et al. 2024c ). This method provides new insights into the current status and trends of specific research areas, along with quantitative evidence, thereby enhancing the objectivity and scientific validity of the research conclusions (Chen et al. 2023 ; Geng et al. 2024 ). VOSviewer and CiteSpace are two widely used bibliometric software tools in academia (Pan et al. 2018 ), recognized for their robust functionalities based on the JAVA platform. Although each has its unique features, combining these two software tools effectively constructs mapping relationships between literature knowledge units and clearly displays the macrostructure of the knowledge domains. Particularly, VOSviewer, with its excellent graphical representation capabilities, serves as an ideal tool for handling large datasets and precisely identifying the focal points and hotspots of research topics. Therefore, this study utilizes VOSviewer (version 1.6.19) and CiteSpace (version 6.1.R6), combined with in-depth literature analysis, to comprehensively examine and interpret the research theme of older adults’ technology acceptance through an integrated application of quantitative and qualitative methods.

Data source

Web of Science is a comprehensively recognized database in academia, featuring literature that has undergone rigorous peer review and editorial scrutiny (Lin and Yu 2024b ; Mongeon and Paul-Hus 2016 ; Pranckutė 2021 ). This study utilizes the Web of Science Core Collection as its data source, specifically including three major citation indices: Science Citation Index Expanded (SCIE), Social Sciences Citation Index (SSCI), and Arts & Humanities Citation Index (A&HCI). These indices encompass high-quality research literature in the fields of science, social sciences, and arts and humanities, ensuring the comprehensiveness and reliability of the data. We combined “older adults” with “technology acceptance” through thematic search, with the specific search strategy being: TS = (elder OR elderly OR aging OR ageing OR senile OR senior OR old people OR “older adult*”) AND TS = (“technology acceptance” OR “user acceptance” OR “consumer acceptance”). The time span of literature search is from 2013 to 2023, with the types limited to “Article” and “Review” and the language to “English”. Additionally, the search was completed by October 27, 2023, to avoid data discrepancies caused by database updates. The initial search yielded 764 journal articles. Given that searches often retrieve articles that are superficially relevant but actually non-compliant, manual screening post-search was essential to ensure the relevance of the literature (Chen et al. 2024 ). Through manual screening, articles significantly deviating from the research theme were eliminated and rigorously reviewed. Ultimately, this study obtained 500 valid sample articles from the Web of Science Core Collection. The complete PRISMA screening process is illustrated in Fig. 1 .

Presentation of the data culling process in detail.

Data standardization

Raw data exported from databases often contain multiple expressions of the same terminology (Nguyen and Hallinger 2020 ). To ensure the accuracy and consistency of data, it is necessary to standardize the raw data (Strotmann and Zhao 2012 ). This study follows the data standardization process proposed by Taskin and Al ( 2019 ), mainly executing the following operations:

(1) Standardization of author and institution names is conducted to address different name expressions for the same author. For instance, “Chan, Alan Hoi Shou” and “Chan, Alan H. S.” are considered the same author, and distinct authors with the same name are differentiated by adding identifiers. Diverse forms of institutional names are unified to address variations caused by name changes or abbreviations, such as standardizing “FRANKFURT UNIV APPL SCI” and “Frankfurt University of Applied Sciences,” as well as “Chinese University of Hong Kong” and “University of Hong Kong” to consistent names.

(2) Different expressions of journal names are unified. For example, “International Journal of Human-Computer Interaction” and “Int J Hum Comput Interact” are standardized to a single name. This ensures consistency in journal names and prevents misclassification of literature due to differing journal names. Additionally, it involves checking if the journals have undergone name changes in the past decade to prevent any impact on the analysis due to such changes.

(3) Keywords data are cleansed by removing words that do not directly pertain to specific research content (e.g., people, review), merging synonyms (e.g., “UX” and “User Experience,” “aging-in-place” and “aging in place”), and standardizing plural forms of keywords (e.g., “assistive technologies” and “assistive technology,” “social robots” and “social robot”). This reduces redundant information in knowledge mapping.

Bibliometric results and analysis

Distribution power (rq1), literature descriptive statistical analysis.

Table 1 presents a detailed descriptive statistical overview of the literature in the field of older adults’ technology acceptance. After deduplication using the CiteSpace software, this study confirmed a valid sample size of 500 articles. Authored by 1839 researchers, the documents encompass 792 research institutions across 54 countries and are published in 217 different academic journals. As of the search cutoff date, these articles have accumulated 13,829 citations, with an annual average of 1156 citations, and an average of 27.66 citations per article. The h-index, a composite metric of quantity and quality of scientific output (Kamrani et al. 2021 ), reached 60 in this study.

Trends in publications and disciplinary distribution

The number of publications and citations are significant indicators of the research field’s development, reflecting its continuity, attention, and impact (Ale Ebrahim et al. 2014 ). The ranking of annual publications and citations in the field of older adults’ technology acceptance studies is presented chronologically in Fig. 2A . The figure shows a clear upward trend in the amount of literature in this field. Between 2013 and 2017, the number of publications increased slowly and decreased in 2018. However, in 2019, the number of publications increased rapidly to 52 and reached a peak of 108 in 2022, which is 6.75 times higher than in 2013. In 2022, the frequency of document citations reached its highest point with 3466 citations, reflecting the widespread recognition and citation of research in this field. Moreover, the curve of the annual number of publications fits a quadratic function, with a goodness-of-fit R 2 of 0.9661, indicating that the number of future publications is expected to increase even more rapidly.

A Trends in trends in annual publications and citations (2013–2023). B Overlay analysis of the distribution of discipline fields.

Figure 2B shows that research on older adults’ technology acceptance involves the integration of multidisciplinary knowledge. According to Web of Science Categories, these 500 articles are distributed across 85 different disciplines. We have tabulated the top ten disciplines by publication volume (Table 2 ), which include Medical Informatics (75 articles, 15.00%), Health Care Sciences & Services (71 articles, 14.20%), Gerontology (61 articles, 12.20%), Public Environmental & Occupational Health (57 articles, 11.40%), and Geriatrics & Gerontology (52 articles, 10.40%), among others. The high output in these disciplines reflects the concentrated global academic interest in this comprehensive research topic. Additionally, interdisciplinary research approaches provide diverse perspectives and a solid theoretical foundation for studies on older adults’ technology acceptance, also paving the way for new research directions.

Knowledge flow analysis

A dual-map overlay is a CiteSpace map superimposed on top of a base map, which shows the interrelationships between journals in different domains, representing the publication and citation activities in each domain (Chen and Leydesdorff 2014 ). The overlay map reveals the link between the citing domain (on the left side) and the cited domain (on the right side), reflecting the knowledge flow of the discipline at the journal level (Leydesdorff and Rafols 2012 ). We utilize the in-built Z-score algorithm of the software to cluster the graph, as shown in Fig. 3 .

The left side shows the citing journal, and the right side shows the cited journal.

Figure 3 shows the distribution of citing journals clusters for older adults’ technology acceptance on the left side, while the right side refers to the main cited journals clusters. Two knowledge flow citation trajectories were obtained; they are presented by the color of the cited regions, and the thickness of these trajectories is proportional to the Z-score scaled frequency of citations (Chen et al. 2014 ). Within the cited regions, the most popular fields with the most records covered are “HEALTH, NURSING, MEDICINE” and “PSYCHOLOGY, EDUCATION, SOCIAL”, and the elliptical aspect ratio of these two fields stands out. Fields have prominent elliptical aspect ratios, highlighting their significant influence on older adults’ technology acceptance research. Additionally, the major citation trajectories originate in these two areas and progress to the frontier research area of “PSYCHOLOGY, EDUCATION, HEALTH”. It is worth noting that the citation trajectory from “PSYCHOLOGY, EDUCATION, SOCIAL” has a significant Z-value (z = 6.81), emphasizing the significance and impact of this development path. In the future, “MATHEMATICS, SYSTEMS, MATHEMATICAL”, “MOLECULAR, BIOLOGY, IMMUNOLOGY”, and “NEUROLOGY, SPORTS, OPHTHALMOLOGY” may become emerging fields. The fields of “MEDICINE, MEDICAL, CLINICAL” may be emerging areas of cutting-edge research.

Main research journals analysis

Table 3 provides statistics for the top ten journals by publication volume in the field of older adults’ technology acceptance. Together, these journals have published 137 articles, accounting for 27.40% of the total publications, indicating that there is no highly concentrated core group of journals in this field, with publications being relatively dispersed. Notably, Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction each lead with 15 publications. In terms of citation metrics, International Journal of Medical Informatics and Computers in Human Behavior stand out significantly, with the former accumulating a total of 1,904 citations, averaging 211.56 citations per article, and the latter totaling 1,449 citations, with an average of 96.60 citations per article. These figures emphasize the academic authority and widespread impact of these journals within the research field.

Research power (RQ2)

Countries and collaborations analysis.

The analysis revealed the global research pattern for country distribution and collaboration (Chen et al. 2019 ). Figure 4A shows the network of national collaborations on older adults’ technology acceptance research. The size of the bubbles represents the amount of publications in each country, while the thickness of the connecting lines expresses the closeness of the collaboration among countries. Generally, this research subject has received extensive international attention, with China and the USA publishing far more than any other countries. China has established notable research collaborations with the USA, UK and Malaysia in this field, while other countries have collaborations, but the closeness is relatively low and scattered. Figure 4B shows the annual publication volume dynamics of the top ten countries in terms of total publications. Since 2017, China has consistently increased its annual publications, while the USA has remained relatively stable. In 2019, the volume of publications in each country increased significantly, this was largely due to the global outbreak of the COVID-19 pandemic, which has led to increased reliance on information technology among the elderly for medical consultations, online socialization, and health management (Sinha et al. 2021 ). This phenomenon has led to research advances in technology acceptance among older adults in various countries. Table 4 shows that the top ten countries account for 93.20% of the total cumulative number of publications, with each country having published more than 20 papers. Among these ten countries, all of them except China are developed countries, indicating that the research field of older adults’ technology acceptance has received general attention from developed countries. Currently, China and the USA were the leading countries in terms of publications with 111 and 104 respectively, accounting for 22.20% and 20.80%. The UK, Germany, Italy, and the Netherlands also made significant contributions. The USA and China ranked first and second in terms of the number of citations, while the Netherlands had the highest average citations, indicating the high impact and quality of its research. The UK has shown outstanding performance in international cooperation, while the USA highlights its significant academic influence in this field with the highest h-index value.

A National collaboration network. B Annual volume of publications in the top 10 countries.

Institutions and authors analysis

Analyzing the number of publications and citations can reveal an institution’s or author’s research strength and influence in a particular research area (Kwiek 2021 ). Tables 5 and 6 show the statistics of the institutions and authors whose publication counts are in the top ten, respectively. As shown in Table 5 , higher education institutions hold the main position in this research field. Among the top ten institutions, City University of Hong Kong and The University of Hong Kong from China lead with 14 and 9 publications, respectively. City University of Hong Kong has the highest h-index, highlighting its significant influence in the field. It is worth noting that Tilburg University in the Netherlands is not among the top five in terms of publications, but the high average citation count (130.14) of its literature demonstrates the high quality of its research.

After analyzing the authors’ output using Price’s Law (Redner 1998 ), the highest number of publications among the authors counted ( n  = 10) defines a publication threshold of 3 for core authors in this research area. As a result of quantitative screening, a total of 63 core authors were identified. Table 6 shows that Chen from Zhejiang University, China, Ziefle from RWTH Aachen University, Germany, and Rogers from Macquarie University, Australia, were the top three authors in terms of the number of publications, with 10, 9, and 8 articles, respectively. In terms of average citation rate, Peek and Wouters, both scholars from the Netherlands, have significantly higher rates than other scholars, with 183.2 and 152.67 respectively. This suggests that their research is of high quality and widely recognized. Additionally, Chen and Rogers have high h-indices in this field.

Knowledge base and theme progress (RQ3)

Research knowledge base.

Co-citation relationships occur when two documents are cited together (Zhang and Zhu 2022 ). Co-citation mapping uses references as nodes to represent the knowledge base of a subject area (Min et al. 2021). Figure 5A illustrates co-occurrence mapping in older adults’ technology acceptance research, where larger nodes signify higher co-citation frequencies. Co-citation cluster analysis can be used to explore knowledge structure and research boundaries (Hota et al. 2020 ; Shiau et al. 2023 ). The co-citation clustering mapping of older adults’ technology acceptance research literature (Fig. 5B ) shows that the Q value of the clustering result is 0.8129 (>0.3), and the average value of the weight S is 0.9391 (>0.7), indicating that the clusters are uniformly distributed with a significant and credible structure. This further proves that the boundaries of the research field are clear and there is significant differentiation in the field. The figure features 18 cluster labels, each associated with thematic color blocks corresponding to different time slices. Highlighted emerging research themes include #2 Smart Home Technology, #7 Social Live, and #10 Customer Service. Furthermore, the clustering labels extracted are primarily classified into three categories: theoretical model deepening, emerging technology applications, research methods and evaluation, as detailed in Table 7 .

A Co-citation analysis of references. B Clustering network analysis of references.

Seminal literature analysis

The top ten nodes in terms of co-citation frequency were selected for further analysis. Table 8 displays the corresponding node information. Studies were categorized into four main groups based on content analysis. (1) Research focusing on specific technology usage by older adults includes studies by Peek et al. ( 2014 ), Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ), who investigated the factors influencing the use of e-technology, smartphones, mHealth, and smart wearables, respectively. (2) Concerning the development of theoretical models of technology acceptance, Chen and Chan ( 2014 ) introduced the Senior Technology Acceptance Model (STAM), and Macedo ( 2017 ) analyzed the predictive power of UTAUT2 in explaining older adults’ intentional behaviors and information technology usage. (3) In exploring older adults’ information technology adoption and behavior, Lee and Coughlin ( 2015 ) emphasized that the adoption of technology by older adults is a multifactorial process that includes performance, price, value, usability, affordability, accessibility, technical support, social support, emotion, independence, experience, and confidence. Yusif et al. ( 2016 ) conducted a literature review examining the key barriers affecting older adults’ adoption of assistive technology, including factors such as privacy, trust, functionality/added value, cost, and stigma. (4) From the perspective of research into older adults’ technology acceptance, Mitzner et al. ( 2019 ) assessed the long-term usage of computer systems designed for the elderly, whereas Guner and Acarturk ( 2020 ) compared information technology usage and acceptance between older and younger adults. The breadth and prevalence of this literature make it a vital reference for researchers in the field, also providing new perspectives and inspiration for future research directions.

Research thematic progress

Burst citation is a node of literature that guides the sudden change in dosage, which usually represents a prominent development or major change in a particular field, with innovative and forward-looking qualities. By analyzing the emergent literature, it is often easy to understand the dynamics of the subject area, mapping the emerging thematic change (Chen et al. 2022 ). Figure 6 shows the burst citation mapping in the field of older adults’ technology acceptance research, with burst citations represented by red nodes (Fig. 6A ). For the ten papers with the highest burst intensity (Fig. 6B ), this study will conduct further analysis in conjunction with literature review.

A Burst detection of co-citation. B The top 10 references with the strongest citation bursts.

As shown in Fig. 6 , Mitzner et al. ( 2010 ) broke the stereotype that older adults are fearful of technology, found that they actually have positive attitudes toward technology, and emphasized the centrality of ease of use and usefulness in the process of technology acceptance. This finding provides an important foundation for subsequent research. During the same period, Wagner et al. ( 2010 ) conducted theory-deepening and applied research on technology acceptance among older adults. The research focused on older adults’ interactions with computers from the perspective of Social Cognitive Theory (SCT). This expanded the understanding of technology acceptance, particularly regarding the relationship between behavior, environment, and other SCT elements. In addition, Pan and Jordan-Marsh ( 2010 ) extended the TAM to examine the interactions among predictors of perceived usefulness, perceived ease of use, subjective norm, and convenience conditions when older adults use the Internet, taking into account the moderating roles of gender and age. Heerink et al. ( 2010 ) adapted and extended the UTAUT, constructed a technology acceptance model specifically designed for older users’ acceptance of assistive social agents, and validated it using controlled experiments and longitudinal data, explaining intention to use by combining functional assessment and social interaction variables.

Then the research theme shifted to an in-depth analysis of the factors influencing technology acceptance among older adults. Two papers with high burst strengths emerged during this period: Peek et al. ( 2014 ) (Strength = 12.04), Chen and Chan ( 2014 ) (Strength = 9.81). Through a systematic literature review and empirical study, Peek STM and Chen K, among others, identified multidimensional factors that influence older adults’ technology acceptance. Peek et al. ( 2014 ) analyzed literature on the acceptance of in-home care technology among older adults and identified six factors that influence their acceptance: concerns about technology, expected benefits, technology needs, technology alternatives, social influences, and older adult characteristics, with a focus on differences between pre- and post-implementation factors. Chen and Chan ( 2014 ) constructed the STAM by administering a questionnaire to 1012 older adults and adding eight important factors, including technology anxiety, self-efficacy, cognitive ability, and physical function, based on the TAM. This enriches the theoretical foundation of the field. In addition, Braun ( 2013 ) highlighted the role of perceived usefulness, trust in social networks, and frequency of Internet use in older adults’ use of social networks, while ease of use and social pressure were not significant influences. These findings contribute to the study of older adults’ technology acceptance within specific technology application domains.

Recent research has focused on empirical studies of personal factors and emerging technologies. Ma et al. ( 2016 ) identified key personal factors affecting smartphone acceptance among older adults through structured questionnaires and face-to-face interviews with 120 participants. The study found that cost, self-satisfaction, and convenience were important factors influencing perceived usefulness and ease of use. This study offers empirical evidence to comprehend the main factors that drive smartphone acceptance among Chinese older adults. Additionally, Yusif et al. ( 2016 ) presented an overview of the obstacles that hinder older adults’ acceptance of assistive technologies, focusing on privacy, trust, and functionality.

In summary, research on older adults’ technology acceptance has shifted from early theoretical deepening and analysis of influencing factors to empirical studies in the areas of personal factors and emerging technologies, which have greatly enriched the theoretical basis of older adults’ technology acceptance and provided practical guidance for the design of emerging technology products.

Research hotspots, evolutionary trends, and quality distribution (RQ4)

Core keywords analysis.

Keywords concise the main idea and core of the literature, and are a refined summary of the research content (Huang et al. 2021 ). In CiteSpace, nodes with a centrality value greater than 0.1 are considered to be critical nodes. Analyzing keywords with high frequency and centrality helps to visualize the hot topics in the research field (Park et al. 2018 ). The merged keywords were imported into CiteSpace, and the top 10 keywords were counted and sorted by frequency and centrality respectively, as shown in Table 9 . The results show that the keyword “TAM” has the highest frequency (92), followed by “UTAUT” (24), which reflects that the in-depth study of the existing technology acceptance model and its theoretical expansion occupy a central position in research related to older adults’ technology acceptance. Furthermore, the terms ‘assistive technology’ and ‘virtual reality’ are both high-frequency and high-centrality terms (frequency = 17, centrality = 0.10), indicating that the research on assistive technology and virtual reality for older adults is the focus of current academic attention.

Research hotspots analysis

Using VOSviewer for keyword co-occurrence analysis organizes keywords into groups or clusters based on their intrinsic connections and frequencies, clearly highlighting the research field’s hot topics. The connectivity among keywords reveals correlations between different topics. To ensure accuracy, the analysis only considered the authors’ keywords. Subsequently, the keywords were filtered by setting the keyword frequency to 5 to obtain the keyword clustering map of the research on older adults’ technology acceptance research keyword clustering mapping (Fig. 7 ), combined with the keyword co-occurrence clustering network (Fig. 7A ) and the corresponding density situation (Fig. 7B ) to make a detailed analysis of the following four groups of clustered themes.

A Co-occurrence clustering network. B Keyword density.

Cluster #1—Research on the factors influencing technology adoption among older adults is a prominent topic, covering age, gender, self-efficacy, attitude, and and intention to use (Berkowsky et al. 2017 ; Wang et al. 2017 ). It also examined older adults’ attitudes towards and acceptance of digital health technologies (Ahmad and Mozelius, 2022 ). Moreover, the COVID-19 pandemic, significantly impacting older adults’ technology attitudes and usage, has underscored the study’s importance and urgency. Therefore, it is crucial to conduct in-depth studies on how older adults accept, adopt, and effectively use new technologies, to address their needs and help them overcome the digital divide within digital inclusion. This will improve their quality of life and healthcare experiences.

Cluster #2—Research focuses on how older adults interact with assistive technologies, especially assistive robots and health monitoring devices, emphasizing trust, usability, and user experience as crucial factors (Halim et al. 2022 ). Moreover, health monitoring technologies effectively track and manage health issues common in older adults, like dementia and mild cognitive impairment (Lussier et al. 2018 ; Piau et al. 2019 ). Interactive exercise games and virtual reality have been deployed to encourage more physical and cognitive engagement among older adults (Campo-Prieto et al. 2021 ). Personalized and innovative technology significantly enhances older adults’ participation, improving their health and well-being.

Cluster #3—Optimizing health management for older adults using mobile technology. With the development of mobile health (mHealth) and health information technology, mobile applications, smartphones, and smart wearable devices have become effective tools to help older users better manage chronic conditions, conduct real-time health monitoring, and even receive telehealth services (Dupuis and Tsotsos 2018 ; Olmedo-Aguirre et al. 2022 ; Kim et al. 2014 ). Additionally, these technologies can mitigate the problem of healthcare resource inequality, especially in developing countries. Older adults’ acceptance and use of these technologies are significantly influenced by their behavioral intentions, motivational factors, and self-management skills. These internal motivational factors, along with external factors, jointly affect older adults’ performance in health management and quality of life.

Cluster #4—Research on technology-assisted home care for older adults is gaining popularity. Environmentally assisted living enhances older adults’ independence and comfort at home, offering essential support and security. This has a crucial impact on promoting healthy aging (Friesen et al. 2016 ; Wahlroos et al. 2023 ). The smart home is a core application in this field, providing a range of solutions that facilitate independent living for the elderly in a highly integrated and user-friendly manner. This fulfills different dimensions of living and health needs (Majumder et al. 2017 ). Moreover, eHealth offers accurate and personalized health management and healthcare services for older adults (Delmastro et al. 2018 ), ensuring their needs are met at home. Research in this field often employs qualitative methods and structural equation modeling to fully understand older adults’ needs and experiences at home and analyze factors influencing technology adoption.

Evolutionary trends analysis

To gain a deeper understanding of the evolutionary trends in research hotspots within the field of older adults’ technology acceptance, we conducted a statistical analysis of the average appearance times of keywords, using CiteSpace to generate the time-zone evolution mapping (Fig. 8 ) and burst keywords. The time-zone mapping visually displays the evolution of keywords over time, intuitively reflecting the frequency and initial appearance of keywords in research, commonly used to identify trends in research topics (Jing et al. 2024a ; Kumar et al. 2021 ). Table 10 lists the top 15 keywords by burst strength, with the red sections indicating high-frequency citations and their burst strength in specific years. These burst keywords reveal the focus and trends of research themes over different periods (Kleinberg 2002 ). Combining insights from the time-zone mapping and burst keywords provides more objective and accurate research insights (Wang et al. 2023b ).

Reflecting the frequency and time of first appearance of keywords in the study.

An integrated analysis of Fig. 8 and Table 10 shows that early research on older adults’ technology acceptance primarily focused on factors such as perceived usefulness, ease of use, and attitudes towards information technology, including their use of computers and the internet (Pan and Jordan-Marsh 2010 ), as well as differences in technology use between older adults and other age groups (Guner and Acarturk 2020 ). Subsequently, the research focus expanded to improving the quality of life for older adults, exploring how technology can optimize health management and enhance the possibility of independent living, emphasizing the significant role of technology in improving the quality of life for the elderly. With ongoing technological advancements, recent research has shifted towards areas such as “virtual reality,” “telehealth,” and “human-robot interaction,” with a focus on the user experience of older adults (Halim et al. 2022 ). The appearance of keywords such as “physical activity” and “exercise” highlights the value of technology in promoting physical activity and health among older adults. This phase of research tends to make cutting-edge technology genuinely serve the practical needs of older adults, achieving its widespread application in daily life. Additionally, research has focused on expanding and quantifying theoretical models of older adults’ technology acceptance, involving keywords such as “perceived risk”, “validation” and “UTAUT”.

In summary, from 2013 to 2023, the field of older adults’ technology acceptance has evolved from initial explorations of influencing factors, to comprehensive enhancements in quality of life and health management, and further to the application and deepening of theoretical models and cutting-edge technologies. This research not only reflects the diversity and complexity of the field but also demonstrates a comprehensive and in-depth understanding of older adults’ interactions with technology across various life scenarios and needs.

Research quality distribution

To reveal the distribution of research quality in the field of older adults’ technology acceptance, a strategic diagram analysis is employed to calculate and illustrate the internal development and interrelationships among various research themes (Xie et al. 2020 ). The strategic diagram uses Centrality as the X-axis and Density as the Y-axis to divide into four quadrants, where the X-axis represents the strength of the connection between thematic clusters and other themes, with higher values indicating a central position in the research field; the Y-axis indicates the level of development within the thematic clusters, with higher values denoting a more mature and widely recognized field (Li and Zhou 2020 ).

Through cluster analysis and manual verification, this study categorized 61 core keywords (Frequency ≥5) into 11 thematic clusters. Subsequently, based on the keywords covered by each thematic cluster, the research themes and their directions for each cluster were summarized (Table 11 ), and the centrality and density coordinates for each cluster were precisely calculated (Table 12 ). Finally, a strategic diagram of the older adults’ technology acceptance research field was constructed (Fig. 9 ). Based on the distribution of thematic clusters across the quadrants in the strategic diagram, the structure and developmental trends of the field were interpreted.

Classification and visualization of theme clusters based on density and centrality.

As illustrated in Fig. 9 , (1) the theme clusters of #3 Usage Experience and #4 Assisted Living Technology are in the first quadrant, characterized by high centrality and density. Their internal cohesion and close links with other themes indicate their mature development, systematic research content or directions have been formed, and they have a significant influence on other themes. These themes play a central role in the field of older adults’ technology acceptance and have promising prospects. (2) The theme clusters of #6 Smart Devices, #9 Theoretical Models, and #10 Mobile Health Applications are in the second quadrant, with higher density but lower centrality. These themes have strong internal connections but weaker external links, indicating that these three themes have received widespread attention from researchers and have been the subject of related research, but more as self-contained systems and exhibit independence. Therefore, future research should further explore in-depth cooperation and cross-application with other themes. (3) The theme clusters of #7 Human-Robot Interaction, #8 Characteristics of the Elderly, and #11 Research Methods are in the third quadrant, with lower centrality and density. These themes are loosely connected internally and have weak links with others, indicating their developmental immaturity. Compared to other topics, they belong to the lower attention edge and niche themes, and there is a need for further investigation. (4) The theme clusters of #1 Digital Healthcare Technology, #2 Psychological Factors, and #5 Socio-Cultural Factors are located in the fourth quadrant, with high centrality but low density. Although closely associated with other research themes, the internal cohesion within these clusters is relatively weak. This suggests that while these themes are closely linked to other research areas, their own development remains underdeveloped, indicating a core immaturity. Nevertheless, these themes are crucial within the research domain of elderly technology acceptance and possess significant potential for future exploration.

Discussion on distribution power (RQ1)

Over the past decade, academic interest and influence in the area of older adults’ technology acceptance have significantly increased. This trend is evidenced by a quantitative analysis of publication and citation volumes, particularly noticeable in 2019 and 2022, where there was a substantial rise in both metrics. The rise is closely linked to the widespread adoption of emerging technologies such as smart homes, wearable devices, and telemedicine among older adults. While these technologies have enhanced their quality of life, they also pose numerous challenges, sparking extensive research into their acceptance, usage behaviors, and influencing factors among the older adults (Pirzada et al. 2022 ; Garcia Reyes et al. 2023 ). Furthermore, the COVID-19 pandemic led to a surge in technology demand among older adults, especially in areas like medical consultation, online socialization, and health management, further highlighting the importance and challenges of technology. Health risks and social isolation have compelled older adults to rely on technology for daily activities, accelerating its adoption and application within this demographic. This phenomenon has made technology acceptance a critical issue, driving societal and academic focus on the study of technology acceptance among older adults.

The flow of knowledge at the level of high-output disciplines and journals, along with the primary publishing outlets, indicates the highly interdisciplinary nature of research into older adults’ technology acceptance. This reflects the complexity and breadth of issues related to older adults’ technology acceptance, necessitating the integration of multidisciplinary knowledge and approaches. Currently, research is primarily focused on medical health and human-computer interaction, demonstrating academic interest in improving health and quality of life for older adults and addressing the urgent needs related to their interactions with technology. In the field of medical health, research aims to provide advanced and innovative healthcare technologies and services to meet the challenges of an aging population while improving the quality of life for older adults (Abdi et al. 2020 ; Wilson et al. 2021 ). In the field of human-computer interaction, research is focused on developing smarter and more user-friendly interaction models to meet the needs of older adults in the digital age, enabling them to actively participate in social activities and enjoy a higher quality of life (Sayago, 2019 ). These studies are crucial for addressing the challenges faced by aging societies, providing increased support and opportunities for the health, welfare, and social participation of older adults.

Discussion on research power (RQ2)

This study analyzes leading countries and collaboration networks, core institutions and authors, revealing the global research landscape and distribution of research strength in the field of older adults’ technology acceptance, and presents quantitative data on global research trends. From the analysis of country distribution and collaborations, China and the USA hold dominant positions in this field, with developed countries like the UK, Germany, Italy, and the Netherlands also excelling in international cooperation and research influence. The significant investment in technological research and the focus on the technological needs of older adults by many developed countries reflect their rapidly aging societies, policy support, and resource allocation.

China is the only developing country that has become a major contributor in this field, indicating its growing research capabilities and high priority given to aging societies and technological innovation. Additionally, China has close collaborations with countries such as USA, the UK, and Malaysia, driven not only by technological research needs but also by shared challenges and complementarities in aging issues among these nations. For instance, the UK has extensive experience in social welfare and aging research, providing valuable theoretical guidance and practical experience. International collaborations, aimed at addressing the challenges of aging, integrate the strengths of various countries, advancing in-depth and widespread development in the research of technology acceptance among older adults.

At the institutional and author level, City University of Hong Kong leads in publication volume, with research teams led by Chan and Chen demonstrating significant academic activity and contributions. Their research primarily focuses on older adults’ acceptance and usage behaviors of various technologies, including smartphones, smart wearables, and social robots (Chen et al. 2015 ; Li et al. 2019 ; Ma et al. 2016 ). These studies, targeting specific needs and product characteristics of older adults, have developed new models of technology acceptance based on existing frameworks, enhancing the integration of these technologies into their daily lives and laying a foundation for further advancements in the field. Although Tilburg University has a smaller publication output, it holds significant influence in the field of older adults’ technology acceptance. Particularly, the high citation rate of Peek’s studies highlights their excellence in research. Peek extensively explored older adults’ acceptance and usage of home care technologies, revealing the complexity and dynamics of their technology use behaviors. His research spans from identifying systemic influencing factors (Peek et al. 2014 ; Peek et al. 2016 ), emphasizing familial impacts (Luijkx et al. 2015 ), to constructing comprehensive models (Peek et al. 2017 ), and examining the dynamics of long-term usage (Peek et al. 2019 ), fully reflecting the evolving technology landscape and the changing needs of older adults. Additionally, the ongoing contributions of researchers like Ziefle, Rogers, and Wouters in the field of older adults’ technology acceptance demonstrate their research influence and leadership. These researchers have significantly enriched the knowledge base in this area with their diverse perspectives. For instance, Ziefle has uncovered the complex attitudes of older adults towards technology usage, especially the trade-offs between privacy and security, and how different types of activities affect their privacy needs (Maidhof et al. 2023 ; Mujirishvili et al. 2023 ; Schomakers and Ziefle 2023 ; Wilkowska et al. 2022 ), reflecting a deep exploration and ongoing innovation in the field of older adults’ technology acceptance.

Discussion on knowledge base and thematic progress (RQ3)

Through co-citation analysis and systematic review of seminal literature, this study reveals the knowledge foundation and thematic progress in the field of older adults’ technology acceptance. Co-citation networks and cluster analyses illustrate the structural themes of the research, delineating the differentiation and boundaries within this field. Additionally, burst detection analysis offers a valuable perspective for understanding the thematic evolution in the field of technology acceptance among older adults. The development and innovation of theoretical models are foundational to this research. Researchers enhance the explanatory power of constructed models by deepening and expanding existing technology acceptance theories to address theoretical limitations. For instance, Heerink et al. ( 2010 ) modified and expanded the UTAUT model by integrating functional assessment and social interaction variables to create the almere model. This model significantly enhances the ability to explain the intentions of older users in utilizing assistive social agents and improves the explanation of actual usage behaviors. Additionally, Chen and Chan ( 2014 ) extended the TAM to include age-related health and capability features of older adults, creating the STAM, which substantially improves predictions of older adults’ technology usage behaviors. Personal attributes, health and capability features, and facilitating conditions have a direct impact on technology acceptance. These factors more effectively predict older adults’ technology usage behaviors than traditional attitudinal factors.

With the advancement of technology and the application of emerging technologies, new research topics have emerged, increasingly focusing on older adults’ acceptance and use of these technologies. Prior to this, the study by Mitzner et al. ( 2010 ) challenged the stereotype of older adults’ conservative attitudes towards technology, highlighting the central roles of usability and usefulness in the technology acceptance process. This discovery laid an important foundation for subsequent research. Research fields such as “smart home technology,” “social life,” and “customer service” are emerging, indicating a shift in focus towards the practical and social applications of technology in older adults’ lives. Research not only focuses on the technology itself but also on how these technologies integrate into older adults’ daily lives and how they can improve the quality of life through technology. For instance, studies such as those by Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ) have explored factors influencing older adults’ use of smartphones, mHealth, and smart wearable devices.

Furthermore, the diversification of research methodologies and innovation in evaluation techniques, such as the use of mixed methods, structural equation modeling (SEM), and neural network (NN) approaches, have enhanced the rigor and reliability of the findings, enabling more precise identification of the factors and mechanisms influencing technology acceptance. Talukder et al. ( 2020 ) employed an effective multimethodological strategy by integrating SEM and NN to leverage the complementary strengths of both approaches, thus overcoming their individual limitations and more accurately analyzing and predicting older adults’ acceptance of wearable health technologies (WHT). SEM is utilized to assess the determinants’ impact on the adoption of WHT, while neural network models validate SEM outcomes and predict the significance of key determinants. This combined approach not only boosts the models’ reliability and explanatory power but also provides a nuanced understanding of the motivations and barriers behind older adults’ acceptance of WHT, offering deep research insights.

Overall, co-citation analysis of the literature in the field of older adults’ technology acceptance has uncovered deeper theoretical modeling and empirical studies on emerging technologies, while emphasizing the importance of research methodological and evaluation innovations in understanding complex social science issues. These findings are crucial for guiding the design and marketing strategies of future technology products, especially in the rapidly growing market of older adults.

Discussion on research hotspots and evolutionary trends (RQ4)

By analyzing core keywords, we can gain deep insights into the hot topics, evolutionary trends, and quality distribution of research in the field of older adults’ technology acceptance. The frequent occurrence of the keywords “TAM” and “UTAUT” indicates that the applicability and theoretical extension of existing technology acceptance models among older adults remain a focal point in academia. This phenomenon underscores the enduring influence of the studies by Davis ( 1989 ) and Venkatesh et al. ( 2003 ), whose models provide a robust theoretical framework for explaining and predicting older adults’ acceptance and usage of emerging technologies. With the widespread application of artificial intelligence (AI) and big data technologies, these theoretical models have incorporated new variables such as perceived risk, trust, and privacy issues (Amin et al. 2024 ; Chen et al. 2024 ; Jing et al. 2024b ; Seibert et al. 2021 ; Wang et al. 2024b ), advancing the theoretical depth and empirical research in this field.

Keyword co-occurrence cluster analysis has revealed multiple research hotspots in the field, including factors influencing technology adoption, interactive experiences between older adults and assistive technologies, the application of mobile health technology in health management, and technology-assisted home care. These studies primarily focus on enhancing the quality of life and health management of older adults through emerging technologies, particularly in the areas of ambient assisted living, smart health monitoring, and intelligent medical care. In these domains, the role of AI technology is increasingly significant (Qian et al. 2021 ; Ho 2020 ). With the evolution of next-generation information technologies, AI is increasingly integrated into elder care systems, offering intelligent, efficient, and personalized service solutions by analyzing the lifestyles and health conditions of older adults. This integration aims to enhance older adults’ quality of life in aspects such as health monitoring and alerts, rehabilitation assistance, daily health management, and emotional support (Lee et al. 2023 ). A survey indicates that 83% of older adults prefer AI-driven solutions when selecting smart products, demonstrating the increasing acceptance of AI in elder care (Zhao and Li 2024 ). Integrating AI into elder care presents both opportunities and challenges, particularly in terms of user acceptance, trust, and long-term usage effects, which warrant further exploration (Mhlanga 2023 ). These studies will help better understand the profound impact of AI technology on the lifestyles of older adults and provide critical references for optimizing AI-driven elder care services.

The Time-zone evolution mapping and burst keyword analysis further reveal the evolutionary trends of research hotspots. Early studies focused on basic technology acceptance models and user perceptions, later expanding to include quality of life and health management. In recent years, research has increasingly focused on cutting-edge technologies such as virtual reality, telehealth, and human-robot interaction, with a concurrent emphasis on the user experience of older adults. This evolutionary process demonstrates a deepening shift from theoretical models to practical applications, underscoring the significant role of technology in enhancing the quality of life for older adults. Furthermore, the strategic coordinate mapping analysis clearly demonstrates the development and mutual influence of different research themes. High centrality and density in the themes of Usage Experience and Assisted Living Technology indicate their mature research status and significant impact on other themes. The themes of Smart Devices, Theoretical Models, and Mobile Health Applications demonstrate self-contained research trends. The themes of Human-Robot Interaction, Characteristics of the Elderly, and Research Methods are not yet mature, but they hold potential for development. Themes of Digital Healthcare Technology, Psychological Factors, and Socio-Cultural Factors are closely related to other themes, displaying core immaturity but significant potential.

In summary, the research hotspots in the field of older adults’ technology acceptance are diverse and dynamic, demonstrating the academic community’s profound understanding of how older adults interact with technology across various life contexts and needs. Under the influence of AI and big data, research should continue to focus on the application of emerging technologies among older adults, exploring in depth how they adapt to and effectively use these technologies. This not only enhances the quality of life and healthcare experiences for older adults but also drives ongoing innovation and development in this field.

Research agenda

Based on the above research findings, to further understand and promote technology acceptance and usage among older adults, we recommend future studies focus on refining theoretical models, exploring long-term usage, and assessing user experience in the following detailed aspects:

Refinement and validation of specific technology acceptance models for older adults: Future research should focus on developing and validating technology acceptance models based on individual characteristics, particularly considering variations in technology acceptance among older adults across different educational levels and cultural backgrounds. This includes factors such as age, gender, educational background, and cultural differences. Additionally, research should examine how well specific technologies, such as wearable devices and mobile health applications, meet the needs of older adults. Building on existing theoretical models, this research should integrate insights from multiple disciplines such as psychology, sociology, design, and engineering through interdisciplinary collaboration to create more accurate and comprehensive models, which should then be validated in relevant contexts.

Deepening the exploration of the relationship between long-term technology use and quality of life among older adults: The acceptance and use of technology by users is a complex and dynamic process (Seuwou et al. 2016 ). Existing research predominantly focuses on older adults’ initial acceptance or short-term use of new technologies; however, the impact of long-term use on their quality of life and health is more significant. Future research should focus on the evolution of older adults’ experiences and needs during long-term technology usage, and the enduring effects of technology on their social interactions, mental health, and life satisfaction. Through longitudinal studies and qualitative analysis, this research reveals the specific needs and challenges of older adults in long-term technology use, providing a basis for developing technologies and strategies that better meet their requirements. This understanding aids in comprehensively assessing the impact of technology on older adults’ quality of life and guiding the optimization and improvement of technological products.

Evaluating the Importance of User Experience in Research on Older Adults’ Technology Acceptance: Understanding the mechanisms of information technology acceptance and use is central to human-computer interaction research. Although technology acceptance models and user experience models differ in objectives, they share many potential intersections. Technology acceptance research focuses on structured prediction and assessment, while user experience research concentrates on interpreting design impacts and new frameworks. Integrating user experience to assess older adults’ acceptance of technology products and systems is crucial (Codfrey et al. 2022 ; Wang et al. 2019 ), particularly for older users, where specific product designs should emphasize practicality and usability (Fisk et al. 2020 ). Researchers need to explore innovative age-appropriate design methods to enhance older adults’ usage experience. This includes studying older users’ actual usage preferences and behaviors, optimizing user interfaces, and interaction designs. Integrating feedback from older adults to tailor products to their needs can further promote their acceptance and continued use of technology products.

Conclusions

This study conducted a systematic review of the literature on older adults’ technology acceptance over the past decade through bibliometric analysis, focusing on the distribution power, research power, knowledge base and theme progress, research hotspots, evolutionary trends, and quality distribution. Using a combination of quantitative and qualitative methods, this study has reached the following conclusions:

Technology acceptance among older adults has become a hot topic in the international academic community, involving the integration of knowledge across multiple disciplines, including Medical Informatics, Health Care Sciences Services, and Ergonomics. In terms of journals, “PSYCHOLOGY, EDUCATION, HEALTH” represents a leading field, with key publications including Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction . These journals possess significant academic authority and extensive influence in the field.

Research on technology acceptance among older adults is particularly active in developed countries, with China and USA publishing significantly more than other nations. The Netherlands leads in high average citation rates, indicating the depth and impact of its research. Meanwhile, the UK stands out in terms of international collaboration. At the institutional level, City University of Hong Kong and The University of Hong Kong in China are in leading positions. Tilburg University in the Netherlands demonstrates exceptional research quality through its high average citation count. At the author level, Chen from China has the highest number of publications, while Peek from the Netherlands has the highest average citation count.

Co-citation analysis of references indicates that the knowledge base in this field is divided into three main categories: theoretical model deepening, emerging technology applications, and research methods and evaluation. Seminal literature focuses on four areas: specific technology use by older adults, expansion of theoretical models of technology acceptance, information technology adoption behavior, and research perspectives. Research themes have evolved from initial theoretical deepening and analysis of influencing factors to empirical studies on individual factors and emerging technologies.

Keyword analysis indicates that TAM and UTAUT are the most frequently occurring terms, while “assistive technology” and “virtual reality” are focal points with high frequency and centrality. Keyword clustering analysis reveals that research hotspots are concentrated on the influencing factors of technology adoption, human-robot interaction experiences, mobile health management, and technology for aging in place. Time-zone evolution mapping and burst keyword analysis have revealed the research evolution from preliminary exploration of influencing factors, to enhancements in quality of life and health management, and onto advanced technology applications and deepening of theoretical models. Furthermore, analysis of research quality distribution indicates that Usage Experience and Assisted Living Technology have become core topics, while Smart Devices, Theoretical Models, and Mobile Health Applications point towards future research directions.

Through this study, we have systematically reviewed the dynamics, core issues, and evolutionary trends in the field of older adults’ technology acceptance, constructing a comprehensive Knowledge Mapping of the domain and presenting a clear framework of existing research. This not only lays the foundation for subsequent theoretical discussions and innovative applications in the field but also provides an important reference for relevant scholars.

Limitations

To our knowledge, this is the first bibliometric analysis concerning technology acceptance among older adults, and we adhered strictly to bibliometric standards throughout our research. However, this study relies on the Web of Science Core Collection, and while its authority and breadth are widely recognized, this choice may have missed relevant literature published in other significant databases such as PubMed, Scopus, and Google Scholar, potentially overlooking some critical academic contributions. Moreover, given that our analysis was confined to literature in English, it may not reflect studies published in other languages, somewhat limiting the global representativeness of our data sample.

It is noteworthy that with the rapid development of AI technology, its increasingly widespread application in elderly care services is significantly transforming traditional care models. AI is profoundly altering the lifestyles of the elderly, from health monitoring and smart diagnostics to intelligent home systems and personalized care, significantly enhancing their quality of life and health care standards. The potential for AI technology within the elderly population is immense, and research in this area is rapidly expanding. However, due to the restrictive nature of the search terms used in this study, it did not fully cover research in this critical area, particularly in addressing key issues such as trust, privacy, and ethics.

Consequently, future research should not only expand data sources, incorporating multilingual and multidatabase literature, but also particularly focus on exploring older adults’ acceptance of AI technology and its applications, in order to construct a more comprehensive academic landscape of older adults’ technology acceptance, thereby enriching and extending the knowledge system and academic trends in this field.

Data availability

The datasets analyzed during the current study are available in the Dataverse repository: https://doi.org/10.7910/DVN/6K0GJH .

Abdi S, de Witte L, Hawley M (2020) Emerging technologies with potential care and support applications for older people: review of gray literature. JMIR Aging 3(2):e17286. https://doi.org/10.2196/17286

Article   PubMed   PubMed Central   Google Scholar  

Achuthan K, Nair VK, Kowalski R, Ramanathan S, Raman R (2023) Cyberbullying research—Alignment to sustainable development and impact of COVID-19: Bibliometrics and science mapping analysis. Comput Human Behav 140:107566. https://doi.org/10.1016/j.chb.2022.107566

Article   Google Scholar  

Ahmad A, Mozelius P (2022) Human-Computer Interaction for Older Adults: a Literature Review on Technology Acceptance of eHealth Systems. J Eng Res Sci 1(4):119–126. https://doi.org/10.55708/js0104014

Ale Ebrahim N, Salehi H, Embi MA, Habibi F, Gholizadeh H, Motahar SM (2014) Visibility and citation impact. Int Educ Stud 7(4):120–125. https://doi.org/10.5539/ies.v7n4p120

Amin MS, Johnson VL, Prybutok V, Koh CE (2024) An investigation into factors affecting the willingness to disclose personal health information when using AI-enabled caregiver robots. Ind Manag Data Syst 124(4):1677–1699. https://doi.org/10.1108/IMDS-09-2023-0608

Baer NR, Vietzke J, Schenk L (2022) Middle-aged and older adults’ acceptance of mobile nutrition and fitness apps: a systematic mixed studies review. PLoS One 17(12):e0278879. https://doi.org/10.1371/journal.pone.0278879

Barnard Y, Bradley MD, Hodgson F, Lloyd AD (2013) Learning to use new technologies by older adults: Perceived difficulties, experimentation behaviour and usability. Comput Human Behav 29(4):1715–1724. https://doi.org/10.1016/j.chb.2013.02.006

Berkowsky RW, Sharit J, Czaja SJ (2017) Factors predicting decisions about technology adoption among older adults. Innov Aging 3(1):igy002. https://doi.org/10.1093/geroni/igy002

Braun MT (2013) Obstacles to social networking website use among older adults. Comput Human Behav 29(3):673–680. https://doi.org/10.1016/j.chb.2012.12.004

Article   MathSciNet   Google Scholar  

Campo-Prieto P, Rodríguez-Fuentes G, Cancela-Carral JM (2021) Immersive virtual reality exergame promotes the practice of physical activity in older people: An opportunity during COVID-19. Multimodal Technol Interact 5(9):52. https://doi.org/10.3390/mti5090052

Chen C (2006) CiteSpace II: Detecting and visualizing emerging trends and transient patterns in scientific literature. J Am Soc Inf Sci Technol 57(3):359–377. https://doi.org/10.1002/asi.20317

Chen C, Dubin R, Kim MC (2014) Emerging trends and new developments in regenerative medicine: a scientometric update (2000–2014). Expert Opin Biol Ther 14(9):1295–1317. https://doi.org/10.1517/14712598.2014.920813

Article   PubMed   Google Scholar  

Chen C, Leydesdorff L (2014) Patterns of connections and movements in dual‐map overlays: A new method of publication portfolio analysis. J Assoc Inf Sci Technol 65(2):334–351. https://doi.org/10.1002/asi.22968

Chen J, Wang C, Tang Y (2022) Knowledge mapping of volunteer motivation: A bibliometric analysis and cross-cultural comparative study. Front Psychol 13:883150. https://doi.org/10.3389/fpsyg.2022.883150

Chen JY, Liu YD, Dai J, Wang CL (2023) Development and status of moral education research: Visual analysis based on knowledge graph. Front Psychol 13:1079955. https://doi.org/10.3389/fpsyg.2022.1079955

Chen K, Chan AH (2011) A review of technology acceptance by older adults. Gerontechnology 10(1):1–12. https://doi.org/10.4017/gt.2011.10.01.006.00

Chen K, Chan AH (2014) Gerontechnology acceptance by elderly Hong Kong Chinese: a senior technology acceptance model (STAM). Ergonomics 57(5):635–652. https://doi.org/10.1080/00140139.2014.895855

Chen K, Zhang Y, Fu X (2019) International research collaboration: An emerging domain of innovation studies? Res Policy 48(1):149–168. https://doi.org/10.1016/j.respol.2018.08.005

Chen X, Hu Z, Wang C (2024) Empowering education development through AIGC: A systematic literature review. Educ Inf Technol 1–53. https://doi.org/10.1007/s10639-024-12549-7

Chen Y, Chen CM, Liu ZY, Hu ZG, Wang XW (2015) The methodology function of CiteSpace mapping knowledge domains. Stud Sci Sci 33(2):242–253. https://doi.org/10.16192/j.cnki.1003-2053.2015.02.009

Codfrey GS, Baharum A, Zain NHM, Omar M, Deris FD (2022) User Experience in Product Design and Development: Perspectives and Strategies. Math Stat Eng Appl 71(2):257–262. https://doi.org/10.17762/msea.v71i2.83

Dai J, Zhang X, Wang CL (2024) A meta-analysis of learners’ continuance intention toward online education platforms. Educ Inf Technol 1–36. https://doi.org/10.1007/s10639-024-12654-7

Davis FD (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 13(3):319–340. https://doi.org/10.2307/249008

Delmastro F, Dolciotti C, Palumbo F, Magrini M, Di Martino F, La Rosa D, Barcaro U (2018) Long-term care: how to improve the quality of life with mobile and e-health services. In 2018 14th International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob), pp. 12–19. IEEE. https://doi.org/10.1109/WiMOB.2018.8589157

Dupuis K, Tsotsos LE (2018) Technology for remote health monitoring in an older population: a role for mobile devices. Multimodal Technol Interact 2(3):43. https://doi.org/10.3390/mti2030043

Ferguson C, Hickman LD, Turkmani S, Breen P, Gargiulo G, Inglis SC (2021) Wearables only work on patients that wear them”: Barriers and facilitators to the adoption of wearable cardiac monitoring technologies. Cardiovasc Digit Health J 2(2):137–147. https://doi.org/10.1016/j.cvdhj.2021.02.001

Fisk AD, Czaja SJ, Rogers WA, Charness N, Sharit J (2020) Designing for older adults: Principles and creative human factors approaches. CRC Press. https://doi.org/10.1201/9781420080681

Friesen S, Brémault-Phillips S, Rudrum L, Rogers LG (2016) Environmental design that supports healthy aging: Evaluating a new supportive living facility. J Hous Elderly 30(1):18–34. https://doi.org/10.1080/02763893.2015.1129380

Garcia Reyes EP, Kelly R, Buchanan G, Waycott J (2023) Understanding Older Adults’ Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 6:e43197. https://doi.org/10.2196/43197

Geng Z, Wang J, Liu J, Miao J (2024) Bibliometric analysis of the development, current status, and trends in adult degenerative scoliosis research: A systematic review from 1998 to 2023. J Pain Res 17:153–169. https://doi.org/10.2147/JPR.S437575

González A, Ramírez MP, Viadel V (2012) Attitudes of the elderly toward information and communications technologies. Educ Gerontol 38(9):585–594. https://doi.org/10.1080/03601277.2011.595314

Guner H, Acarturk C (2020) The use and acceptance of ICT by senior citizens: a comparison of technology acceptance model (TAM) for elderly and young adults. Univ Access Inf Soc 19(2):311–330. https://doi.org/10.1007/s10209-018-0642-4

Halim I, Saptari A, Perumal PA, Abdullah Z, Abdullah S, Muhammad MN (2022) A Review on Usability and User Experience of Assistive Social Robots for Older Persons. Int J Integr Eng 14(6):102–124. https://penerbit.uthm.edu.my/ojs/index.php/ijie/article/view/8566

He Y, He Q, Liu Q (2022) Technology acceptance in socially assistive robots: Scoping review of models, measurement, and influencing factors. J Healthc Eng 2022(1):6334732. https://doi.org/10.1155/2022/6334732

Heerink M, Kröse B, Evers V, Wielinga B (2010) Assessing acceptance of assistive social agent technology by older adults: the almere model. Int J Soc Robot 2:361–375. https://doi.org/10.1007/s12369-010-0068-5

Ho A (2020) Are we ready for artificial intelligence health monitoring in elder care? BMC Geriatr 20(1):358. https://doi.org/10.1186/s12877-020-01764-9

Hoque R, Sorwar G (2017) Understanding factors influencing the adoption of mHealth by the elderly: An extension of the UTAUT model. Int J Med Inform 101:75–84. https://doi.org/10.1016/j.ijmedinf.2017.02.002

Hota PK, Subramanian B, Narayanamurthy G (2020) Mapping the intellectual structure of social entrepreneurship research: A citation/co-citation analysis. J Bus Ethics 166(1):89–114. https://doi.org/10.1007/s10551-019-04129-4

Huang R, Yan P, Yang X (2021) Knowledge map visualization of technology hotspots and development trends in China’s textile manufacturing industry. IET Collab Intell Manuf 3(3):243–251. https://doi.org/10.1049/cim2.12024

Article   ADS   Google Scholar  

Jing Y, Wang C, Chen Y, Wang H, Yu T, Shadiev R (2023) Bibliometric mapping techniques in educational technology research: A systematic literature review. Educ Inf Technol 1–29. https://doi.org/10.1007/s10639-023-12178-6

Jing YH, Wang CL, Chen ZY, Shen SS, Shadiev R (2024a) A Bibliometric Analysis of Studies on Technology-Supported Learning Environments: Hotopics and Frontier Evolution. J Comput Assist Learn 1–16. https://doi.org/10.1111/jcal.12934

Jing YH, Wang HM, Chen XJ, Wang CL (2024b) What factors will affect the effectiveness of using ChatGPT to solve programming problems? A quasi-experimental study. Humanit Soc Sci Commun 11:319. https://doi.org/10.1057/s41599-024-02751-w

Kamrani P, Dorsch I, Stock WG (2021) Do researchers know what the h-index is? And how do they estimate its importance? Scientometrics 126(7):5489–5508. https://doi.org/10.1007/s11192-021-03968-1

Kim HS, Lee KH, Kim H, Kim JH (2014) Using mobile phones in healthcare management for the elderly. Maturitas 79(4):381–388. https://doi.org/10.1016/j.maturitas.2014.08.013

Article   MathSciNet   PubMed   Google Scholar  

Kleinberg J (2002) Bursty and hierarchical structure in streams. In Proceedings of the eighth ACM SIGKDD international conference on Knowledge discovery and data mining, pp. 91–101. https://doi.org/10.1145/775047.775061

Kruse C, Fohn J, Wilson N, Patlan EN, Zipp S, Mileski M (2020) Utilization barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review. JMIR Med Inform 8(8):e20359. https://doi.org/10.2196/20359

Kumar S, Lim WM, Pandey N, Christopher Westland J (2021) 20 years of electronic commerce research. Electron Commer Res 21:1–40. https://doi.org/10.1007/s10660-021-09464-1

Kwiek M (2021) What large-scale publication and citation data tell us about international research collaboration in Europe: Changing national patterns in global contexts. Stud High Educ 46(12):2629–2649. https://doi.org/10.1080/03075079.2020.1749254

Lee C, Coughlin JF (2015) PERSPECTIVE: Older adults’ adoption of technology: an integrated approach to identifying determinants and barriers. J Prod Innov Manag 32(5):747–759. https://doi.org/10.1111/jpim.12176

Lee CH, Wang C, Fan X, Li F, Chen CH (2023) Artificial intelligence-enabled digital transformation in elderly healthcare field: scoping review. Adv Eng Inform 55:101874. https://doi.org/10.1016/j.aei.2023.101874

Leydesdorff L, Rafols I (2012) Interactive overlays: A new method for generating global journal maps from Web-of-Science data. J Informetr 6(2):318–332. https://doi.org/10.1016/j.joi.2011.11.003

Li J, Ma Q, Chan AH, Man S (2019) Health monitoring through wearable technologies for older adults: Smart wearables acceptance model. Appl Ergon 75:162–169. https://doi.org/10.1016/j.apergo.2018.10.006

Article   ADS   PubMed   Google Scholar  

Li X, Zhou D (2020) Product design requirement information visualization approach for intelligent manufacturing services. China Mech Eng 31(07):871, http://www.cmemo.org.cn/EN/Y2020/V31/I07/871

Google Scholar  

Lin Y, Yu Z (2024a) An integrated bibliometric analysis and systematic review modelling students’ technostress in higher education. Behav Inf Technol 1–25. https://doi.org/10.1080/0144929X.2024.2332458

Lin Y, Yu Z (2024b) A bibliometric analysis of artificial intelligence chatbots in educational contexts. Interact Technol Smart Educ 21(2):189–213. https://doi.org/10.1108/ITSE-12-2022-0165

Liu L, Duffy VG (2023) Exploring the future development of Artificial Intelligence (AI) applications in chatbots: a bibliometric analysis. Int J Soc Robot 15(5):703–716. https://doi.org/10.1007/s12369-022-00956-0

Liu R, Li X, Chu J (2022) Evolution of applied variables in the research on technology acceptance of the elderly. In: International Conference on Human-Computer Interaction, Cham: Springer International Publishing, pp 500–520. https://doi.org/10.1007/978-3-031-05581-23_5

Luijkx K, Peek S, Wouters E (2015) “Grandma, you should do it—It’s cool” Older Adults and the Role of Family Members in Their Acceptance of Technology. Int J Environ Res Public Health 12(12):15470–15485. https://doi.org/10.3390/ijerph121214999

Lussier M, Lavoie M, Giroux S, Consel C, Guay M, Macoir J, Bier N (2018) Early detection of mild cognitive impairment with in-home monitoring sensor technologies using functional measures: a systematic review. IEEE J Biomed Health Inform 23(2):838–847. https://doi.org/10.1109/JBHI.2018.2834317

López-Robles JR, Otegi-Olaso JR, Porto Gomez I, Gamboa-Rosales NK, Gamboa-Rosales H, Robles-Berumen H (2018) Bibliometric network analysis to identify the intellectual structure and evolution of the big data research field. In: International Conference on Intelligent Data Engineering and Automated Learning, Cham: Springer International Publishing, pp 113–120. https://doi.org/10.1007/978-3-030-03496-2_13

Ma Q, Chan AH, Chen K (2016) Personal and other factors affecting acceptance of smartphone technology by older Chinese adults. Appl Ergon 54:62–71. https://doi.org/10.1016/j.apergo.2015.11.015

Ma Q, Chan AHS, Teh PL (2021) Insights into Older Adults’ Technology Acceptance through Meta-Analysis. Int J Hum-Comput Interact 37(11):1049–1062. https://doi.org/10.1080/10447318.2020.1865005

Macedo IM (2017) Predicting the acceptance and use of information and communication technology by older adults: An empirical examination of the revised UTAUT2. Comput Human Behav 75:935–948. https://doi.org/10.1016/j.chb.2017.06.013

Maidhof C, Offermann J, Ziefle M (2023) Eyes on privacy: acceptance of video-based AAL impacted by activities being filmed. Front Public Health 11:1186944. https://doi.org/10.3389/fpubh.2023.1186944

Majumder S, Aghayi E, Noferesti M, Memarzadeh-Tehran H, Mondal T, Pang Z, Deen MJ (2017) Smart homes for elderly healthcare—Recent advances and research challenges. Sensors 17(11):2496. https://doi.org/10.3390/s17112496

Article   ADS   PubMed   PubMed Central   Google Scholar  

Mhlanga D (2023) Artificial Intelligence in elderly care: Navigating ethical and responsible AI adoption for seniors. Available at SSRN 4675564. 4675564 min) Identifying citation patterns of scientific breakthroughs: A perspective of dynamic citation process. Inf Process Manag 58(1):102428. https://doi.org/10.1016/j.ipm.2020.102428

Mitzner TL, Boron JB, Fausset CB, Adams AE, Charness N, Czaja SJ, Sharit J (2010) Older adults talk technology: Technology usage and attitudes. Comput Human Behav 26(6):1710–1721. https://doi.org/10.1016/j.chb.2010.06.020

Mitzner TL, Savla J, Boot WR, Sharit J, Charness N, Czaja SJ, Rogers WA (2019) Technology adoption by older adults: Findings from the PRISM trial. Gerontologist 59(1):34–44. https://doi.org/10.1093/geront/gny113

Mongeon P, Paul-Hus A (2016) The journal coverage of Web of Science and Scopus: a comparative analysis. Scientometrics 106:213–228. https://doi.org/10.1007/s11192-015-1765-5

Mostaghel R (2016) Innovation and technology for the elderly: Systematic literature review. J Bus Res 69(11):4896–4900. https://doi.org/10.1016/j.jbusres.2016.04.049

Mujirishvili T, Maidhof C, Florez-Revuelta F, Ziefle M, Richart-Martinez M, Cabrero-García J (2023) Acceptance and privacy perceptions toward video-based active and assisted living technologies: Scoping review. J Med Internet Res 25:e45297. https://doi.org/10.2196/45297

Naseri RNN, Azis SN, Abas N (2023) A Review of Technology Acceptance and Adoption Models in Consumer Study. FIRM J Manage Stud 8(2):188–199. https://doi.org/10.33021/firm.v8i2.4536

Nguyen UP, Hallinger P (2020) Assessing the distinctive contributions of Simulation & Gaming to the literature, 1970–2019: A bibliometric review. Simul Gaming 51(6):744–769. https://doi.org/10.1177/1046878120941569

Olmedo-Aguirre JO, Reyes-Campos J, Alor-Hernández G, Machorro-Cano I, Rodríguez-Mazahua L, Sánchez-Cervantes JL (2022) Remote healthcare for elderly people using wearables: A review. Biosensors 12(2):73. https://doi.org/10.3390/bios12020073

Pan S, Jordan-Marsh M (2010) Internet use intention and adoption among Chinese older adults: From the expanded technology acceptance model perspective. Comput Human Behav 26(5):1111–1119. https://doi.org/10.1016/j.chb.2010.03.015

Pan X, Yan E, Cui M, Hua W (2018) Examining the usage, citation, and diffusion patterns of bibliometric map software: A comparative study of three tools. J Informetr 12(2):481–493. https://doi.org/10.1016/j.joi.2018.03.005

Park JS, Kim NR, Han EJ (2018) Analysis of trends in science and technology using keyword network analysis. J Korea Ind Inf Syst Res 23(2):63–73. https://doi.org/10.9723/jksiis.2018.23.2.063

Peek ST, Luijkx KG, Rijnaard MD, Nieboer ME, Van Der Voort CS, Aarts S, Wouters EJ (2016) Older adults’ reasons for using technology while aging in place. Gerontology 62(2):226–237. https://doi.org/10.1159/000430949

Peek ST, Luijkx KG, Vrijhoef HJ, Nieboer ME, Aarts S, van der Voort CS, Wouters EJ (2017) Origins and consequences of technology acquirement by independent-living seniors: Towards an integrative model. BMC Geriatr 17:1–18. https://doi.org/10.1186/s12877-017-0582-5

Peek ST, Wouters EJ, Van Hoof J, Luijkx KG, Boeije HR, Vrijhoef HJ (2014) Factors influencing acceptance of technology for aging in place: a systematic review. Int J Med Inform 83(4):235–248. https://doi.org/10.1016/j.ijmedinf.2014.01.004

Peek STM, Luijkx KG, Vrijhoef HJM, Nieboer ME, Aarts S, Van Der Voort CS, Wouters EJM (2019) Understanding changes and stability in the long-term use of technologies by seniors who are aging in place: a dynamical framework. BMC Geriatr 19:1–13. https://doi.org/10.1186/s12877-019-1241-9

Perez AJ, Siddiqui F, Zeadally S, Lane D (2023) A review of IoT systems to enable independence for the elderly and disabled individuals. Internet Things 21:100653. https://doi.org/10.1016/j.iot.2022.100653

Piau A, Wild K, Mattek N, Kaye J (2019) Current state of digital biomarker technologies for real-life, home-based monitoring of cognitive function for mild cognitive impairment to mild Alzheimer disease and implications for clinical care: systematic review. J Med Internet Res 21(8):e12785. https://doi.org/10.2196/12785

Pirzada P, Wilde A, Doherty GH, Harris-Birtill D (2022) Ethics and acceptance of smart homes for older adults. Inform Health Soc Care 47(1):10–37. https://doi.org/10.1080/17538157.2021.1923500

Pranckutė R (2021) Web of Science (WoS) and Scopus: The titans of bibliographic information in today’s academic world. Publications 9(1):12. https://doi.org/10.3390/publications9010012

Qian K, Zhang Z, Yamamoto Y, Schuller BW (2021) Artificial intelligence internet of things for the elderly: From assisted living to health-care monitoring. IEEE Signal Process Mag 38(4):78–88. https://doi.org/10.1109/MSP.2021.3057298

Redner S (1998) How popular is your paper? An empirical study of the citation distribution. Eur Phys J B-Condens Matter Complex Syst 4(2):131–134. https://doi.org/10.1007/s100510050359

Sayago S (ed.) (2019) Perspectives on human-computer interaction research with older people. Switzerland: Springer International Publishing. https://doi.org/10.1007/978-3-030-06076-3

Schomakers EM, Ziefle M (2023) Privacy vs. security: trade-offs in the acceptance of smart technologies for aging-in-place. Int J Hum Comput Interact 39(5):1043–1058. https://doi.org/10.1080/10447318.2022.2078463

Schroeder T, Dodds L, Georgiou A, Gewald H, Siette J (2023) Older adults and new technology: Mapping review of the factors associated with older adults’ intention to adopt digital technologies. JMIR Aging 6(1):e44564. https://doi.org/10.2196/44564

Seibert K, Domhoff D, Bruch D, Schulte-Althoff M, Fürstenau D, Biessmann F, Wolf-Ostermann K (2021) Application scenarios for artificial intelligence in nursing care: rapid review. J Med Internet Res 23(11):e26522. https://doi.org/10.2196/26522

Seuwou P, Banissi E, Ubakanma G (2016) User acceptance of information technology: A critical review of technology acceptance models and the decision to invest in Information Security. In: Global Security, Safety and Sustainability-The Security Challenges of the Connected World: 11th International Conference, ICGS3 2017, London, UK, January 18-20, 2017, Proceedings 11:230-251. Springer International Publishing. https://doi.org/10.1007/978-3-319-51064-4_19

Shiau WL, Wang X, Zheng F (2023) What are the trend and core knowledge of information security? A citation and co-citation analysis. Inf Manag 60(3):103774. https://doi.org/10.1016/j.im.2023.103774

Sinha S, Verma A, Tiwari P (2021) Technology: Saving and enriching life during COVID-19. Front Psychol 12:647681. https://doi.org/10.3389/fpsyg.2021.647681

Soar J (2010) The potential of information and communication technologies to support ageing and independent living. Ann Telecommun 65:479–483. https://doi.org/10.1007/s12243-010-0167-1

Strotmann A, Zhao D (2012) Author name disambiguation: What difference does it make in author‐based citation analysis? J Am Soc Inf Sci Technol 63(9):1820–1833. https://doi.org/10.1002/asi.22695

Talukder MS, Sorwar G, Bao Y, Ahmed JU, Palash MAS (2020) Predicting antecedents of wearable healthcare technology acceptance by elderly: A combined SEM-Neural Network approach. Technol Forecast Soc Change 150:119793. https://doi.org/10.1016/j.techfore.2019.119793

Taskin Z, Al U (2019) Natural language processing applications in library and information science. Online Inf Rev 43(4):676–690. https://doi.org/10.1108/oir-07-2018-0217

Touqeer H, Zaman S, Amin R, Hussain M, Al-Turjman F, Bilal M (2021) Smart home security: challenges, issues and solutions at different IoT layers. J Supercomput 77(12):14053–14089. https://doi.org/10.1007/s11227-021-03825-1

United Nations Department of Economic and Social Affairs (2023) World population ageing 2023: Highlights. https://www.un.org/zh/193220

Valk CAL, Lu Y, Randriambelonoro M, Jessen J (2018) Designing for technology acceptance of wearable and mobile technologies for senior citizen users. In: 21st DMI: Academic Design Management Conference (ADMC 2018), Design Management Institute, pp 1361–1373. https://www.dmi.org/page/ADMC2018

Van Eck N, Waltman L (2010) Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 84(2):523–538. https://doi.org/10.1007/s11192-009-0146-3

Vancea M, Solé-Casals J (2016) Population aging in the European Information Societies: towards a comprehensive research agenda in eHealth innovations for elderly. Aging Dis 7(4):526. https://doi.org/10.14336/AD.2015.1214

Venkatesh V, Morris MG, Davis GB, Davis FD (2003) User acceptance of information technology: Toward a unified view. MIS Q 27(3):425–478. https://doi.org/10.2307/30036540

Wagner N, Hassanein K, Head M (2010) Computer use by older adults: A multi-disciplinary review. Comput Human Behav 26(5):870–882. https://doi.org/10.1016/j.chb.2010.03.029

Wahlroos N, Narsakka N, Stolt M, Suhonen R (2023) Physical environment maintaining independence and self-management of older people in long-term care settings—An integrative literature review. J Aging Environ 37(3):295–313. https://doi.org/10.1080/26892618.2022.2092927

Wang CL, Chen XJ, Yu T, Liu YD, Jing YH (2024a) Education reform and change driven by digital technology: a bibliometric study from a global perspective. Humanit Soc Sci Commun 11(1):1–17. https://doi.org/10.1057/s41599-024-02717-y

Wang CL, Dai J, Zhu KK, Yu T, Gu XQ (2023a) Understanding the Continuance Intention of College Students Toward New E-learning Spaces Based on an Integrated Model of the TAM and TTF. Int J Hum-comput Int 1–14. https://doi.org/10.1080/10447318.2023.2291609

Wang CL, Wang HM, Li YY, Dai J, Gu XQ, Yu T (2024b) Factors Influencing University Students’ Behavioral Intention to Use Generative Artificial Intelligence: Integrating the Theory of Planned Behavior and AI Literacy. Int J Hum-comput Int 1–23. https://doi.org/10.1080/10447318.2024.2383033

Wang J, Zhao W, Zhang Z, Liu X, Xie T, Wang L, Zhang Y (2024c) A journey of challenges and victories: a bibliometric worldview of nanomedicine since the 21st century. Adv Mater 36(15):2308915. https://doi.org/10.1002/adma.202308915

Wang J, Chen Y, Huo S, Mai L, Jia F (2023b) Research hotspots and trends of social robot interaction design: A bibliometric analysis. Sensors 23(23):9369. https://doi.org/10.3390/s23239369

Wang KH, Chen G, Chen HG (2017) A model of technology adoption by older adults. Soc Behav Personal 45(4):563–572. https://doi.org/10.2224/sbp.5778

Wang S, Bolling K, Mao W, Reichstadt J, Jeste D, Kim HC, Nebeker C (2019) Technology to Support Aging in Place: Older Adults’ Perspectives. Healthcare 7(2):60. https://doi.org/10.3390/healthcare7020060

Wang Z, Liu D, Sun Y, Pang X, Sun P, Lin F, Ren K (2022) A survey on IoT-enabled home automation systems: Attacks and defenses. IEEE Commun Surv Tutor 24(4):2292–2328. https://doi.org/10.1109/COMST.2022.3201557

Wilkowska W, Offermann J, Spinsante S, Poli A, Ziefle M (2022) Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies. PloS One 17(7):e0269642. https://doi.org/10.1371/journal.pone.0269642

Wilson J, Heinsch M, Betts D, Booth D, Kay-Lambkin F (2021) Barriers and facilitators to the use of e-health by older adults: a scoping review. BMC Public Health 21:1–12. https://doi.org/10.1186/s12889-021-11623-w

Xia YQ, Deng YL, Tao XY, Zhang SN, Wang CL (2024) Digital art exhibitions and psychological well-being in Chinese Generation Z: An analysis based on the S-O-R framework. Humanit Soc Sci Commun 11:266. https://doi.org/10.1057/s41599-024-02718-x

Xie H, Zhang Y, Duan K (2020) Evolutionary overview of urban expansion based on bibliometric analysis in Web of Science from 1990 to 2019. Habitat Int 95:102100. https://doi.org/10.1016/j.habitatint.2019.10210

Xu Z, Ge Z, Wang X, Skare M (2021) Bibliometric analysis of technology adoption literature published from 1997 to 2020. Technol Forecast Soc Change 170:120896. https://doi.org/10.1016/j.techfore.2021.120896

Yap YY, Tan SH, Choon SW (2022) Elderly’s intention to use technologies: a systematic literature review. Heliyon 8(1). https://doi.org/10.1016/j.heliyon.2022.e08765

Yu T, Dai J, Wang CL (2023) Adoption of blended learning: Chinese university students’ perspectives. Humanit Soc Sci Commun 10:390. https://doi.org/10.1057/s41599-023-01904-7

Yusif S, Soar J, Hafeez-Baig A (2016) Older people, assistive technologies, and the barriers to adoption: A systematic review. Int J Med Inform 94:112–116. https://doi.org/10.1016/j.ijmedinf.2016.07.004

Zhang J, Zhu L (2022) Citation recommendation using semantic representation of cited papers’ relations and content. Expert Syst Appl 187:115826. https://doi.org/10.1016/j.eswa.2021.115826

Zhao Y, Li J (2024) Opportunities and challenges of integrating artificial intelligence in China’s elderly care services. Sci Rep 14(1):9254. https://doi.org/10.1038/s41598-024-60067-w

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This research was supported by the Social Science Foundation of Shaanxi Province in China (Grant No. 2023J014).

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Shang, X., Liu, Z., Gong, C. et al. Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023. Humanit Soc Sci Commun 11 , 1115 (2024). https://doi.org/10.1057/s41599-024-03658-2

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Science, health, and public trust.

September 8, 2021

Explaining How Research Works

We’ve heard “follow the science” a lot during the pandemic. But it seems science has taken us on a long and winding road filled with twists and turns, even changing directions at times. That’s led some people to feel they can’t trust science. But when what we know changes, it often means science is working.

Explaining the scientific process may be one way that science communicators can help maintain public trust in science. Placing research in the bigger context of its field and where it fits into the scientific process can help people better understand and interpret new findings as they emerge. A single study usually uncovers only a piece of a larger puzzle.

Questions about how the world works are often investigated on many different levels. For example, scientists can look at the different atoms in a molecule, cells in a tissue, or how different tissues or systems affect each other. Researchers often must choose one or a finite number of ways to investigate a question. It can take many different studies using different approaches to start piecing the whole picture together.

Sometimes it might seem like research results contradict each other. But often, studies are just looking at different aspects of the same problem. Researchers can also investigate a question using different techniques or timeframes. That may lead them to arrive at different conclusions from the same data.

Using the data available at the time of their study, scientists develop different explanations, or models. New information may mean that a novel model needs to be developed to account for it. The models that prevail are those that can withstand the test of time and incorporate new information. Science is a constantly evolving and self-correcting process.

Scientists gain more confidence about a model through the scientific process. They replicate each other’s work. They present at conferences. And papers undergo peer review, in which experts in the field review the work before it can be published in scientific journals. This helps ensure that the study is up to current scientific standards and maintains a level of integrity. Peer reviewers may find problems with the experiments or think different experiments are needed to justify the conclusions. They might even offer new ways to interpret the data.

It’s important for science communicators to consider which stage a study is at in the scientific process when deciding whether to cover it. Some studies are posted on preprint servers for other scientists to start weighing in on and haven’t yet been fully vetted. Results that haven't yet been subjected to scientific scrutiny should be reported on with care and context to avoid confusion or frustration from readers.

We’ve developed a one-page guide, "How Research Works: Understanding the Process of Science" to help communicators put the process of science into perspective. We hope it can serve as a useful resource to help explain why science changes—and why it’s important to expect that change. Please take a look and share your thoughts with us by sending an email to  [email protected].

Below are some additional resources:

• Discoveries in Basic Science: A Perfectly Imperfect Process
• When Clinical Research Is in the News
• What is Basic Science and Why is it Important?
• ​ What is a Research Organism?
• What Are Clinical Trials and Studies?
• Basic Research – Digital Media Kit
• Decoding Science: How Does Science Know What It Knows? (NAS)
• Can Science Help People Make Decisions ? (NAS)

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Fermented-food diet increases microbiome diversity, decreases inflammatory proteins, study finds

Stanford researchers discover that a 10-week diet high in fermented foods boosts microbiome diversity and improves immune responses.

July 12, 2021 - By Janelle Weaver

Stanford researchers found that eating a diet high in fermented foods such as kimchi increases the diversity of gut microbes, which is associated with improved health. Nungning20/Shutterstock

A diet rich in fermented foods enhances the diversity of gut microbes and decreases molecular signs of inflammation, according to researchers at the Stanford School of Medicine .

In a clinical trial, 36 healthy adults were randomly assigned to a 10-week diet that included either fermented or high-fiber foods. The two diets resulted in different effects on the gut microbiome and the immune system.

Eating foods such as yogurt, kefir, fermented cottage cheese, kimchi and other fermented vegetables, vegetable brine drinks, and kombucha tea led to an increase in overall microbial diversity, with stronger effects from larger servings. “This is a stunning finding,” said Justin Sonnenburg , PhD, an associate professor of microbiology and immunology. “It provides one of the first examples of how a simple change in diet can reproducibly remodel the microbiota across a cohort of healthy adults.”

In addition, four types of immune cells showed less activation in the fermented-food group. The levels of 19 inflammatory proteins measured in blood samples also decreased. One of these proteins, interleukin 6, has been linked to conditions such as rheumatoid arthritis, Type 2 diabetes and chronic stress.

“Microbiota-targeted diets can change immune status, providing a promising avenue for decreasing inflammation in healthy adults,” said Christopher Gardner , PhD, the Rehnborg Farquhar Professor and director of nutrition studies at the Stanford Prevention Research Center . “This finding was consistent across all participants in the study who were assigned to the higher fermented food group.”

Justin Sonnenburg

Microbe diversity stable in fiber-rich diet

By contrast, none of these 19 inflammatory proteins decreased in participants assigned to a high-fiber diet rich in legumes, seeds, whole grains, nuts, vegetables and fruits. On average, the diversity of their gut microbes also remained stable. “We expected high fiber to have a more universally beneficial effect and increase microbiota diversity,” said Erica Sonnenburg , PhD, a senior research scientist in basic life sciences, microbiology and immunology. “The data suggest that increased fiber intake alone over a short time period is insufficient to increase microbiota diversity.”

The study published online July 12 in Cell. Justin and Erica Sonnenburg and Christopher Gardner are co-senior authors. The lead authors are Hannah Wastyk , a PhD student in bioengineering, and former postdoctoral scholar Gabriela Fragiadakis, PhD, who is now an assistant professor of medicine at UC-San Francisco.

A wide body of evidence has demonstrated that diet shapes the gut microbiome, which can affect the immune system and overall health. According to Gardner, low microbiome diversity has been linked to obesity and diabetes.

“We wanted to conduct a proof-of-concept study that could test whether microbiota-targeted food could be an avenue for combatting the overwhelming rise in chronic inflammatory diseases,” Gardner said.

The researchers focused on fiber and fermented foods due to previous reports of their potential health benefits. While high-fiber diets have been associated with lower rates of mortality, the consumption of fermented foods can help with weight maintenance and may decrease the risk of diabetes, cancer and cardiovascular disease.

Erica Sonnenburg

The researchers analyzed blood and stool samples collected during a three-week pre-trial period, the 10 weeks of the diet, and a four-week period after the diet when the participants ate as they chose.

The findings paint a nuanced picture of the influence of diet on gut microbes and immune status. On one hand, those who increased their consumption of fermented foods showed similar effects on their microbiome diversity and inflammatory markers, consistent with prior research showing that short-term changes in diet can rapidly alter the gut microbiome. On the other hand, the limited change in the microbiome within the high-fiber group dovetails with the researchers’ previous reports of a general resilience of the human microbiome over short time periods.

Designing a suite of dietary and microbial strategies

The results also showed that greater fiber intake led to more carbohydrates in stool samples, pointing to incomplete fiber degradation by gut microbes. These findings are consistent with other research suggesting that the microbiome of people living in the industrialized world is depleted of fiber-degrading microbes.

“It is possible that a longer intervention would have allowed for the microbiota to adequately adapt to the increase in fiber consumption,” Erica Sonnenburg said. “Alternatively, the deliberate introduction of fiber-consuming microbes may be required to increase the microbiota’s capacity to break down the carbohydrates.”

In addition to exploring these possibilities, the researchers plan to conduct studies in mice to investigate the molecular mechanisms by which diets alter the microbiome and reduce inflammatory proteins. They also aim to test whether high-fiber and fermented foods synergize to influence the microbiome and immune system of humans. Another goal is to examine whether the consumption of fermented food decreases inflammation or improves other health markers in patients with immunological and metabolic diseases, and in pregnant women and older individuals.

Christopher Gardner

“There are many more ways to target the microbiome with food and supplements, and we hope to continue to investigate how different diets, probiotics and prebiotics impact the microbiome and health in different groups,” Justin Sonnenburg said.

Other Stanford co-authors are Dalia Perelman, health educator; former graduate students Dylan Dahan, PhD, and Carlos Gonzalez, PhD; graduate student Bryan Merrill; former research assistant Madeline Topf; postdoctoral scholars William Van Treuren, PhD, and Shuo Han, PhD; Jennifer Robinson, PhD, administrative director of the Community Health and Prevention Research Master’s Program and program manager of the Nutrition Studies Group; and Joshua Elias, PhD.

Researchers from Chan-Zuckerberg Biohub also contributed to the study.

The work was supported by donations to the Center for Human Microbiome Research; Paul and Kathy Klingenstein; the Hand Foundation; Heather Buhr and Jon Feiber; Meredith and John Pasquesi; the National Institutes of Health (grant T32 AI 7328-29); a Stanford Dean’s Postdoctoral Fellowship; a National Science Foundation Graduate Student Fellowship; and seed funding from the Institute for Immunity, Transplantation and Infection and from the Sean N. Parker Center for Allergy and Asthma Research.

• Janelle Weaver

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Understanding Clinical Trials

Clinical research: what is it.

Your doctor may have said that you are eligible for a clinical trial, or you may have seen an ad for a clinical research study. What is clinical research, and is it right for you?

Clinical research is the comprehensive study of the safety and effectiveness of the most promising advances in patient care. Clinical research is different than laboratory research. It involves people who volunteer to help us better understand medicine and health. Lab research generally does not involve people — although it helps us learn which new ideas may help people.

Every drug, device, tool, diagnostic test, technique and technology used in medicine today was once tested in volunteers who took part in clinical research studies.

At Johns Hopkins Medicine, we believe that clinical research is key to improve care for people in our community and around the world. Once you understand more about clinical research, you may appreciate why it’s important to participate — for yourself and the community.

What Are the Types of Clinical Research?

There are two main kinds of clinical research:

Observational Studies

Observational studies are studies that aim to identify and analyze patterns in medical data or in biological samples, such as tissue or blood provided by study participants.

Clinical Trials

Clinical trials, which are also called interventional studies, test the safety and effectiveness of medical interventions — such as medications, procedures and tools — in living people.

Clinical research studies need people of every age, health status, race, gender, ethnicity and cultural background to participate. This will increase the chances that scientists and clinicians will develop treatments and procedures that are likely to be safe and work well in all people. Potential volunteers are carefully screened to ensure that they meet all of the requirements for any study before they begin. Most of the reasons people are not included in studies is because of concerns about safety.

Both healthy people and those with diagnosed medical conditions can take part in clinical research. Participation is always completely voluntary, and participants can leave a study at any time for any reason.

“The only way medical advancements can be made is if people volunteer to participate in clinical research. The research participant is just as necessary as the researcher in this partnership to advance health care.” Liz Martinez, Johns Hopkins Medicine Research Participant Advocate

Types of Research Studies

Within the two main kinds of clinical research, there are many types of studies. They vary based on the study goals, participants and other factors.

Biospecimen studies

Healthy volunteer studies.

 Goals of Clinical Trials

Because every clinical trial is designed to answer one or more medical questions, different trials have different goals. Those goals include:

Treatment trials

Prevention trials, screening trials, phases of a clinical trial.

In general, a new drug needs to go through a series of four types of clinical trials. This helps researchers show that the medication is safe and effective. As a study moves through each phase, researchers learn more about a medication, including its risks and benefits.

Is the medication safe and what is the right dose?   Phase one trials involve small numbers of participants, often normal volunteers.

Does the new medication work and what are the side effects?   Phase two trials test the treatment or procedure on a larger number of participants. These participants usually have the condition or disease that the treatment is intended to remedy.

Is the new medication more effective than existing treatments?  Phase three trials have even more people enrolled. Some may get a placebo (a substance that has no medical effect) or an already approved treatment, so that the new medication can be compared to that treatment.

Is the new medication effective and safe over the long term?   Phase four happens after the treatment or procedure has been approved. Information about patients who are receiving the treatment is gathered and studied to see if any new information is seen when given to a large number of patients.

“Johns Hopkins has a comprehensive system overseeing research that is audited by the FDA and the Association for Accreditation of Human Research Protection Programs to make certain all research participants voluntarily agreed to join a study and their safety was maximized.” Gail Daumit, M.D., M.H.S., Vice Dean for Clinical Investigation, Johns Hopkins University School of Medicine

Is It Safe to Participate in Clinical Research?

There are several steps in place to protect volunteers who take part in clinical research studies. Clinical Research is regulated by the federal government. In addition, the institutional review board (IRB) and Human Subjects Research Protection Program at each study location have many safeguards built in to each study to protect the safety and privacy of participants.

Clinical researchers are required by law to follow the safety rules outlined by each study's protocol. A protocol is a detailed plan of what researchers will do in during the study.

In the U.S., every study site's IRB — which is made up of both medical experts and members of the general public — must approve all clinical research. IRB members also review plans for all clinical studies. And, they make sure that research participants are protected from as much risk as possible.

Earning Your Trust

This was not always the case. Many people of color are wary of joining clinical research because of previous poor treatment of underrepresented minorities throughout the U.S. This includes medical research performed on enslaved people without their consent, or not giving treatment to Black men who participated in the Tuskegee Study of Untreated Syphilis in the Negro Male. Since the 1970s, numerous regulations have been in place to protect the rights of study participants.

Many clinical research studies are also supervised by a data and safety monitoring committee. This is a group made up of experts in the area being studied. These biomedical professionals regularly monitor clinical studies as they progress. If they discover or suspect any problems with a study, they immediately stop the trial. In addition, Johns Hopkins Medicine’s Research Participant Advocacy Group focuses on improving the experience of people who participate in clinical research.

Clinical research participants with concerns about anything related to the study they are taking part in should contact Johns Hopkins Medicine’s IRB or our Research Participant Advocacy Group .

Learn More About Clinical Research at Johns Hopkins Medicine

For information about clinical trial opportunities at Johns Hopkins Medicine, visit our trials site.

Video Clinical Research for a Healthier Tomorrow: A Family Shares Their Story

Clinical Research for a Healthier Tomorrow: A Family Shares Their Story

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What Is Research, and Why Do People Do It?

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• Jinfa Cai 7 ,
• Stephen Hwang 7 ,
• Anne K Morris 6 &
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Abstractspiepr Abs1

Every day people do research as they gather information to learn about something of interest. In the scientific world, however, research means something different than simply gathering information. Scientific research is characterized by its careful planning and observing, by its relentless efforts to understand and explain, and by its commitment to learn from everyone else seriously engaged in research. We call this kind of research scientific inquiry and define it as “formulating, testing, and revising hypotheses.” By “hypotheses” we do not mean the hypotheses you encounter in statistics courses. We mean predictions about what you expect to find and rationales for why you made these predictions. Throughout this and the remaining chapters we make clear that the process of scientific inquiry applies to all kinds of research studies and data, both qualitative and quantitative.

You have full access to this open access chapter,  Download chapter PDF

Part I. What Is Research?

Have you ever studied something carefully because you wanted to know more about it? Maybe you wanted to know more about your grandmother’s life when she was younger so you asked her to tell you stories from her childhood, or maybe you wanted to know more about a fertilizer you were about to use in your garden so you read the ingredients on the package and looked them up online. According to the dictionary definition, you were doing research.

Recall your high school assignments asking you to “research” a topic. The assignment likely included consulting a variety of sources that discussed the topic, perhaps including some “original” sources. Often, the teacher referred to your product as a “research paper.”

Were you conducting research when you interviewed your grandmother or wrote high school papers reviewing a particular topic? Our view is that you were engaged in part of the research process, but only a small part. In this book, we reserve the word “research” for what it means in the scientific world, that is, for scientific research or, more pointedly, for scientific inquiry .

Exercise 1.1

Before you read any further, write a definition of what you think scientific inquiry is. Keep it short—Two to three sentences. You will periodically update this definition as you read this chapter and the remainder of the book.

This book is about scientific inquiry—what it is and how to do it. For starters, scientific inquiry is a process, a particular way of finding out about something that involves a number of phases. Each phase of the process constitutes one aspect of scientific inquiry. You are doing scientific inquiry as you engage in each phase, but you have not done scientific inquiry until you complete the full process. Each phase is necessary but not sufficient.

In this chapter, we set the stage by defining scientific inquiry—describing what it is and what it is not—and by discussing what it is good for and why people do it. The remaining chapters build directly on the ideas presented in this chapter.

A first thing to know is that scientific inquiry is not all or nothing. “Scientificness” is a continuum. Inquiries can be more scientific or less scientific. What makes an inquiry more scientific? You might be surprised there is no universally agreed upon answer to this question. None of the descriptors we know of are sufficient by themselves to define scientific inquiry. But all of them give you a way of thinking about some aspects of the process of scientific inquiry. Each one gives you different insights.

Exercise 1.2

As you read about each descriptor below, think about what would make an inquiry more or less scientific. If you think a descriptor is important, use it to revise your definition of scientific inquiry.

Creating an Image of Scientific Inquiry

We will present three descriptors of scientific inquiry. Each provides a different perspective and emphasizes a different aspect of scientific inquiry. We will draw on all three descriptors to compose our definition of scientific inquiry.

Descriptor 1. Experience Carefully Planned in Advance

Sir Ronald Fisher, often called the father of modern statistical design, once referred to research as “experience carefully planned in advance” (1935, p. 8). He said that humans are always learning from experience, from interacting with the world around them. Usually, this learning is haphazard rather than the result of a deliberate process carried out over an extended period of time. Research, Fisher said, was learning from experience, but experience carefully planned in advance.

This phrase can be fully appreciated by looking at each word. The fact that scientific inquiry is based on experience means that it is based on interacting with the world. These interactions could be thought of as the stuff of scientific inquiry. In addition, it is not just any experience that counts. The experience must be carefully planned . The interactions with the world must be conducted with an explicit, describable purpose, and steps must be taken to make the intended learning as likely as possible. This planning is an integral part of scientific inquiry; it is not just a preparation phase. It is one of the things that distinguishes scientific inquiry from many everyday learning experiences. Finally, these steps must be taken beforehand and the purpose of the inquiry must be articulated in advance of the experience. Clearly, scientific inquiry does not happen by accident, by just stumbling into something. Stumbling into something unexpected and interesting can happen while engaged in scientific inquiry, but learning does not depend on it and serendipity does not make the inquiry scientific.

Descriptor 2. Observing Something and Trying to Explain Why It Is the Way It Is

When we were writing this chapter and googled “scientific inquiry,” the first entry was: “Scientific inquiry refers to the diverse ways in which scientists study the natural world and propose explanations based on the evidence derived from their work.” The emphasis is on studying, or observing, and then explaining . This descriptor takes the image of scientific inquiry beyond carefully planned experience and includes explaining what was experienced.

According to the Merriam-Webster dictionary, “explain” means “(a) to make known, (b) to make plain or understandable, (c) to give the reason or cause of, and (d) to show the logical development or relations of” (Merriam-Webster, n.d. ). We will use all these definitions. Taken together, they suggest that to explain an observation means to understand it by finding reasons (or causes) for why it is as it is. In this sense of scientific inquiry, the following are synonyms: explaining why, understanding why, and reasoning about causes and effects. Our image of scientific inquiry now includes planning, observing, and explaining why.

We need to add a final note about this descriptor. We have phrased it in a way that suggests “observing something” means you are observing something in real time—observing the way things are or the way things are changing. This is often true. But, observing could mean observing data that already have been collected, maybe by someone else making the original observations (e.g., secondary analysis of NAEP data or analysis of existing video recordings of classroom instruction). We will address secondary analyses more fully in Chap. 4 . For now, what is important is that the process requires explaining why the data look like they do.

We must note that for us, the term “data” is not limited to numerical or quantitative data such as test scores. Data can also take many nonquantitative forms, including written survey responses, interview transcripts, journal entries, video recordings of students, teachers, and classrooms, text messages, and so forth.

Exercise 1.3

What are the implications of the statement that just “observing” is not enough to count as scientific inquiry? Does this mean that a detailed description of a phenomenon is not scientific inquiry?

Find sources that define research in education that differ with our position, that say description alone, without explanation, counts as scientific research. Identify the precise points where the opinions differ. What are the best arguments for each of the positions? Which do you prefer? Why?

Descriptor 3. Updating Everyone’s Thinking in Response to More and Better Information

This descriptor focuses on a third aspect of scientific inquiry: updating and advancing the field’s understanding of phenomena that are investigated. This descriptor foregrounds a powerful characteristic of scientific inquiry: the reliability (or trustworthiness) of what is learned and the ultimate inevitability of this learning to advance human understanding of phenomena. Humans might choose not to learn from scientific inquiry, but history suggests that scientific inquiry always has the potential to advance understanding and that, eventually, humans take advantage of these new understandings.

Before exploring these bold claims a bit further, note that this descriptor uses “information” in the same way the previous two descriptors used “experience” and “observations.” These are the stuff of scientific inquiry and we will use them often, sometimes interchangeably. Frequently, we will use the term “data” to stand for all these terms.

An overriding goal of scientific inquiry is for everyone to learn from what one scientist does. Much of this book is about the methods you need to use so others have faith in what you report and can learn the same things you learned. This aspect of scientific inquiry has many implications.

One implication is that scientific inquiry is not a private practice. It is a public practice available for others to see and learn from. Notice how different this is from everyday learning. When you happen to learn something from your everyday experience, often only you gain from the experience. The fact that research is a public practice means it is also a social one. It is best conducted by interacting with others along the way: soliciting feedback at each phase, taking opportunities to present work-in-progress, and benefitting from the advice of others.

A second implication is that you, as the researcher, must be committed to sharing what you are doing and what you are learning in an open and transparent way. This allows all phases of your work to be scrutinized and critiqued. This is what gives your work credibility. The reliability or trustworthiness of your findings depends on your colleagues recognizing that you have used all appropriate methods to maximize the chances that your claims are justified by the data.

A third implication of viewing scientific inquiry as a collective enterprise is the reverse of the second—you must be committed to receiving comments from others. You must treat your colleagues as fair and honest critics even though it might sometimes feel otherwise. You must appreciate their job, which is to remain skeptical while scrutinizing what you have done in considerable detail. To provide the best help to you, they must remain skeptical about your conclusions (when, for example, the data are difficult for them to interpret) until you offer a convincing logical argument based on the information you share. A rather harsh but good-to-remember statement of the role of your friendly critics was voiced by Karl Popper, a well-known twentieth century philosopher of science: “. . . if you are interested in the problem which I tried to solve by my tentative assertion, you may help me by criticizing it as severely as you can” (Popper, 1968, p. 27).

A final implication of this third descriptor is that, as someone engaged in scientific inquiry, you have no choice but to update your thinking when the data support a different conclusion. This applies to your own data as well as to those of others. When data clearly point to a specific claim, even one that is quite different than you expected, you must reconsider your position. If the outcome is replicated multiple times, you need to adjust your thinking accordingly. Scientific inquiry does not let you pick and choose which data to believe; it mandates that everyone update their thinking when the data warrant an update.

Doing Scientific Inquiry

We define scientific inquiry in an operational sense—what does it mean to do scientific inquiry? What kind of process would satisfy all three descriptors: carefully planning an experience in advance; observing and trying to explain what you see; and, contributing to updating everyone’s thinking about an important phenomenon?

We define scientific inquiry as formulating , testing , and revising hypotheses about phenomena of interest.

Of course, we are not the only ones who define it in this way. The definition for the scientific method posted by the editors of Britannica is: “a researcher develops a hypothesis, tests it through various means, and then modifies the hypothesis on the basis of the outcome of the tests and experiments” (Britannica, n.d. ).

Notice how defining scientific inquiry this way satisfies each of the descriptors. “Carefully planning an experience in advance” is exactly what happens when formulating a hypothesis about a phenomenon of interest and thinking about how to test it. “ Observing a phenomenon” occurs when testing a hypothesis, and “ explaining ” what is found is required when revising a hypothesis based on the data. Finally, “updating everyone’s thinking” comes from comparing publicly the original with the revised hypothesis.

Doing scientific inquiry, as we have defined it, underscores the value of accumulating knowledge rather than generating random bits of knowledge. Formulating, testing, and revising hypotheses is an ongoing process, with each revised hypothesis begging for another test, whether by the same researcher or by new researchers. The editors of Britannica signaled this cyclic process by adding the following phrase to their definition of the scientific method: “The modified hypothesis is then retested, further modified, and tested again.” Scientific inquiry creates a process that encourages each study to build on the studies that have gone before. Through collective engagement in this process of building study on top of study, the scientific community works together to update its thinking.

Before exploring more fully the meaning of “formulating, testing, and revising hypotheses,” we need to acknowledge that this is not the only way researchers define research. Some researchers prefer a less formal definition, one that includes more serendipity, less planning, less explanation. You might have come across more open definitions such as “research is finding out about something.” We prefer the tighter hypothesis formulation, testing, and revision definition because we believe it provides a single, coherent map for conducting research that addresses many of the thorny problems educational researchers encounter. We believe it is the most useful orientation toward research and the most helpful to learn as a beginning researcher.

A final clarification of our definition is that it applies equally to qualitative and quantitative research. This is a familiar distinction in education that has generated much discussion. You might think our definition favors quantitative methods over qualitative methods because the language of hypothesis formulation and testing is often associated with quantitative methods. In fact, we do not favor one method over another. In Chap. 4 , we will illustrate how our definition fits research using a range of quantitative and qualitative methods.

Exercise 1.4

Look for ways to extend what the field knows in an area that has already received attention by other researchers. Specifically, you can search for a program of research carried out by more experienced researchers that has some revised hypotheses that remain untested. Identify a revised hypothesis that you might like to test.

Unpacking the Terms Formulating, Testing, and Revising Hypotheses

To get a full sense of the definition of scientific inquiry we will use throughout this book, it is helpful to spend a little time with each of the key terms.

We first want to make clear that we use the term “hypothesis” as it is defined in most dictionaries and as it used in many scientific fields rather than as it is usually defined in educational statistics courses. By “hypothesis,” we do not mean a null hypothesis that is accepted or rejected by statistical analysis. Rather, we use “hypothesis” in the sense conveyed by the following definitions: “An idea or explanation for something that is based on known facts but has not yet been proved” (Cambridge University Press, n.d. ), and “An unproved theory, proposition, or supposition, tentatively accepted to explain certain facts and to provide a basis for further investigation or argument” (Agnes & Guralnik, 2008 ).

We distinguish two parts to “hypotheses.” Hypotheses consist of predictions and rationales . Predictions are statements about what you expect to find when you inquire about something. Rationales are explanations for why you made the predictions you did, why you believe your predictions are correct. So, for us “formulating hypotheses” means making explicit predictions and developing rationales for the predictions.

“Testing hypotheses” means making observations that allow you to assess in what ways your predictions were correct and in what ways they were incorrect. In education research, it is rarely useful to think of your predictions as either right or wrong. Because of the complexity of most issues you will investigate, most predictions will be right in some ways and wrong in others.

By studying the observations you make (data you collect) to test your hypotheses, you can revise your hypotheses to better align with the observations. This means revising your predictions plus revising your rationales to justify your adjusted predictions. Even though you might not run another test, formulating revised hypotheses is an essential part of conducting a research study. Comparing your original and revised hypotheses informs everyone of what you learned by conducting your study. In addition, a revised hypothesis sets the stage for you or someone else to extend your study and accumulate more knowledge of the phenomenon.

We should note that not everyone makes a clear distinction between predictions and rationales as two aspects of hypotheses. In fact, common, non-scientific uses of the word “hypothesis” may limit it to only a prediction or only an explanation (or rationale). We choose to explicitly include both prediction and rationale in our definition of hypothesis, not because we assert this should be the universal definition, but because we want to foreground the importance of both parts acting in concert. Using “hypothesis” to represent both prediction and rationale could hide the two aspects, but we make them explicit because they provide different kinds of information. It is usually easier to make predictions than develop rationales because predictions can be guesses, hunches, or gut feelings about which you have little confidence. Developing a compelling rationale requires careful thought plus reading what other researchers have found plus talking with your colleagues. Often, while you are developing your rationale you will find good reasons to change your predictions. Developing good rationales is the engine that drives scientific inquiry. Rationales are essentially descriptions of how much you know about the phenomenon you are studying. Throughout this guide, we will elaborate on how developing good rationales drives scientific inquiry. For now, we simply note that it can sharpen your predictions and help you to interpret your data as you test your hypotheses.

Hypotheses in education research take a variety of forms or types. This is because there are a variety of phenomena that can be investigated. Investigating educational phenomena is sometimes best done using qualitative methods, sometimes using quantitative methods, and most often using mixed methods (e.g., Hay, 2016 ; Weis et al. 2019a ; Weisner, 2005 ). This means that, given our definition, hypotheses are equally applicable to qualitative and quantitative investigations.

Hypotheses take different forms when they are used to investigate different kinds of phenomena. Two very different activities in education could be labeled conducting experiments and descriptions. In an experiment, a hypothesis makes a prediction about anticipated changes, say the changes that occur when a treatment or intervention is applied. You might investigate how students’ thinking changes during a particular kind of instruction.

A second type of hypothesis, relevant for descriptive research, makes a prediction about what you will find when you investigate and describe the nature of a situation. The goal is to understand a situation as it exists rather than to understand a change from one situation to another. In this case, your prediction is what you expect to observe. Your rationale is the set of reasons for making this prediction; it is your current explanation for why the situation will look like it does.

You will probably read, if you have not already, that some researchers say you do not need a prediction to conduct a descriptive study. We will discuss this point of view in Chap. 2 . For now, we simply claim that scientific inquiry, as we have defined it, applies to all kinds of research studies. Descriptive studies, like others, not only benefit from formulating, testing, and revising hypotheses, but also need hypothesis formulating, testing, and revising.

One reason we define research as formulating, testing, and revising hypotheses is that if you think of research in this way you are less likely to go wrong. It is a useful guide for the entire process, as we will describe in detail in the chapters ahead. For example, as you build the rationale for your predictions, you are constructing the theoretical framework for your study (Chap. 3 ). As you work out the methods you will use to test your hypothesis, every decision you make will be based on asking, “Will this help me formulate or test or revise my hypothesis?” (Chap. 4 ). As you interpret the results of testing your predictions, you will compare them to what you predicted and examine the differences, focusing on how you must revise your hypotheses (Chap. 5 ). By anchoring the process to formulating, testing, and revising hypotheses, you will make smart decisions that yield a coherent and well-designed study.

Exercise 1.5

Compare the concept of formulating, testing, and revising hypotheses with the descriptions of scientific inquiry contained in Scientific Research in Education (NRC, 2002 ). How are they similar or different?

Exercise 1.6

Provide an example to illustrate and emphasize the differences between everyday learning/thinking and scientific inquiry.

Learning from Doing Scientific Inquiry

We noted earlier that a measure of what you have learned by conducting a research study is found in the differences between your original hypothesis and your revised hypothesis based on the data you collected to test your hypothesis. We will elaborate this statement in later chapters, but we preview our argument here.

Even before collecting data, scientific inquiry requires cycles of making a prediction, developing a rationale, refining your predictions, reading and studying more to strengthen your rationale, refining your predictions again, and so forth. And, even if you have run through several such cycles, you still will likely find that when you test your prediction you will be partly right and partly wrong. The results will support some parts of your predictions but not others, or the results will “kind of” support your predictions. A critical part of scientific inquiry is making sense of your results by interpreting them against your predictions. Carefully describing what aspects of your data supported your predictions, what aspects did not, and what data fell outside of any predictions is not an easy task, but you cannot learn from your study without doing this analysis.

Analyzing the matches and mismatches between your predictions and your data allows you to formulate different rationales that would have accounted for more of the data. The best revised rationale is the one that accounts for the most data. Once you have revised your rationales, you can think about the predictions they best justify or explain. It is by comparing your original rationales to your new rationales that you can sort out what you learned from your study.

Suppose your study was an experiment. Maybe you were investigating the effects of a new instructional intervention on students’ learning. Your original rationale was your explanation for why the intervention would change the learning outcomes in a particular way. Your revised rationale explained why the changes that you observed occurred like they did and why your revised predictions are better. Maybe your original rationale focused on the potential of the activities if they were implemented in ideal ways and your revised rationale included the factors that are likely to affect how teachers implement them. By comparing the before and after rationales, you are describing what you learned—what you can explain now that you could not before. Another way of saying this is that you are describing how much more you understand now than before you conducted your study.

Revised predictions based on carefully planned and collected data usually exhibit some of the following features compared with the originals: more precision, more completeness, and broader scope. Revised rationales have more explanatory power and become more complete, more aligned with the new predictions, sharper, and overall more convincing.

Part II. Why Do Educators Do Research?

Doing scientific inquiry is a lot of work. Each phase of the process takes time, and you will often cycle back to improve earlier phases as you engage in later phases. Because of the significant effort required, you should make sure your study is worth it. So, from the beginning, you should think about the purpose of your study. Why do you want to do it? And, because research is a social practice, you should also think about whether the results of your study are likely to be important and significant to the education community.

If you are doing research in the way we have described—as scientific inquiry—then one purpose of your study is to understand , not just to describe or evaluate or report. As we noted earlier, when you formulate hypotheses, you are developing rationales that explain why things might be like they are. In our view, trying to understand and explain is what separates research from other kinds of activities, like evaluating or describing.

One reason understanding is so important is that it allows researchers to see how or why something works like it does. When you see how something works, you are better able to predict how it might work in other contexts, under other conditions. And, because conditions, or contextual factors, matter a lot in education, gaining insights into applying your findings to other contexts increases the contributions of your work and its importance to the broader education community.

Consequently, the purposes of research studies in education often include the more specific aim of identifying and understanding the conditions under which the phenomena being studied work like the observations suggest. A classic example of this kind of study in mathematics education was reported by William Brownell and Harold Moser in 1949 . They were trying to establish which method of subtracting whole numbers could be taught most effectively—the regrouping method or the equal additions method. However, they realized that effectiveness might depend on the conditions under which the methods were taught—“meaningfully” versus “mechanically.” So, they designed a study that crossed the two instructional approaches with the two different methods (regrouping and equal additions). Among other results, they found that these conditions did matter. The regrouping method was more effective under the meaningful condition than the mechanical condition, but the same was not true for the equal additions algorithm.

What do education researchers want to understand? In our view, the ultimate goal of education is to offer all students the best possible learning opportunities. So, we believe the ultimate purpose of scientific inquiry in education is to develop understanding that supports the improvement of learning opportunities for all students. We say “ultimate” because there are lots of issues that must be understood to improve learning opportunities for all students. Hypotheses about many aspects of education are connected, ultimately, to students’ learning. For example, formulating and testing a hypothesis that preservice teachers need to engage in particular kinds of activities in their coursework in order to teach particular topics well is, ultimately, connected to improving students’ learning opportunities. So is hypothesizing that school districts often devote relatively few resources to instructional leadership training or hypothesizing that positioning mathematics as a tool students can use to combat social injustice can help students see the relevance of mathematics to their lives.

We do not exclude the importance of research on educational issues more removed from improving students’ learning opportunities, but we do think the argument for their importance will be more difficult to make. If there is no way to imagine a connection between your hypothesis and improving learning opportunities for students, even a distant connection, we recommend you reconsider whether it is an important hypothesis within the education community.

Notice that we said the ultimate goal of education is to offer all students the best possible learning opportunities. For too long, educators have been satisfied with a goal of offering rich learning opportunities for lots of students, sometimes even for just the majority of students, but not necessarily for all students. Evaluations of success often are based on outcomes that show high averages. In other words, if many students have learned something, or even a smaller number have learned a lot, educators may have been satisfied. The problem is that there is usually a pattern in the groups of students who receive lower quality opportunities—students of color and students who live in poor areas, urban and rural. This is not acceptable. Consequently, we emphasize the premise that the purpose of education research is to offer rich learning opportunities to all students.

One way to make sure you will be able to convince others of the importance of your study is to consider investigating some aspect of teachers’ shared instructional problems. Historically, researchers in education have set their own research agendas, regardless of the problems teachers are facing in schools. It is increasingly recognized that teachers have had trouble applying to their own classrooms what researchers find. To address this problem, a researcher could partner with a teacher—better yet, a small group of teachers—and talk with them about instructional problems they all share. These discussions can create a rich pool of problems researchers can consider. If researchers pursued one of these problems (preferably alongside teachers), the connection to improving learning opportunities for all students could be direct and immediate. “Grounding a research question in instructional problems that are experienced across multiple teachers’ classrooms helps to ensure that the answer to the question will be of sufficient scope to be relevant and significant beyond the local context” (Cai et al., 2019b , p. 115).

As a beginning researcher, determining the relevance and importance of a research problem is especially challenging. We recommend talking with advisors, other experienced researchers, and peers to test the educational importance of possible research problems and topics of study. You will also learn much more about the issue of research importance when you read Chap. 5 .

Exercise 1.7

Identify a problem in education that is closely connected to improving learning opportunities and a problem that has a less close connection. For each problem, write a brief argument (like a logical sequence of if-then statements) that connects the problem to all students’ learning opportunities.

Part III. Conducting Research as a Practice of Failing Productively

Scientific inquiry involves formulating hypotheses about phenomena that are not fully understood—by you or anyone else. Even if you are able to inform your hypotheses with lots of knowledge that has already been accumulated, you are likely to find that your prediction is not entirely accurate. This is normal. Remember, scientific inquiry is a process of constantly updating your thinking. More and better information means revising your thinking, again, and again, and again. Because you never fully understand a complicated phenomenon and your hypotheses never produce completely accurate predictions, it is easy to believe you are somehow failing.

The trick is to fail upward, to fail to predict accurately in ways that inform your next hypothesis so you can make a better prediction. Some of the best-known researchers in education have been open and honest about the many times their predictions were wrong and, based on the results of their studies and those of others, they continuously updated their thinking and changed their hypotheses.

A striking example of publicly revising (actually reversing) hypotheses due to incorrect predictions is found in the work of Lee J. Cronbach, one of the most distinguished educational psychologists of the twentieth century. In 1955, Cronbach delivered his presidential address to the American Psychological Association. Titling it “Two Disciplines of Scientific Psychology,” Cronbach proposed a rapprochement between two research approaches—correlational studies that focused on individual differences and experimental studies that focused on instructional treatments controlling for individual differences. (We will examine different research approaches in Chap. 4 ). If these approaches could be brought together, reasoned Cronbach ( 1957 ), researchers could find interactions between individual characteristics and treatments (aptitude-treatment interactions or ATIs), fitting the best treatments to different individuals.

In 1975, after years of research by many researchers looking for ATIs, Cronbach acknowledged the evidence for simple, useful ATIs had not been found. Even when trying to find interactions between a few variables that could provide instructional guidance, the analysis, said Cronbach, creates “a hall of mirrors that extends to infinity, tormenting even the boldest investigators and defeating even ambitious designs” (Cronbach, 1975 , p. 119).

As he was reflecting back on his work, Cronbach ( 1986 ) recommended moving away from documenting instructional effects through statistical inference (an approach he had championed for much of his career) and toward approaches that probe the reasons for these effects, approaches that provide a “full account of events in a time, place, and context” (Cronbach, 1986 , p. 104). This is a remarkable change in hypotheses, a change based on data and made fully transparent. Cronbach understood the value of failing productively.

Closer to home, in a less dramatic example, one of us began a line of scientific inquiry into how to prepare elementary preservice teachers to teach early algebra. Teaching early algebra meant engaging elementary students in early forms of algebraic reasoning. Such reasoning should help them transition from arithmetic to algebra. To begin this line of inquiry, a set of activities for preservice teachers were developed. Even though the activities were based on well-supported hypotheses, they largely failed to engage preservice teachers as predicted because of unanticipated challenges the preservice teachers faced. To capitalize on this failure, follow-up studies were conducted, first to better understand elementary preservice teachers’ challenges with preparing to teach early algebra, and then to better support preservice teachers in navigating these challenges. In this example, the initial failure was a necessary step in the researchers’ scientific inquiry and furthered the researchers’ understanding of this issue.

We present another example of failing productively in Chap. 2 . That example emerges from recounting the history of a well-known research program in mathematics education.

Making mistakes is an inherent part of doing scientific research. Conducting a study is rarely a smooth path from beginning to end. We recommend that you keep the following things in mind as you begin a career of conducting research in education.

First, do not get discouraged when you make mistakes; do not fall into the trap of feeling like you are not capable of doing research because you make too many errors.

Second, learn from your mistakes. Do not ignore your mistakes or treat them as errors that you simply need to forget and move past. Mistakes are rich sites for learning—in research just as in other fields of study.

Third, by reflecting on your mistakes, you can learn to make better mistakes, mistakes that inform you about a productive next step. You will not be able to eliminate your mistakes, but you can set a goal of making better and better mistakes.

Exercise 1.8

How does scientific inquiry differ from everyday learning in giving you the tools to fail upward? You may find helpful perspectives on this question in other resources on science and scientific inquiry (e.g., Failure: Why Science is So Successful by Firestein, 2015).

Exercise 1.9

Use what you have learned in this chapter to write a new definition of scientific inquiry. Compare this definition with the one you wrote before reading this chapter. If you are reading this book as part of a course, compare your definition with your colleagues’ definitions. Develop a consensus definition with everyone in the course.

Part IV. Preview of Chap. 2

Now that you have a good idea of what research is, at least of what we believe research is, the next step is to think about how to actually begin doing research. This means how to begin formulating, testing, and revising hypotheses. As for all phases of scientific inquiry, there are lots of things to think about. Because it is critical to start well, we devote Chap. 2 to getting started with formulating hypotheses.

Agnes, M., & Guralnik, D. B. (Eds.). (2008). Hypothesis. In Webster’s new world college dictionary (4th ed.). Wiley.

Google Scholar  

Britannica. (n.d.). Scientific method. In Encyclopaedia Britannica . Retrieved July 15, 2022 from https://www.britannica.com/science/scientific-method

Brownell, W. A., & Moser, H. E. (1949). Meaningful vs. mechanical learning: A study in grade III subtraction . Duke University Press..

Cai, J., Morris, A., Hohensee, C., Hwang, S., Robison, V., Cirillo, M., Kramer, S. L., & Hiebert, J. (2019b). Posing significant research questions. Journal for Research in Mathematics Education, 50 (2), 114–120. https://doi.org/10.5951/jresematheduc.50.2.0114

Article   Google Scholar  

Cambridge University Press. (n.d.). Hypothesis. In Cambridge dictionary . Retrieved July 15, 2022 from https://dictionary.cambridge.org/us/dictionary/english/hypothesis

Cronbach, J. L. (1957). The two disciplines of scientific psychology. American Psychologist, 12 , 671–684.

Cronbach, L. J. (1975). Beyond the two disciplines of scientific psychology. American Psychologist, 30 , 116–127.

Cronbach, L. J. (1986). Social inquiry by and for earthlings. In D. W. Fiske & R. A. Shweder (Eds.), Metatheory in social science: Pluralisms and subjectivities (pp. 83–107). University of Chicago Press.

Hay, C. M. (Ed.). (2016). Methods that matter: Integrating mixed methods for more effective social science research . University of Chicago Press.

Merriam-Webster. (n.d.). Explain. In Merriam-Webster.com dictionary . Retrieved July 15, 2022, from https://www.merriam-webster.com/dictionary/explain

National Research Council. (2002). Scientific research in education . National Academy Press.

Weis, L., Eisenhart, M., Duncan, G. J., Albro, E., Bueschel, A. C., Cobb, P., Eccles, J., Mendenhall, R., Moss, P., Penuel, W., Ream, R. K., Rumbaut, R. G., Sloane, F., Weisner, T. S., & Wilson, J. (2019a). Mixed methods for studies that address broad and enduring issues in education research. Teachers College Record, 121 , 100307.

Weisner, T. S. (Ed.). (2005). Discovering successful pathways in children’s development: Mixed methods in the study of childhood and family life . University of Chicago Press.

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Hiebert, J., Cai, J., Hwang, S., Morris, A.K., Hohensee, C. (2023). What Is Research, and Why Do People Do It?. In: Doing Research: A New Researcher’s Guide. Research in Mathematics Education. Springer, Cham. https://doi.org/10.1007/978-3-031-19078-0_1

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• Published: 02 September 2024

Leadership support and satisfaction of healthcare professionals in China’s leading hospitals: a cross-sectional study

• Jinhong Zhao 1 , 2 ,
• Tingfang Liu 2 &
• Yuanli Liu 2  

BMC Health Services Research volume  24 , Article number:  1016 ( 2024 ) Cite this article

Metrics details

Healthcare professionals’ job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China’s leading hospitals.

A cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals.

The overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals’ perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412  ∼  7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134  ∼  14.471) significantly enhances healthcare personnel satisfaction.

The findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.

Peer Review reports

Introduction

In the era of accelerated globalization, the investigation of global leadership has assumed heightened significance [ 1 ]. Leadership, as a dynamic and evolving process, holds the potential to cultivate both the personal and professional growth of followers [ 2 ]. Effective healthcare leadership can enhance medical service quality, patient safety, and staff job satisfaction through skill development, vision establishment, and clear direction-setting [ 3 , 4 , 5 ]. Moreover, leadership support can effectively enhance staff well-being and work efficiency [ 6 , 7 ]. For example, Mendes et al. found that the quality of healthcare is significantly influenced by four dimensions of leadership: communication, recognition, development, and innovation [ 8 ]. Additionally, Shanafelt et al. discovered that leaders can effectively reduce employee burnout and subsequently improve the quality of medical services by formulating and implementing targeted work interventions and motivating employees [ 9 ].

Job satisfaction among healthcare professionals is a crucial indicator of healthcare performance, playing a vital role in addressing challenges related to hospital quality outcomes, patient satisfaction, and nurse retention rates [ 10 , 11 , 12 , 13 ]. Researchers from different national backgrounds have conducted studies on the job satisfaction of healthcare workers across various disciplines. For example, Balasubramanian et al. examined the satisfaction of immigrant dentists in Australia [ 14 ], Mascari et al. studied physicians and hospital researchers in the United States [ 15 ], and Rosta et al. investigated the satisfaction of doctors in Norway [ 12 ]. Research has demonstrated that characteristics of the work environment, balanced workloads, relationships with colleagues, career opportunities, and leadership support all influence job satisfaction [ 16 ]. Several instruments are commonly used to measure job satisfaction, each relevant depending on the context and discipline. For instance, the Job Descriptive Index (JDI) focuses on different facets of job satisfaction such as work, pay, promotion, supervision, and co-workers [ 17 ]. The Job Satisfaction Survey (JSS) covers similar dimensions and is particularly useful in public sector organizations due to its comprehensive nature and ease of use [ 18 ]. The Minnesota Satisfaction Questionnaire (MSQ) is a comprehensive tool that assesses employee satisfaction across multiple dimensions including intrinsic and extrinsic satisfaction, and is commonly used for evaluating job satisfaction in the healthcare field [ 19 ].

Recent studies have linked leadership to healthcare professionals’ job satisfaction, highlighting the pivotal role of leadership in guiding, coordinating, and motivating employees [ 5 ]. For instance, the Mayo Clinic found that leadership from immediate supervisors could alleviate burnout and increase job satisfaction [ 20 ]. Choi’s research indicated that leadership empowerment significantly enhances nursing staff’s job satisfaction [ 21 ]. Additionally, Liu discovered that the support provided by hospital senior leadership is closely associated with employee satisfaction [ 22 ].

In China, while leadership research has gained some traction in areas such as business and education, it remains relatively scarce within healthcare institutions. Existing studies primarily focus on the nursing sector, and comprehensive assessments of leadership at the leading public hospitals (top 10% of Chinese hospitals) have not been extensively conducted [ 23 , 24 ]. Research on leadership and healthcare professionals’ satisfaction often relies on single indicators to measure job satisfaction, such as overall job satisfaction or specific aspects like compensation satisfaction and burnout levels [ 25 ]. This narrow focus may fail to fully capture the multidimensional nature of employee satisfaction, which includes aspects such as workload, ability utilization, sense of achievement, initiative, training and self-development, and interpersonal communication [ 26 ]. Additionally, most existing studies focus on the job satisfaction of nurses or physicians in isolation, lacking comparative research across different groups within healthcare institutions, such as doctors, nurses, and administrative personnel [ 27 , 28 , 29 ].

Therefore, this study utilized the MSQ to conduct a thorough assessment of employee satisfaction and assess the impact of leadership support on the satisfaction of healthcare personnel in China’s leading public hospitals. Through this research, we aim to enhance the core competitiveness of hospitals and provide valuable data to support leadership assessments in developing countries’ healthcare institutions. Moreover, this study seeks to contribute to the broader international understanding of effective leadership practices in China’s leading public hospitals, with implications for global health management strategies.

Study design and participants

From July to December 2021, a cross-sectional survey study was conducted on healthcare professionals in China’s 3 leading hospitals. The 3 leading hospitals represent three regions in China with different levels of social and economic development, one in the eastern, one in the central, and one in the western. In each hospital, a convenience sampling method was used to conduct a questionnaire survey among physicians, nurses, and administrative staff.

Criteria for inclusion of healthcare professionals: (1) employed at the hospital for at least 1 year or more; (2) formal employees of the hospital (full-time staff); (3) possessing cognitive clarity and the ability to independently understand and respond to electronic questionnaires, as assessed by their leaders. Exclusion criteria: (1) diagnosed with mental health disorders that impair their ability to participate, as identified by the hospital’s mental health professionals; (2) unable to communicate effectively due to severe language barriers, hearing impairments, or other communication disorders, as determined by their direct supervisors or relevant medical evaluations; (3) visiting scholars, interns, or graduate students currently enrolled in a degree program.

Instrument development

Leadership support.

In reference to the Malcolm Baldrige National Quality Award (MBNQA) framework and Supporting Relationship Theory [ 6 , 30 , 31 ], we determined the survey scale after three expert discussions involving 5–7 individuals. These experts included personnel from health administrative departments, leading public hospital leaders, middle management, and researchers specializing in hospital management. Their collective expertise ensured that the survey comprehensively assessed leadership support within hospitals from the perspective of healthcare personnel. The Leadership Support Scale consists of 5 items: Environmental Support: ‘My leaders provide a work environment that helps me perform my job,’ Resource Support: ‘My leaders provide the resources needed to improve my work,’ Decision Support: ‘My leaders support my decisions to satisfy patients,’ Research Support: ‘My leaders support my application for scientific research projects,’ and Innovation Encouragement: ‘My leaders encourage me to innovate actively and think about problems in new ways‘ (Supplementary material). All questionnaire items are rated on a 5-point Likert scale, ranging from 1 = Strongly Disagree to 5 = Strongly Agree. The Cronbach’s alpha coefficient for the 5-item scale is 0.753.

Job satisfaction

The measurement of job satisfaction was carried out using the Minnesota Satisfaction Questionnaire (MSQ) [ 32 , 33 ], which has been widely used and has been shown by scholars to have good reliability and validity in China [ 34 , 35 ]. The questionnaire consists of 20 items that measure healthcare personnel’s satisfaction with various aspects of their job, including individual job load, ability utilization, achievement, initiative, hospital training and self-development, authority, hospital policies and practices, compensation, teamwork, creativity, independence, moral standards, hospital rewards and punishments, personal responsibility, job security, social service contribution, social status, employee relations and communication, and hospital working conditions and environment. Responses to these items were balanced and rated on a scale from 1 to 5, with 1 = Very Dissatisfied, 2 = Dissatisfied, 3 = Neither Dissatisfied nor Satisfied, 4 = Satisfied, and 5 = Very Satisfied. Scores range from 20 to 100, with higher scores indicating higher satisfaction. In this study, a comprehensive assessment of healthcare personnel’s job satisfaction was made using a score of 80 and above [ 32 ], where a score of ≥ 80 was considered satisfied, and below 80 was considered dissatisfied. The Cronbach’s alpha coefficient for the questionnaire in this survey was 0.983.

Investigation process

The survey was administered through an online platform “Wenjuanxing”, and distributed by department heads to healthcare professionals within their respective departments. The selection of departments and potential participants followed a structured process: (1) Potential participants were identified based on the inclusion criteria, which were communicated to the department heads. (2) Department heads received a digital link to the survey, which they forwarded to eligible staff members via email or internal communication platforms. (3) The informed consent form was integrated into the survey link, detailing the research objectives, ensuring anonymity, and emphasizing voluntary participation. At the beginning of the online survey, participants were asked if they agreed to participate. Those who consented continued with the survey, while those who did not agree were directed to end the survey immediately.

According to Kendall’s experience and methodology, the sample size can be 5–10 times the number of independent variables (40 items) [ 36 , 37 ]. Our sample size is ten times the number of independent variables. Considering potentially disqualified questionnaires, the sample size was increased by 10%, resulting in a minimum total sample size of 460. Therefore, we distributed 500 survey questionnaires.

Data analysis

We summarized the sociodemographic characteristics of healthcare personnel survey samples using descriptive statistical methods. For all variables, we calculated the frequencies and percentages of categorical variables. Different sociodemographic characteristics in relation to healthcare personnel’s perception of leadership support and satisfaction were analyzed using the Pearson χ² test. We employed a binary logistic regression model to estimate the risk ratio of healthcare personnel satisfaction under different levels of leadership support. Estimates from three sequentially adjusted models were reported to transparently demonstrate the impact of various adjustments: (1) unadjusted; (2) adjusted for hospital of origin; (3) adjusted for hospital of origin, gender, age, education level, job type, and department. For the binary logistic regression model, we employed a backward stepwise regression approach, with inclusion at P  < 0.05 and exclusion at P  > 0.10 criteria. In all analyses, a two-tailed p -value of < 0.05 was considered significant, and all analyses were conducted using SPSS 26.0 (IBM Corp., Armonk, NY, USA).

Demographic characteristics and job satisfaction

This study recruited a total of 500 healthcare personnel from hospitals to participate in the survey, with 487 valid questionnaires collected, resulting in an effective response rate of 97.4%. The majority of participants were female (77.21%), with ages concentrated between 30 and 49 years old (73.71%). The predominant job titles were mid-level (45.17%) and junior-level (27.31%), and educational backgrounds were mostly at the undergraduate (45.17%) and graduate (48.25%) levels. The marital status of most participants was married (79.88%), and their primary departments were surgery (38.19%) and internal medicine (24.85%). The overall satisfaction rate among the sampled healthcare personnel was 74.33%. Differences in satisfaction were statistically significant among healthcare personnel of different genders, ages, educational levels, job types, hospitals, and departments ( P  < 0.05). Table  1 displays the participants’ demographic characteristics and job satisfaction.

By analyzed the satisfaction level of healthcare personnel in different dimensions, the results show that “Social service” (94.3%) and “Moral values” (92.0%) have the highest satisfaction. “Activity” (66.8%) and “Compensation” (71.9%) were the least satisfied. Table  2 shows participants’ job satisfaction in different dimensions.

Perception of different types of leadership support among healthcare professionals

Overall, surveyed healthcare personnel perceived significant levels of support from hospital leadership for research encouragement (96.92%), innovation inspiration (96.30%), and the work environment (93.63%), while perceiving lower levels of support for decision-making (81.72%) and resource allocation (80.08%). Female healthcare personnel perceived significantly higher levels of resource support compared to males ( P  < 0.05). Healthcare personnel in the 30–39 age group perceived significantly higher levels of resource, environmental, and research support compared to other age groups ( P  < 0.05). Healthcare personnel with senior-level job titles perceived significantly lower levels of resource and decision-making support compared to associate-level and lower job titles, and those with doctoral degrees perceived significantly lower levels of resource support compared to other educational backgrounds ( P  < 0.05).

Clinical doctors perceived significantly lower levels of resource and environmental support compared to administrative personnel and clinical nurses, while administrative personnel perceived significantly lower levels of decision-making support compared to clinical doctors and clinical nurses ( P  < 0.05). Among healthcare personnel in internal medicine, perceptions of resource, environmental, research, and innovation support were significantly lower than those in surgery, administration, and other departments, whereas perceptions of decision-making support in administrative departments were significantly lower than in internal medicine, surgery, and other departments ( P  < 0.05). Figure  1 displays the perception of leadership support among healthcare personnel with different demographic characteristics.

Perception of leadership support among healthcare professionals with different demographic characteristics in China’s leading public hospitals (* indicates P  < 0.05, ** indicates P  < 0.01, and *** indicates P  < 0.001.)

The impact of leadership support on job satisfaction among healthcare professionals

The study results indicate that healthcare personnel who perceive that their leaders provide sufficient resource, environmental, and decision-making support have significantly higher job satisfaction than those who feel that leaders have not provided enough support ( P  < 0.05). Similarly, healthcare personnel who perceive that their leaders provide sufficient research and innovation inspiration have significantly higher job satisfaction than those who believe leaders have not provided enough inspiration ( P  < 0.05). Table  3 displays the univariate analysis of leadership support on healthcare professional satisfaction.

With healthcare personnel satisfaction as the dependent variable, leadership resource support, environmental support, decision-making support, research support, and innovation inspiration were included in the binary logistic regression model. After adjusting for hospital, gender, age, education level, job type, and department, leadership’s increased resource support (OR: 4.312, 95% CI: 2.412  ∼  7.710) and environmental support (OR: 4.052, 95% CI: 1.134  ∼  14.471) were found to enhance the satisfaction levels of healthcare personnel significantly. Additionally, healthcare professionals in Hospital 2 (OR: 3.654, 95% CI: 1.796 to 7.435) and Hospital 3 (OR: 2.354, 95% CI: 1.099 to 5.038) exhibited higher levels of satisfaction compared to those in Hospital 1. Table 4 displays the binary Logistic regression analysis of leadership support on satisfaction among healthcare professionals.

This study aimed to determine the impact of support from hospital senior leadership on the job satisfaction of healthcare personnel and to explore the effects of demographic and different types of support on the job satisfaction of healthcare personnel in China. The research indicates that hospital leadership’s resource support, environmental support, and decision-making support have a significantly positive impact on the job satisfaction of healthcare personnel. These forms of support can assist healthcare personnel in better adapting to the constantly changing work environment and demands, thereby enhancing their job satisfaction, and ultimately, positively influencing the overall performance of the hospital and the quality of patient care.

Our research indicates that, using the same MSQ to measure job satisfaction, the job satisfaction among healthcare personnel in China’s top-tier hospitals is at 74.33%, which is higher than the results of a nationwide survey in 2016 (48.22%) [ 38 ] and a survey among doctors in Shanghai in 2013 (35.2%) in China [ 39 ]. This improvement is likely due to the Chinese government’s recent focus on healthcare personnel’s compensation and benefits, along with corresponding improvement measures, which have increased their job satisfaction. It’s worth noting that while job satisfaction among healthcare personnel in China’s top-tier hospitals is higher than the national average in China, it is slightly lower than the job satisfaction of doctors in the United States, as measured by the MSQ (81.73%) [ 40 ]. However, when compared to the job satisfaction by the MSQ of doctors in Southern Nigeria (26.7%) [ 32 ], nurses in South Korea (65.89%) [ 41 ], and nurses in Iran (59.7%) [ 42 ], the level of job satisfaction among healthcare personnel in China’s top-tier hospitals is significantly higher. This suggests that China has achieved some level of success in improving healthcare personnel’s job satisfaction. Studies have shown that for healthcare professionals, job satisfaction is influenced by work conditions, compensation, and opportunities for promotion, with varying levels of satisfaction observed across different cultural backgrounds and specialties [ 29 , 43 ]. Furthermore, the observed differences in job satisfaction levels can be influenced by cultural factors unique to China, including hierarchical workplace structures and the emphasis on collective well-being over individual recognition.

Leadership support can influence employees’ work attitudes and emotions. Effective leaders can establish a positive work environment, and provide constructive feedback, thereby enhancing employee job satisfaction [ 44 , 45 ]. Our research results show that clinical physicians perceive significantly lower levels of resource and environmental support compared to administrative staff and clinical nurses, while administrative staff perceive significantly lower levels of decision-making support compared to clinical physicians and clinical nurses. This difference can be attributed to their different roles and job nature within the healthcare team [ 9 ]. Nurses typically have direct patient care responsibilities, performing medical procedures, providing care, and monitoring patient conditions, making them in greater need of resource and environmental support to efficiently deliver high-quality care [ 46 ]. Doctors usually have responsibilities for clinical diagnosis and treatment, requiring better healthcare environments and resources due to their serious commitment to patients’ lives. Administrative staff often oversee the hospital’s day-to-day operations and management, including budgeting, resource allocation, and personnel management. Their work may be more organizationally oriented, involving strategic planning and management decisions. Therefore, they may require more decision-making support to succeed at the managerial level [ 47 ].

The job satisfaction of healthcare personnel is influenced by various factors, including the work environment, workload, career development, and leadership support [ 48 , 49 ]. When healthcare personnel are satisfied with their work, their job enthusiasm increases, contributing to higher patient satisfaction. Healthcare organizations should assess the leadership and management qualities of each hospital to enhance their leadership capabilities. This will directly impact employee satisfaction, retention rates, and patient satisfaction [ 50 ]. Resource support provided by leaders, such as data, human resources, financial resources, equipment resources, supplies (such as medications), and training opportunities, significantly influences the job satisfaction of healthcare personnel [ 51 ]. From a theoretical perspective, researchers believe that leaders’ behavior, by providing resources to followers, is one of the primary ways to influence employee satisfaction [ 7 ]. These resources can assist healthcare personnel in better fulfilling their job responsibilities, improving work efficiency, and thereby enhancing their job satisfaction.

In hospital organizations, leaders play a crucial role in shaping the work environment for healthcare personnel and providing decision-making support [ 52 , 53 ]. Hospital leaders are committed to ensuring the safety of the work environment for their employees by formulating and promoting policies and regulations. They also play a key role in actively identifying and addressing issues in the work environment, including conflicts among employees and resource shortages. These initiatives are aimed at continuously improving working conditions, enabling healthcare personnel to better fulfill their duties [ 54 ]. The actions of these leaders not only contribute to improving the job satisfaction of healthcare personnel but also create the necessary foundation for providing high-quality healthcare services.

It is worth noting that our research results show that in the context of leading public hospitals in China, leadership support for research, encouragement of innovation, and decision-making do not appear to significantly enhance the job satisfaction of healthcare personnel, which differs from some international literature [ 23 , 55 , 56 ]. International studies often suggest that fostering innovation is particularly important in influencing healthcare personnel’s job satisfaction [ 57 , 58 ]. Inspiring a shared vision is particularly important in motivating nursing staff and enhancing their job satisfaction and organizational commitment [ 59 ]. This may reflect the Chinese healthcare personnel’s perception of leadership’s innovation encouragement, scientific research encouragement, and decision support, but it does not significantly improve their job satisfaction. However, material support (resources and environment) can significantly increase their satisfaction.

Strengths and limitations of this study

For the first time, we analyzed the role of perceived leadership support in enhancing healthcare providers in China’s leading public hospitals. We assessed the impact of perceived leadership on healthcare professional satisfaction across five dimensions: resources, environment, decision-making, research, and innovation. The sample includes physicians, nurses, and administrative staff, providing a comprehensive understanding of leadership support’s impact on diverse positions and professional groups.

However, it’s important to note that this study exclusively recruited healthcare professionals from three leading public hospitals in China, limiting the generalizability of the research findings. Additionally, the cross-sectional nature of the study means that causality cannot be established. There is also a potential for response bias as the data were collected through self-reported questionnaires. Furthermore, the use of convenience sampling may introduce selection bias, and the reliance on electronic questionnaires may exclude those less comfortable with digital technology.

Implications for research and practice

The results of this study provide important empirical evidence supporting the significance of leadership assessment in the context of Chinese hospitals. Specifically, the findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals, which has implications for hospital operational efficiency and the quality of patient care. For hospital administrators and policymakers, the study highlights the need to prioritize leadership development programs that focus on the three dimensions of leadership support: resources, environment, and decision-making. Implementing targeted interventions in these areas can lead to improved job satisfaction. Moreover, this study serves as a foundation for comparative research across different cultural and organizational contexts, contributing to a deeper understanding of how leadership practices can be optimized to meet the unique needs of healthcare professionals in various regions.

Our study found a close positive correlation between leadership support in Chinese leading public hospitals and employee job satisfaction. They achieve this by providing ample resources to ensure employees can effectively fulfill their job responsibilities. Furthermore, they create a comfortable work environment and encourage active employee participation. By nurturing outstanding leadership and support, hospitals can enhance employee job satisfaction, leading to improved overall performance and service quality. This is crucial for providing high-quality healthcare and meeting patient needs.

Data availability

Data are available upon reasonable request.

Kempster S, Parry KW. Grounded theory and leadership research: a critical realist perspective. Leadersh Q. 2011;22(1):106–20.

Article   Google Scholar  

Northouse PG. Leadership: Theory and Practice: Leadership: Theory and Practice; 2014.

Mosadeghrad AM. Factors affecting medical service quality. Iran J Public Health. 2014;43(2):210.

PubMed   PubMed Central   Google Scholar  

de Vries JM, Curtis EA. Nursing leadership in Ireland: experiences and obstacles. Leadersh Health Serv. 2019;32(3):348–63.

Boamah SA, Laschinger HKS, Wong C, Clarke S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nurs Outlook. 2018;66(2):180–9.

Article   PubMed   Google Scholar  

Likert R. The human organization: its management and values. 1967.

Inceoglu I, Thomas G, Chu C, Plans D, Gerbasi A. Leadership behavior and employee well-being: an integrated review and a future research agenda. Leadersh Q. 2018;29(1):179–202.

Mendes L, Fradique MJJG. Influence of leadership on quality nursing care. Int J Health Care Qual Assur. 2014;27(5):439–50.

Shanafelt TD, Noseworthy JH, editors. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings; 2017: Elsevier.

Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987–93.

Cicolini G, Comparcini D, Simonetti V. Workplace empowerment and nurses’ job satisfaction: a systematic literature review. J Nurs Manag. 2014;22(7):855–71.

Rosta J, Aasland OG, Nylenna M. Changes in job satisfaction among doctors in Norway from 2010 to 2017: a study based on repeated surveys. BMJ open. 2019;9(9):e027891.

Article   PubMed   PubMed Central   Google Scholar  

Zhang Z, Shi G, Li L, Bian Y. Job satisfaction among primary care physicians in western China. BMC Fam Pract. 2020;21:1–10.

Balasubramanian M, Spencer AJ, Short SD, Watkins K, Chrisopoulos S, Brennan DS. Job satisfaction among ‘migrant dentists’ in Australia: implications for dentist migration and workforce policy. Aust Dent J. 2016;61(2):174–82.

Article   CAS   PubMed   Google Scholar  

Mascari C. Job satisfaction of doctors vs. researchers in the US University Hospital Environment: a comparative case study. Northcentral University; 2020.

Friedberg MW, Chen PG, Van Busum KR, Aunon F, Pham C, Caloyeras J et al. Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Rand Health Q. 2014;3(4).

Nhung DTH, Linh TM. Identifying work-related factors influencing job satisfaction using job descriptive index questionnaire: a study of IT companies in Hanoi. J Int Econ Manage. 2021;21(1):63–85.

Gomez Garcia R, Alonso Sangregorio M, Lucía Llamazares Sánchez M. Evaluation of job satisfaction in a sample of Spanish social workers through the ‘Job satisfaction survey’scale. Eur J Social Work. 2018;21(1):140–54.

Walkowiak D, Staszewski R. The job satisfaction of Polish nurses as measured with the Minnesota satisfaction questionnaire. J Public Health Nurs Med Rescue. 2019;4:34–40.

Google Scholar  

Dyrbye LN, Major-Elechi B, Hays JT, Fraser CH, Buskirk SJ, West CP, editors. Relationship between organizational leadership and health care employee burnout and satisfaction. Mayo Clinic Proceedings; 2020: Elsevier.

Choi SL, Goh CF, Adam MBH, Tan OK. Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Hum Resour Health. 2016;14:1–14.

Liu W, Zhao S, Shi L, Zhang Z, Liu X, Li L, et al. Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study. BMJ open. 2018;8(6):e019525.

Wang X, Chontawan R, Nantsupawat R. Transformational leadership: effect on the job satisfaction of registered nurses in a hospital in China. J Adv Nurs. 2012;68(2):444–51.

Wang L, Tao H, Bowers BJ, Brown R, Zhang Y. When nurse emotional intelligence matters: how transformational leadership influences intent to stay. J Nurs Manag. 2018;26(4):358–65.

Adamopoulos IP. Job satisfaction in public health care sector, measures scales and theoretical background. Eur J Environ Public Health. 2022;6(2):em0116.

Montano D, Reeske A, Franke F, Hüffmeier J. Leadership, followers’ mental health and job performance in organizations: a comprehensive meta-analysis from an occupational health perspective. J Organizational Behav. 2017;38(3):327–50.

Carlson MA, Morris S, Day F, Dadich A, Ryan A, Fradgley EA, Paul C. Psychometric properties of leadership scales for health professionals: a systematic review. Implement Sci. 2021;16(1):85.

Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344.

Cunningham R, Westover J, Harvey J. Drivers of job satisfaction among healthcare professionals: a quantitative review. Int J Healthc Manag. 2023;16(4):534–42.

Foster TC, Johnson JK, Nelson EC, Batalden PB. Using a Malcolm Baldrige framework to understand high-performing clinical microsystems. BMJ Qual Saf. 2007;16(5):334–41.

Shields JA, Jennings JL. Using the Malcolm Baldrige are we making progress survey for organizational self-assessment and performance improvement. J Healthc Qual. 2013;35(4):5–15.

Bello S, Adewole DA, Afolabi RF. Work facets predicting overall job satisfaction among resident doctors in selected teaching hospitals in Southern Nigeria: a Minnesota satisfaction Questionnaire Survey. J Occup Health Epidemiol. 2020;9(1):52–60.

Ozyurt A, Hayran O, Sur H. Predictors of burnout and job satisfaction among Turkish physicians. J Association Physicians. 2006;99(3):161–9.

Article   CAS   Google Scholar  

Wang YY, Xiong Y, Zhang Y, Li CY, Fu LL, Luo HL, Sun Y. Compassion fatigue among haemodialysis nurses in public and private hospitals in China. Int J Nurs Pract. 2022;28(1):e13011.

Jiang F, Hu L, Rakofsky J, Liu T, Wu S, Zhao P, et al. Sociodemographic characteristics and job satisfaction of psychiatrists in China: results from the first nationwide survey. Psychiatric Serv. 2018;69(12):1245–51.

Kendall MG. Note on bias in the estimation of autocorrelation. Biometrika. 1954;41(3–4):403–4.

Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. Houghton Mifflin college division; 2003.

Zhou H, Han X, Zhang J, Sun J, Hu L, Hu G et al. Job satisfaction and Associated Factors among medical staff in Tertiary Public hospitals: results from a National Cross-sectional Survey in China. Int J Environ Res Public Health. 2018;15(7).

Liu J, Yu W, Ding T, Li M, Zhang L. Cross-sectional survey on job satisfaction and its associated factors among doctors in tertiary public hospitals in Shanghai, China. BMJ Open. 2019;9(3):e023823.

Ritter B. Senior healthcare leaders: exploring the relationship between the rates of job satisfaction and person-job value congruence. Int J Healthc Manag. 2021;14(1):85–90.

Shin S, Oh SJ, Kim J, Lee I, Bae SH. Impact of nurse staffing on intent to leave, job satisfaction, and occupational injuries in Korean hospitals: a cross-sectional study. Nurs Health Sci. 2020;22(3):658–66.

Shahrbabaki PM, Abolghaseminejad P, Lari LA, Zeidabadinejad S, Dehghan M. The relationship between nurses’ psychological resilience and job satisfaction during the COVID-19 pandemic: a descriptive-analytical cross-sectional study in Iran. BMC Nurs. 2023;22(1):137.

Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600-13.

Laschinger HKS, Wong CA, Grau AL. The influence of authentic leadership on newly graduated nurses’ experiences of workplace bullying, burnout and retention outcomes: a cross-sectional study. Int J Nurs Stud. 2012;49(10):1266–76.

Chang C-S. Moderating effects of nurses’ organizational support on the relationship between job satisfaction and organizational commitment. West J Nurs Res. 2015;37(6):724–45.

Lake ET, Friese CR. Variations in nursing practice environments: relation to staffing and hospital characteristics. Nurs Res. 2006;55(1):1–9.

Bååthe F, Erik Norbäck L. Engaging physicians in organisational improvement work. J Health Organ Manag. 2013;27(4):479–97.

Zhang M, Zhu CJ, Dowling PJ, Bartram T. Exploring the effects of high-performance work systems (HPWS) on the work-related well-being of Chinese hospital employees. Int J Hum Resource Manage. 2013;24(16):3196–212.

Baek H, Han K, Ryu E. Authentic leadership, job satisfaction and organizational commitment: the moderating effect of nurse tenure. J Nurs Adm Manag. 2019;27(8):1655–63.

Robbins B, Davidhizar R. Transformational leadership in health care today. Health Care Manag. 2020;39(3):117–21.

Hussain MK, Khayat RAM. The impact of transformational leadership on job satisfaction and organisational commitment among hospital staff: a systematic review. J Health Manage. 2021;23(4):614–30.

Mete M, Goldman C, Shanafelt T, Marchalik D. Impact of leadership behaviour on physician well-being, burnout, professional fulfilment and intent to leave: a multicentre cross-sectional survey study. BMJ open. 2022;12(6):e057554.

Avolio BJ, Walumbwa FO, Weber TJ, Leadership. Current theories, research, and future directions. Ann Rev Psychol. 2009;60:421–49.

Zhang L-f, You L-m, Liu K, Zheng J, Fang J-b, Lu M-m, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook. 2014;62(2):128–37.

Cummings G, Estabrooks CA. The effects of hospital restructuring that included layoffs on individual nurses who remained employed: a systematic review of impact. Int J Sociol Soc Policy. 2003;23(8/9):8–53.

Laschinger HKS, Finegan J, Shamian J. The impact of workplace empowerment, organizational trust on staff nurses’ work satisfaction and organizational commitment. Health Care Manage Rev. 2001:7–23.

Wong CA, Laschinger HKS. The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study. Int J Nurs Stud. 2015;52(12):1824–33.

Alrowwad Aa, Abualoush SH. Masa’deh re. Innovation and intellectual capital as intermediary variables among transformational leadership, transactional leadership, and organizational performance. J Manage Dev. 2020;39(2):196–222.

Chiok Foong Loke J. Leadership behaviours: effects on job satisfaction, productivity and organizational commitment. J Nurs Adm Manag. 2001;9(4):191–204.

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This study was funded by the Fundamental Research Funds for the Central Universities (2020-RC630-001), the Fundamental Research Funds for the Central Universities (3332022166), and the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (2021-I2M-1-046).

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Jinhong Zhao

School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

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Contributions

JZ, TL, and YL designed the study. JZ collected the original data in China, reviewed the literature, performed the analyses, and wrote the first draft of the manuscript. TL and YL critically revised the manuscript. All authors contributed to the interpretation of data and the final approved version.

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Correspondence to Tingfang Liu or Yuanli Liu .

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This study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Chinese Academy of Medical Sciences & Peking Union Medical College Institutional Review Board (CAMS & PUMC-IRC-2020-026). The survey was distributed by department heads and included informed consent and survey materials. The informed consent form described the research objectives, assured anonymity, emphasized voluntary participation, and instructed participants to complete the questionnaire through the online system. The statement ‘No signature is required, completing the survey implies consent to participate in the study’ implies implied consent.

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Zhao, J., Liu, T. & Liu, Y. Leadership support and satisfaction of healthcare professionals in China’s leading hospitals: a cross-sectional study. BMC Health Serv Res 24 , 1016 (2024). https://doi.org/10.1186/s12913-024-11449-3

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Letting funding for the All of Us research program lapse will cost the U.S. far more than it saves

Investing in preventive medicine and drug target discovery now will save lives and billions of dollars.

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By Pradeep Natarajan

Sept. 3, 2024

Natarajan is the director of preventive cardiology at Massachusetts General Hospital.

I was in high school when I first encountered the ruthlessness of the number one killer in the U.S. A close friend of mine, then only 16 years old, witnessed his father having a heart attack while checking the mail. Despite desperate attempts at CPR on the driveway, he wasn’t able to save his dad, a seemingly healthy man in his early 40s. That event put me on a path to become a cardiologist. Twenty-five years later, as a physician at Massachusetts General Hospital in Boston, I’m still seeing young patients having heart attacks, though they often have nothing in their health profiles to indicate increased risks.

As a preventive cardiologist, I wish I had a better way to identify patients who have a heightened risk for heart disease earlier so that they can take action before it’s too late. Prevention is the best medicine — it saves lives and health care dollars — but in our current paradigm, we’re focused on treating conditions after they occur.

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Fortunately, there is a new, effective way to better find those at highest risk very early in life, well before they develop risk factors like diabetes or high blood pressure. My research group at Massachusetts General Hospital and the Broad Institute of MIT and Harvard, and many other labs, have been developing genetic tests that can predict disease risk well before disease becomes apparent, called polygenic risk scores.

These types of predictive tests and genetics-informed treatments hold enormous promise for the fight against heart disease, diabetes, cancer, and so much more. Polygenic risk scores have been developed for heart attack and other forms of heart disease, but they aren’t currently accurate for many segments of the U.S. population.

The only way to make these tools actually work for the diverse U.S. population is to study the health profiles of hundreds of thousands of Americans. Generating these profiles is precisely a key goal of All of Us, a federal precision-medicine research effort that’s now facing a potentially fatal funding cliff.

This world-leading initiative, launched in 2018, is recruiting 1 million volunteers from across the U.S. The project is collecting their health, medical, and genetic information, and making that large and invaluable dataset available to scientists like me so that we can find new drug targets and develop preventive tests from genetics for a wide range of diseases.

The data that All of Us has collected so far represents people from all across America, including those from rural and urban communities and from all walks of life. These people are helping us develop better polygenic risk scores and novel therapeutic strategies that will improve the health of all Americans for generations to come. But without full support from Congress, All of Us will only be able to generate roughly half of the genetic data it has promised. Less data from fewer communities means less accurate genetic tests and fewer new drugs that can keep people out of the emergency room.

All of Us faces a whopping 71% decrease in funding for the coming fiscal year, which starts Oct. 1, compared with its funding level just two years ago. That’s because a major source of its first round of funding, in the 2016 21st Century Cures Act, was designed with fluctuating budget levels over 10 years. This cut is but the start. With just two years left, the clock is nearly up entirely. While I am hopeful about recent efforts from two members of the House on a Cures 2.0 bill and from the Senate Appropriations Committee to restore All of Us funding to the FY 2023 level, it’ll be up to both chambers of Congress this fall to ensure this important program has stable funding to keep going.

All of Us is only half complete, and a loss of stable funding threatens its timeliness and impact. It is unclear how many more Americans will be able to sign up to contribute to this work; I worry that without the necessary support, recruitment levels will fall sharply and data generation will slow dramatically. 

This funding loss will be a blow for preventive medicine in another way, too, by starving the drug development pipeline of much needed new drug targets that are rooted in human genetics. Many in the drug discovery world are familiar with the story of PCSK9 inhibitors, which lower LDL cholesterol levels to help prevent heart disease. These treatments were first approved by the Food and Drug Administration in 2015, just 10 years after genetic studies — similar to the ones that All of Us data can empower — suggested that the PCSK9 gene would be a promising target for cholesterol drugs. The big difference with the full set of All of Us data is that it would include many more people from underrepresented populations, which likely harbor disease-associated gene targets that are yet to be discovered. Without this entire diverse dataset, the genetics community will miss out on opportunities to generate more drug discovery success stories like the PCSK9 one.

This program has another advantage: maintaining and extending this country’s global edge in the life sciences. Other countries with nationalized health systems, like the United Kingdom and Finland, are making progress toward their own large genetic and medical datasets, or biobanks, that reflect the health status of their populations. While this information is useful for researchers all over the world, it is insufficient for developing the genetic insights, diagnostics, and treatments that are most relevant for Americans, because it doesn’t account for the population diversity and unique experiences and environments of the American people the way that All of Us data would.

All of Us is a big bet on a better future. Genomics-based tools will be critical for preventing and treating disease. Better prevention and treatment would save lives, livelihoods, and money: for heart disease alone, the American Heart Association projects annual inflation-adjusted health care costs will triple in the next two decades, from $400 billion to $1.34 trillion.

By restoring funding to All of Us, Congress can help deliver on the promise of a better health care system, and better health for all Americans.

Pradeep Natarajan, M.D., is the director of preventive cardiology and the Paul and Phyllis Fireman endowed chair in vascular medicine at Massachusetts General Hospital (MGH), associate professor of medicine at Harvard Medical School, and associate member of the Broad Institute of MIT and Harvard. MGH and Broad are both institutional recipients of All of Us funding to advance research. Dr. Natarajan does not receive direct funding from All of Us.

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STAT’s investigation is based on interviews with nearly 100 people around the country, including incarcerated patients and grieving families, prison officials, and legal and medical experts. Reporter Nicholas Florko also filed more than 225 public records requests and combed through thousands of pages of legal filings to tell these stories. His analysis of deaths in custody is based on a special data use agreement between STAT and the Department of Justice.

You can read more about the reporting for this project and the methodology behind our calculations.

The series is the culmination of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.

Pradeep Natarajan

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Cannabis and hallucinogen use among adults remained at historic highs in 2023

Vaping among younger adults and binge drinking among mid-life adults also maintained historically high levels, NIH-supported study shows

Past-year use of cannabis and hallucinogens stayed at historically high levels in 2023 among adults aged 19 to 30 and 35 to 50, according to the latest findings  from the  Monitoring the Future survey . In contrast, past-year use of cigarettes remained at historically low levels in both adult groups. Past-month and daily alcohol use continued a decade-long decline among those 19 to 30 years old, with binge drinking reaching all-time lows. However, among 35- to 50-year-olds, the prevalence of binge drinking in 2023 increased from five and 10 years ago. The Monitoring the Future study is conducted by scientists at the University of Michigan’s Institute for Social Research, Ann Arbor, and is funded by the National Institutes of Health.

Reports of vaping nicotine or vaping cannabis in the past year among adults 19 to 30 rose over five years, and both trends remained at record highs in 2023. Among adults 35 to 50, the prevalences of nicotine vaping and of cannabis vaping stayed steady from the year before, with long-term (five and 10 year) trends not yet observable in this age group as this question was added to the survey for this age group in 2019.

For the first time in 2023, 19- to 30-year-old female respondents reported a higher prevalence of past-year cannabis use than male respondents in the same age group, reflecting a reversal of the gap between sexes. Conversely, male respondents 35 to 50 years old maintained a higher prevalence of past-year cannabis use than female respondents of the same age group, consistent with what’s been observed for the past decade.

“We have seen that people at different stages of adulthood are trending toward use of drugs like cannabis and psychedelics and away from tobacco cigarettes,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “These findings underscore the urgent need for rigorous research on the potential risks and benefits of cannabis and hallucinogens – especially as new products continue to emerge.”

Since 1975, the Monitoring the Future study has annually surveyed substance use behaviors and attitudes among a nationally representative sample of teens. A longitudinal panel study component of Monitoring the Future conducts follow-up surveys on a subset of these participants (now totaling approximately 20,000 people per year), collecting data from individuals every other year from ages 19 to 30 and every five years after the participants turn 30 to track their drug use through adulthood. Participants self-report their drug use behaviors across various time periods, including lifetime, past year (12 months), past month (30 days), and other use frequencies depending on the substance type. Data for the 2023 panel study were collected via online and paper surveys from April 2023 through October 2023.

Full data summaries and data tables showing the trends below, including breakdowns by substance, are available in the report . Key findings include:

Cannabis use in the past year and past month remained at historically high levels for both adult age groups in 2023. Among adults 19 to 30 years old, approximately 42% reported cannabis use in the past year, 29% in the past month, and 10% daily use (use on 20 or more occasions in the past 30 days). Among adults 35 to 50, reports of use reached 29%, 19%, and 8%, respectively. While these 2023 estimates are not statistically different from those of 2022, they do reflect five- and 10-year increases for both age groups.

Cannabis vaping in the past year and past month was reported by 22% and 14% of adults 19 to 30, respectively, and by 9% and 6% of adults 35 to 50 in 2023. For the younger group, these numbers represent all-time study highs and an increase from five years ago.

Nicotine vaping among adults 19 to 30 maintained historic highs in 2023. Reports of past-year and past-month vaping of nicotine reached 25% and 19%, respectively. These percentages represent an increase from five years ago, but not from one year ago. For adults 35 to 50, the prevalence of vaping nicotine remained steady from the year before (2022), with 7% and 5% reporting past-year and past-month use.

Hallucinogen use in the past year continued a five-year steep incline for both adult groups, reaching 9% for adults 19 to 30 and 4% for adults 35 to 50 in 2023. Types of hallucinogens reported by participants included LSD, mescaline, peyote, shrooms or psilocybin, and PCP.

Alcohol remains the most used substance reported among adults in the study. Past-year alcohol use among adults 19 to 30 has showed a slight upward trend over the past five years, with 84% reporting use in 2023. However, past month drinking (65%), daily drinking (4%), and binge drinking (27%) all remained at study lows in 2023 among adults 19 to 30. These numbers have decreased from 10 years ago. Past-month drinking and binge drinking (having five or more drinks in a row in the past two week period) decreased significantly from the year before for this age group (down from 68% for past month and 31% for binge drinking reported in 2022).

Around 84% of adults 35 to 50 reported past-year alcohol use in 2023, which has not significantly changed from the year before or the past five or 10 years. Past-month alcohol use and binge drinking have slightly increased over the past 10 years for this age group; in 2023, past-month alcohol use was at 69% and binge drinking was at 27%. Daily drinking has decreased in this group over the past five years and was at its lowest level ever recorded in 2023 (8%).

Additional data: In 2023, past-month cigarette smoking, past-year nonmedical use of prescription drugs, and past-year use of opioid medications (surveyed as “narcotics other than heroin”) maintained five- and 10-year declines for both adult groups. Among adults 19 to 30 years old, past-year use of stimulants (surveyed as “amphetamines”) has decreased for the past decade, whereas for adults 35 to 50, past-year stimulant use has been modestly increasing over 10 years. Additional data include drug use reported by college/non-college young adults and among various demographic subgroups, including sex and gender and race and ethnicity.

The 2023 survey year was the first time a cohort from the Monitoring the Future study reached 65 years of age; therefore, trends for the 55- to 65-year-old age group are not yet available.

“The data from 2023 did not show us many significant changes from the year before, but the power of surveys such as Monitoring the Future is to see the ebb and flow of various substance use trends over the longer term,” said Megan Patrick, Ph.D., of the University of Michigan and principal investigator of the Monitoring the Future panel study. “As more and more of our original cohorts – first recruited as teens – now enter later adulthood, we will be able to examine the patterns and effects of drug use throughout the life course. In the coming years, this study will provide crucial data on substance use trends and health consequences among older populations, when people may be entering retirement and other new chapters of their lives.”

View more information on data collection methods for the Monitoring the Future panel study and how the survey adjusts for the effects of potential exclusions in the report . Results from the related 2023 Monitoring the Future study of substance use behaviors and related attitudes among teens in the United States were released in December 2023, and 2024 results are upcoming in December 2024.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org . To learn how to get support for mental health, drug or alcohol conditions visit  FindSupport.gov . If you are ready to locate a treatment facility or provider, you can go directly to  FindTreatment.gov or call  800-662-HELP (4357) .

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov .

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

About substance use disorders: Substance use disorders are chronic, treatable conditions from which people can recover. In 2022, nearly 49 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction. View NIDA’s online guide .

NIH…Turning Discovery Into Health®

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Home » Research Design – Types, Methods and Examples

Research Design – Types, Methods and Examples

Table of Contents

Research Design

Definition:

Research design refers to the overall strategy or plan for conducting a research study. It outlines the methods and procedures that will be used to collect and analyze data, as well as the goals and objectives of the study. Research design is important because it guides the entire research process and ensures that the study is conducted in a systematic and rigorous manner.

Types of Research Design

Types of Research Design are as follows:

Descriptive Research Design

This type of research design is used to describe a phenomenon or situation. It involves collecting data through surveys, questionnaires, interviews, and observations. The aim of descriptive research is to provide an accurate and detailed portrayal of a particular group, event, or situation. It can be useful in identifying patterns, trends, and relationships in the data.

Correlational Research Design

Correlational research design is used to determine if there is a relationship between two or more variables. This type of research design involves collecting data from participants and analyzing the relationship between the variables using statistical methods. The aim of correlational research is to identify the strength and direction of the relationship between the variables.

Experimental Research Design

Experimental research design is used to investigate cause-and-effect relationships between variables. This type of research design involves manipulating one variable and measuring the effect on another variable. It usually involves randomly assigning participants to groups and manipulating an independent variable to determine its effect on a dependent variable. The aim of experimental research is to establish causality.

Quasi-experimental Research Design

Quasi-experimental research design is similar to experimental research design, but it lacks one or more of the features of a true experiment. For example, there may not be random assignment to groups or a control group. This type of research design is used when it is not feasible or ethical to conduct a true experiment.

Case Study Research Design

Case study research design is used to investigate a single case or a small number of cases in depth. It involves collecting data through various methods, such as interviews, observations, and document analysis. The aim of case study research is to provide an in-depth understanding of a particular case or situation.

Longitudinal Research Design

Longitudinal research design is used to study changes in a particular phenomenon over time. It involves collecting data at multiple time points and analyzing the changes that occur. The aim of longitudinal research is to provide insights into the development, growth, or decline of a particular phenomenon over time.

Structure of Research Design

The format of a research design typically includes the following sections:

• Introduction : This section provides an overview of the research problem, the research questions, and the importance of the study. It also includes a brief literature review that summarizes previous research on the topic and identifies gaps in the existing knowledge.
• Research Questions or Hypotheses: This section identifies the specific research questions or hypotheses that the study will address. These questions should be clear, specific, and testable.
• Research Methods : This section describes the methods that will be used to collect and analyze data. It includes details about the study design, the sampling strategy, the data collection instruments, and the data analysis techniques.
• Data Collection: This section describes how the data will be collected, including the sample size, data collection procedures, and any ethical considerations.
• Data Analysis: This section describes how the data will be analyzed, including the statistical techniques that will be used to test the research questions or hypotheses.
• Results : This section presents the findings of the study, including descriptive statistics and statistical tests.
• Discussion and Conclusion : This section summarizes the key findings of the study, interprets the results, and discusses the implications of the findings. It also includes recommendations for future research.
• References : This section lists the sources cited in the research design.

Example of Research Design

An Example of Research Design could be:

Research question: Does the use of social media affect the academic performance of high school students?

Research design:

• Research approach : The research approach will be quantitative as it involves collecting numerical data to test the hypothesis.
• Research design : The research design will be a quasi-experimental design, with a pretest-posttest control group design.
• Sample : The sample will be 200 high school students from two schools, with 100 students in the experimental group and 100 students in the control group.
• Data collection : The data will be collected through surveys administered to the students at the beginning and end of the academic year. The surveys will include questions about their social media usage and academic performance.
• Data analysis : The data collected will be analyzed using statistical software. The mean scores of the experimental and control groups will be compared to determine whether there is a significant difference in academic performance between the two groups.
• Limitations : The limitations of the study will be acknowledged, including the fact that social media usage can vary greatly among individuals, and the study only focuses on two schools, which may not be representative of the entire population.
• Ethical considerations: Ethical considerations will be taken into account, such as obtaining informed consent from the participants and ensuring their anonymity and confidentiality.

How to Write Research Design

Writing a research design involves planning and outlining the methodology and approach that will be used to answer a research question or hypothesis. Here are some steps to help you write a research design:

• Define the research question or hypothesis : Before beginning your research design, you should clearly define your research question or hypothesis. This will guide your research design and help you select appropriate methods.
• Select a research design: There are many different research designs to choose from, including experimental, survey, case study, and qualitative designs. Choose a design that best fits your research question and objectives.
• Develop a sampling plan : If your research involves collecting data from a sample, you will need to develop a sampling plan. This should outline how you will select participants and how many participants you will include.
• Define variables: Clearly define the variables you will be measuring or manipulating in your study. This will help ensure that your results are meaningful and relevant to your research question.
• Choose data collection methods : Decide on the data collection methods you will use to gather information. This may include surveys, interviews, observations, experiments, or secondary data sources.
• Create a data analysis plan: Develop a plan for analyzing your data, including the statistical or qualitative techniques you will use.
• Consider ethical concerns : Finally, be sure to consider any ethical concerns related to your research, such as participant confidentiality or potential harm.

When to Write Research Design

Research design should be written before conducting any research study. It is an important planning phase that outlines the research methodology, data collection methods, and data analysis techniques that will be used to investigate a research question or problem. The research design helps to ensure that the research is conducted in a systematic and logical manner, and that the data collected is relevant and reliable.

Ideally, the research design should be developed as early as possible in the research process, before any data is collected. This allows the researcher to carefully consider the research question, identify the most appropriate research methodology, and plan the data collection and analysis procedures in advance. By doing so, the research can be conducted in a more efficient and effective manner, and the results are more likely to be valid and reliable.

Purpose of Research Design

The purpose of research design is to plan and structure a research study in a way that enables the researcher to achieve the desired research goals with accuracy, validity, and reliability. Research design is the blueprint or the framework for conducting a study that outlines the methods, procedures, techniques, and tools for data collection and analysis.

Some of the key purposes of research design include:

• Providing a clear and concise plan of action for the research study.
• Ensuring that the research is conducted ethically and with rigor.
• Maximizing the accuracy and reliability of the research findings.
• Minimizing the possibility of errors, biases, or confounding variables.
• Ensuring that the research is feasible, practical, and cost-effective.
• Determining the appropriate research methodology to answer the research question(s).
• Identifying the sample size, sampling method, and data collection techniques.
• Determining the data analysis method and statistical tests to be used.
• Facilitating the replication of the study by other researchers.
• Enhancing the validity and generalizability of the research findings.

Applications of Research Design

There are numerous applications of research design in various fields, some of which are:

• Social sciences: In fields such as psychology, sociology, and anthropology, research design is used to investigate human behavior and social phenomena. Researchers use various research designs, such as experimental, quasi-experimental, and correlational designs, to study different aspects of social behavior.
• Education : Research design is essential in the field of education to investigate the effectiveness of different teaching methods and learning strategies. Researchers use various designs such as experimental, quasi-experimental, and case study designs to understand how students learn and how to improve teaching practices.
• Health sciences : In the health sciences, research design is used to investigate the causes, prevention, and treatment of diseases. Researchers use various designs, such as randomized controlled trials, cohort studies, and case-control studies, to study different aspects of health and healthcare.
• Business : Research design is used in the field of business to investigate consumer behavior, marketing strategies, and the impact of different business practices. Researchers use various designs, such as survey research, experimental research, and case studies, to study different aspects of the business world.
• Engineering : In the field of engineering, research design is used to investigate the development and implementation of new technologies. Researchers use various designs, such as experimental research and case studies, to study the effectiveness of new technologies and to identify areas for improvement.

Advantages of Research Design

Here are some advantages of research design:

• Systematic and organized approach : A well-designed research plan ensures that the research is conducted in a systematic and organized manner, which makes it easier to manage and analyze the data.
• Clear objectives: The research design helps to clarify the objectives of the study, which makes it easier to identify the variables that need to be measured, and the methods that need to be used to collect and analyze data.
• Minimizes bias: A well-designed research plan minimizes the chances of bias, by ensuring that the data is collected and analyzed objectively, and that the results are not influenced by the researcher’s personal biases or preferences.
• Efficient use of resources: A well-designed research plan helps to ensure that the resources (time, money, and personnel) are used efficiently and effectively, by focusing on the most important variables and methods.
• Replicability: A well-designed research plan makes it easier for other researchers to replicate the study, which enhances the credibility and reliability of the findings.
• Validity: A well-designed research plan helps to ensure that the findings are valid, by ensuring that the methods used to collect and analyze data are appropriate for the research question.
• Generalizability : A well-designed research plan helps to ensure that the findings can be generalized to other populations, settings, or situations, which increases the external validity of the study.

Research Design Vs Research Methodology

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How to use and assess qualitative research methods

Loraine busetto.

1 Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany

Wolfgang Wick

2 Clinical Cooperation Unit Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany

Christoph Gumbinger

Associated data.

Not applicable.

This paper aims to provide an overview of the use and assessment of qualitative research methods in the health sciences. Qualitative research can be defined as the study of the nature of phenomena and is especially appropriate for answering questions of why something is (not) observed, assessing complex multi-component interventions, and focussing on intervention improvement. The most common methods of data collection are document study, (non-) participant observations, semi-structured interviews and focus groups. For data analysis, field-notes and audio-recordings are transcribed into protocols and transcripts, and coded using qualitative data management software. Criteria such as checklists, reflexivity, sampling strategies, piloting, co-coding, member-checking and stakeholder involvement can be used to enhance and assess the quality of the research conducted. Using qualitative in addition to quantitative designs will equip us with better tools to address a greater range of research problems, and to fill in blind spots in current neurological research and practice.

The aim of this paper is to provide an overview of qualitative research methods, including hands-on information on how they can be used, reported and assessed. This article is intended for beginning qualitative researchers in the health sciences as well as experienced quantitative researchers who wish to broaden their understanding of qualitative research.

What is qualitative research?

Qualitative research is defined as “the study of the nature of phenomena”, including “their quality, different manifestations, the context in which they appear or the perspectives from which they can be perceived” , but excluding “their range, frequency and place in an objectively determined chain of cause and effect” [ 1 ]. This formal definition can be complemented with a more pragmatic rule of thumb: qualitative research generally includes data in form of words rather than numbers [ 2 ].

Why conduct qualitative research?

Because some research questions cannot be answered using (only) quantitative methods. For example, one Australian study addressed the issue of why patients from Aboriginal communities often present late or not at all to specialist services offered by tertiary care hospitals. Using qualitative interviews with patients and staff, it found one of the most significant access barriers to be transportation problems, including some towns and communities simply not having a bus service to the hospital [ 3 ]. A quantitative study could have measured the number of patients over time or even looked at possible explanatory factors – but only those previously known or suspected to be of relevance. To discover reasons for observed patterns, especially the invisible or surprising ones, qualitative designs are needed.

While qualitative research is common in other fields, it is still relatively underrepresented in health services research. The latter field is more traditionally rooted in the evidence-based-medicine paradigm, as seen in " research that involves testing the effectiveness of various strategies to achieve changes in clinical practice, preferably applying randomised controlled trial study designs (...) " [ 4 ]. This focus on quantitative research and specifically randomised controlled trials (RCT) is visible in the idea of a hierarchy of research evidence which assumes that some research designs are objectively better than others, and that choosing a "lesser" design is only acceptable when the better ones are not practically or ethically feasible [ 5 , 6 ]. Others, however, argue that an objective hierarchy does not exist, and that, instead, the research design and methods should be chosen to fit the specific research question at hand – "questions before methods" [ 2 , 7 – 9 ]. This means that even when an RCT is possible, some research problems require a different design that is better suited to addressing them. Arguing in JAMA, Berwick uses the example of rapid response teams in hospitals, which he describes as " a complex, multicomponent intervention – essentially a process of social change" susceptible to a range of different context factors including leadership or organisation history. According to him, "[in] such complex terrain, the RCT is an impoverished way to learn. Critics who use it as a truth standard in this context are incorrect" [ 8 ] . Instead of limiting oneself to RCTs, Berwick recommends embracing a wider range of methods , including qualitative ones, which for "these specific applications, (...) are not compromises in learning how to improve; they are superior" [ 8 ].

Research problems that can be approached particularly well using qualitative methods include assessing complex multi-component interventions or systems (of change), addressing questions beyond “what works”, towards “what works for whom when, how and why”, and focussing on intervention improvement rather than accreditation [ 7 , 9 – 12 ]. Using qualitative methods can also help shed light on the “softer” side of medical treatment. For example, while quantitative trials can measure the costs and benefits of neuro-oncological treatment in terms of survival rates or adverse effects, qualitative research can help provide a better understanding of patient or caregiver stress, visibility of illness or out-of-pocket expenses.

How to conduct qualitative research?

Given that qualitative research is characterised by flexibility, openness and responsivity to context, the steps of data collection and analysis are not as separate and consecutive as they tend to be in quantitative research [ 13 , 14 ]. As Fossey puts it : “sampling, data collection, analysis and interpretation are related to each other in a cyclical (iterative) manner, rather than following one after another in a stepwise approach” [ 15 ]. The researcher can make educated decisions with regard to the choice of method, how they are implemented, and to which and how many units they are applied [ 13 ]. As shown in Fig.  1 , this can involve several back-and-forth steps between data collection and analysis where new insights and experiences can lead to adaption and expansion of the original plan. Some insights may also necessitate a revision of the research question and/or the research design as a whole. The process ends when saturation is achieved, i.e. when no relevant new information can be found (see also below: sampling and saturation). For reasons of transparency, it is essential for all decisions as well as the underlying reasoning to be well-documented.

Iterative research process

While it is not always explicitly addressed, qualitative methods reflect a different underlying research paradigm than quantitative research (e.g. constructivism or interpretivism as opposed to positivism). The choice of methods can be based on the respective underlying substantive theory or theoretical framework used by the researcher [ 2 ].

Data collection

The methods of qualitative data collection most commonly used in health research are document study, observations, semi-structured interviews and focus groups [ 1 , 14 , 16 , 17 ].

Document study

Document study (also called document analysis) refers to the review by the researcher of written materials [ 14 ]. These can include personal and non-personal documents such as archives, annual reports, guidelines, policy documents, diaries or letters.

Observations

Observations are particularly useful to gain insights into a certain setting and actual behaviour – as opposed to reported behaviour or opinions [ 13 ]. Qualitative observations can be either participant or non-participant in nature. In participant observations, the observer is part of the observed setting, for example a nurse working in an intensive care unit [ 18 ]. In non-participant observations, the observer is “on the outside looking in”, i.e. present in but not part of the situation, trying not to influence the setting by their presence. Observations can be planned (e.g. for 3 h during the day or night shift) or ad hoc (e.g. as soon as a stroke patient arrives at the emergency room). During the observation, the observer takes notes on everything or certain pre-determined parts of what is happening around them, for example focusing on physician-patient interactions or communication between different professional groups. Written notes can be taken during or after the observations, depending on feasibility (which is usually lower during participant observations) and acceptability (e.g. when the observer is perceived to be judging the observed). Afterwards, these field notes are transcribed into observation protocols. If more than one observer was involved, field notes are taken independently, but notes can be consolidated into one protocol after discussions. Advantages of conducting observations include minimising the distance between the researcher and the researched, the potential discovery of topics that the researcher did not realise were relevant and gaining deeper insights into the real-world dimensions of the research problem at hand [ 18 ].

Semi-structured interviews

Hijmans & Kuyper describe qualitative interviews as “an exchange with an informal character, a conversation with a goal” [ 19 ]. Interviews are used to gain insights into a person’s subjective experiences, opinions and motivations – as opposed to facts or behaviours [ 13 ]. Interviews can be distinguished by the degree to which they are structured (i.e. a questionnaire), open (e.g. free conversation or autobiographical interviews) or semi-structured [ 2 , 13 ]. Semi-structured interviews are characterized by open-ended questions and the use of an interview guide (or topic guide/list) in which the broad areas of interest, sometimes including sub-questions, are defined [ 19 ]. The pre-defined topics in the interview guide can be derived from the literature, previous research or a preliminary method of data collection, e.g. document study or observations. The topic list is usually adapted and improved at the start of the data collection process as the interviewer learns more about the field [ 20 ]. Across interviews the focus on the different (blocks of) questions may differ and some questions may be skipped altogether (e.g. if the interviewee is not able or willing to answer the questions or for concerns about the total length of the interview) [ 20 ]. Qualitative interviews are usually not conducted in written format as it impedes on the interactive component of the method [ 20 ]. In comparison to written surveys, qualitative interviews have the advantage of being interactive and allowing for unexpected topics to emerge and to be taken up by the researcher. This can also help overcome a provider or researcher-centred bias often found in written surveys, which by nature, can only measure what is already known or expected to be of relevance to the researcher. Interviews can be audio- or video-taped; but sometimes it is only feasible or acceptable for the interviewer to take written notes [ 14 , 16 , 20 ].

Focus groups

Focus groups are group interviews to explore participants’ expertise and experiences, including explorations of how and why people behave in certain ways [ 1 ]. Focus groups usually consist of 6–8 people and are led by an experienced moderator following a topic guide or “script” [ 21 ]. They can involve an observer who takes note of the non-verbal aspects of the situation, possibly using an observation guide [ 21 ]. Depending on researchers’ and participants’ preferences, the discussions can be audio- or video-taped and transcribed afterwards [ 21 ]. Focus groups are useful for bringing together homogeneous (to a lesser extent heterogeneous) groups of participants with relevant expertise and experience on a given topic on which they can share detailed information [ 21 ]. Focus groups are a relatively easy, fast and inexpensive method to gain access to information on interactions in a given group, i.e. “the sharing and comparing” among participants [ 21 ]. Disadvantages include less control over the process and a lesser extent to which each individual may participate. Moreover, focus group moderators need experience, as do those tasked with the analysis of the resulting data. Focus groups can be less appropriate for discussing sensitive topics that participants might be reluctant to disclose in a group setting [ 13 ]. Moreover, attention must be paid to the emergence of “groupthink” as well as possible power dynamics within the group, e.g. when patients are awed or intimidated by health professionals.

Choosing the “right” method

As explained above, the school of thought underlying qualitative research assumes no objective hierarchy of evidence and methods. This means that each choice of single or combined methods has to be based on the research question that needs to be answered and a critical assessment with regard to whether or to what extent the chosen method can accomplish this – i.e. the “fit” between question and method [ 14 ]. It is necessary for these decisions to be documented when they are being made, and to be critically discussed when reporting methods and results.

Let us assume that our research aim is to examine the (clinical) processes around acute endovascular treatment (EVT), from the patient’s arrival at the emergency room to recanalization, with the aim to identify possible causes for delay and/or other causes for sub-optimal treatment outcome. As a first step, we could conduct a document study of the relevant standard operating procedures (SOPs) for this phase of care – are they up-to-date and in line with current guidelines? Do they contain any mistakes, irregularities or uncertainties that could cause delays or other problems? Regardless of the answers to these questions, the results have to be interpreted based on what they are: a written outline of what care processes in this hospital should look like. If we want to know what they actually look like in practice, we can conduct observations of the processes described in the SOPs. These results can (and should) be analysed in themselves, but also in comparison to the results of the document analysis, especially as regards relevant discrepancies. Do the SOPs outline specific tests for which no equipment can be observed or tasks to be performed by specialized nurses who are not present during the observation? It might also be possible that the written SOP is outdated, but the actual care provided is in line with current best practice. In order to find out why these discrepancies exist, it can be useful to conduct interviews. Are the physicians simply not aware of the SOPs (because their existence is limited to the hospital’s intranet) or do they actively disagree with them or does the infrastructure make it impossible to provide the care as described? Another rationale for adding interviews is that some situations (or all of their possible variations for different patient groups or the day, night or weekend shift) cannot practically or ethically be observed. In this case, it is possible to ask those involved to report on their actions – being aware that this is not the same as the actual observation. A senior physician’s or hospital manager’s description of certain situations might differ from a nurse’s or junior physician’s one, maybe because they intentionally misrepresent facts or maybe because different aspects of the process are visible or important to them. In some cases, it can also be relevant to consider to whom the interviewee is disclosing this information – someone they trust, someone they are otherwise not connected to, or someone they suspect or are aware of being in a potentially “dangerous” power relationship to them. Lastly, a focus group could be conducted with representatives of the relevant professional groups to explore how and why exactly they provide care around EVT. The discussion might reveal discrepancies (between SOPs and actual care or between different physicians) and motivations to the researchers as well as to the focus group members that they might not have been aware of themselves. For the focus group to deliver relevant information, attention has to be paid to its composition and conduct, for example, to make sure that all participants feel safe to disclose sensitive or potentially problematic information or that the discussion is not dominated by (senior) physicians only. The resulting combination of data collection methods is shown in Fig.  2 .

Possible combination of data collection methods

Attributions for icons: “Book” by Serhii Smirnov, “Interview” by Adrien Coquet, FR, “Magnifying Glass” by anggun, ID, “Business communication” by Vectors Market; all from the Noun Project

The combination of multiple data source as described for this example can be referred to as “triangulation”, in which multiple measurements are carried out from different angles to achieve a more comprehensive understanding of the phenomenon under study [ 22 , 23 ].

Data analysis

To analyse the data collected through observations, interviews and focus groups these need to be transcribed into protocols and transcripts (see Fig.  3 ). Interviews and focus groups can be transcribed verbatim , with or without annotations for behaviour (e.g. laughing, crying, pausing) and with or without phonetic transcription of dialects and filler words, depending on what is expected or known to be relevant for the analysis. In the next step, the protocols and transcripts are coded , that is, marked (or tagged, labelled) with one or more short descriptors of the content of a sentence or paragraph [ 2 , 15 , 23 ]. Jansen describes coding as “connecting the raw data with “theoretical” terms” [ 20 ]. In a more practical sense, coding makes raw data sortable. This makes it possible to extract and examine all segments describing, say, a tele-neurology consultation from multiple data sources (e.g. SOPs, emergency room observations, staff and patient interview). In a process of synthesis and abstraction, the codes are then grouped, summarised and/or categorised [ 15 , 20 ]. The end product of the coding or analysis process is a descriptive theory of the behavioural pattern under investigation [ 20 ]. The coding process is performed using qualitative data management software, the most common ones being InVivo, MaxQDA and Atlas.ti. It should be noted that these are data management tools which support the analysis performed by the researcher(s) [ 14 ].

From data collection to data analysis

Attributions for icons: see Fig. ​ Fig.2, 2 , also “Speech to text” by Trevor Dsouza, “Field Notes” by Mike O’Brien, US, “Voice Record” by ProSymbols, US, “Inspection” by Made, AU, and “Cloud” by Graphic Tigers; all from the Noun Project

How to report qualitative research?

Protocols of qualitative research can be published separately and in advance of the study results. However, the aim is not the same as in RCT protocols, i.e. to pre-define and set in stone the research questions and primary or secondary endpoints. Rather, it is a way to describe the research methods in detail, which might not be possible in the results paper given journals’ word limits. Qualitative research papers are usually longer than their quantitative counterparts to allow for deep understanding and so-called “thick description”. In the methods section, the focus is on transparency of the methods used, including why, how and by whom they were implemented in the specific study setting, so as to enable a discussion of whether and how this may have influenced data collection, analysis and interpretation. The results section usually starts with a paragraph outlining the main findings, followed by more detailed descriptions of, for example, the commonalities, discrepancies or exceptions per category [ 20 ]. Here it is important to support main findings by relevant quotations, which may add information, context, emphasis or real-life examples [ 20 , 23 ]. It is subject to debate in the field whether it is relevant to state the exact number or percentage of respondents supporting a certain statement (e.g. “Five interviewees expressed negative feelings towards XYZ”) [ 21 ].

How to combine qualitative with quantitative research?

Qualitative methods can be combined with other methods in multi- or mixed methods designs, which “[employ] two or more different methods [ …] within the same study or research program rather than confining the research to one single method” [ 24 ]. Reasons for combining methods can be diverse, including triangulation for corroboration of findings, complementarity for illustration and clarification of results, expansion to extend the breadth and range of the study, explanation of (unexpected) results generated with one method with the help of another, or offsetting the weakness of one method with the strength of another [ 1 , 17 , 24 – 26 ]. The resulting designs can be classified according to when, why and how the different quantitative and/or qualitative data strands are combined. The three most common types of mixed method designs are the convergent parallel design , the explanatory sequential design and the exploratory sequential design. The designs with examples are shown in Fig.  4 .

Three common mixed methods designs

In the convergent parallel design, a qualitative study is conducted in parallel to and independently of a quantitative study, and the results of both studies are compared and combined at the stage of interpretation of results. Using the above example of EVT provision, this could entail setting up a quantitative EVT registry to measure process times and patient outcomes in parallel to conducting the qualitative research outlined above, and then comparing results. Amongst other things, this would make it possible to assess whether interview respondents’ subjective impressions of patients receiving good care match modified Rankin Scores at follow-up, or whether observed delays in care provision are exceptions or the rule when compared to door-to-needle times as documented in the registry. In the explanatory sequential design, a quantitative study is carried out first, followed by a qualitative study to help explain the results from the quantitative study. This would be an appropriate design if the registry alone had revealed relevant delays in door-to-needle times and the qualitative study would be used to understand where and why these occurred, and how they could be improved. In the exploratory design, the qualitative study is carried out first and its results help informing and building the quantitative study in the next step [ 26 ]. If the qualitative study around EVT provision had shown a high level of dissatisfaction among the staff members involved, a quantitative questionnaire investigating staff satisfaction could be set up in the next step, informed by the qualitative study on which topics dissatisfaction had been expressed. Amongst other things, the questionnaire design would make it possible to widen the reach of the research to more respondents from different (types of) hospitals, regions, countries or settings, and to conduct sub-group analyses for different professional groups.

How to assess qualitative research?

A variety of assessment criteria and lists have been developed for qualitative research, ranging in their focus and comprehensiveness [ 14 , 17 , 27 ]. However, none of these has been elevated to the “gold standard” in the field. In the following, we therefore focus on a set of commonly used assessment criteria that, from a practical standpoint, a researcher can look for when assessing a qualitative research report or paper.

Assessors should check the authors’ use of and adherence to the relevant reporting checklists (e.g. Standards for Reporting Qualitative Research (SRQR)) to make sure all items that are relevant for this type of research are addressed [ 23 , 28 ]. Discussions of quantitative measures in addition to or instead of these qualitative measures can be a sign of lower quality of the research (paper). Providing and adhering to a checklist for qualitative research contributes to an important quality criterion for qualitative research, namely transparency [ 15 , 17 , 23 ].

Reflexivity

While methodological transparency and complete reporting is relevant for all types of research, some additional criteria must be taken into account for qualitative research. This includes what is called reflexivity, i.e. sensitivity to the relationship between the researcher and the researched, including how contact was established and maintained, or the background and experience of the researcher(s) involved in data collection and analysis. Depending on the research question and population to be researched this can be limited to professional experience, but it may also include gender, age or ethnicity [ 17 , 27 ]. These details are relevant because in qualitative research, as opposed to quantitative research, the researcher as a person cannot be isolated from the research process [ 23 ]. It may influence the conversation when an interviewed patient speaks to an interviewer who is a physician, or when an interviewee is asked to discuss a gynaecological procedure with a male interviewer, and therefore the reader must be made aware of these details [ 19 ].

Sampling and saturation

The aim of qualitative sampling is for all variants of the objects of observation that are deemed relevant for the study to be present in the sample “ to see the issue and its meanings from as many angles as possible” [ 1 , 16 , 19 , 20 , 27 ] , and to ensure “information-richness [ 15 ]. An iterative sampling approach is advised, in which data collection (e.g. five interviews) is followed by data analysis, followed by more data collection to find variants that are lacking in the current sample. This process continues until no new (relevant) information can be found and further sampling becomes redundant – which is called saturation [ 1 , 15 ] . In other words: qualitative data collection finds its end point not a priori , but when the research team determines that saturation has been reached [ 29 , 30 ].

This is also the reason why most qualitative studies use deliberate instead of random sampling strategies. This is generally referred to as “ purposive sampling” , in which researchers pre-define which types of participants or cases they need to include so as to cover all variations that are expected to be of relevance, based on the literature, previous experience or theory (i.e. theoretical sampling) [ 14 , 20 ]. Other types of purposive sampling include (but are not limited to) maximum variation sampling, critical case sampling or extreme or deviant case sampling [ 2 ]. In the above EVT example, a purposive sample could include all relevant professional groups and/or all relevant stakeholders (patients, relatives) and/or all relevant times of observation (day, night and weekend shift).

Assessors of qualitative research should check whether the considerations underlying the sampling strategy were sound and whether or how researchers tried to adapt and improve their strategies in stepwise or cyclical approaches between data collection and analysis to achieve saturation [ 14 ].

Good qualitative research is iterative in nature, i.e. it goes back and forth between data collection and analysis, revising and improving the approach where necessary. One example of this are pilot interviews, where different aspects of the interview (especially the interview guide, but also, for example, the site of the interview or whether the interview can be audio-recorded) are tested with a small number of respondents, evaluated and revised [ 19 ]. In doing so, the interviewer learns which wording or types of questions work best, or which is the best length of an interview with patients who have trouble concentrating for an extended time. Of course, the same reasoning applies to observations or focus groups which can also be piloted.

Ideally, coding should be performed by at least two researchers, especially at the beginning of the coding process when a common approach must be defined, including the establishment of a useful coding list (or tree), and when a common meaning of individual codes must be established [ 23 ]. An initial sub-set or all transcripts can be coded independently by the coders and then compared and consolidated after regular discussions in the research team. This is to make sure that codes are applied consistently to the research data.

Member checking

Member checking, also called respondent validation , refers to the practice of checking back with study respondents to see if the research is in line with their views [ 14 , 27 ]. This can happen after data collection or analysis or when first results are available [ 23 ]. For example, interviewees can be provided with (summaries of) their transcripts and asked whether they believe this to be a complete representation of their views or whether they would like to clarify or elaborate on their responses [ 17 ]. Respondents’ feedback on these issues then becomes part of the data collection and analysis [ 27 ].

Stakeholder involvement

In those niches where qualitative approaches have been able to evolve and grow, a new trend has seen the inclusion of patients and their representatives not only as study participants (i.e. “members”, see above) but as consultants to and active participants in the broader research process [ 31 – 33 ]. The underlying assumption is that patients and other stakeholders hold unique perspectives and experiences that add value beyond their own single story, making the research more relevant and beneficial to researchers, study participants and (future) patients alike [ 34 , 35 ]. Using the example of patients on or nearing dialysis, a recent scoping review found that 80% of clinical research did not address the top 10 research priorities identified by patients and caregivers [ 32 , 36 ]. In this sense, the involvement of the relevant stakeholders, especially patients and relatives, is increasingly being seen as a quality indicator in and of itself.

How not to assess qualitative research

The above overview does not include certain items that are routine in assessments of quantitative research. What follows is a non-exhaustive, non-representative, experience-based list of the quantitative criteria often applied to the assessment of qualitative research, as well as an explanation of the limited usefulness of these endeavours.

Protocol adherence

Given the openness and flexibility of qualitative research, it should not be assessed by how well it adheres to pre-determined and fixed strategies – in other words: its rigidity. Instead, the assessor should look for signs of adaptation and refinement based on lessons learned from earlier steps in the research process.

Sample size

For the reasons explained above, qualitative research does not require specific sample sizes, nor does it require that the sample size be determined a priori [ 1 , 14 , 27 , 37 – 39 ]. Sample size can only be a useful quality indicator when related to the research purpose, the chosen methodology and the composition of the sample, i.e. who was included and why.

Randomisation

While some authors argue that randomisation can be used in qualitative research, this is not commonly the case, as neither its feasibility nor its necessity or usefulness has been convincingly established for qualitative research [ 13 , 27 ]. Relevant disadvantages include the negative impact of a too large sample size as well as the possibility (or probability) of selecting “ quiet, uncooperative or inarticulate individuals ” [ 17 ]. Qualitative studies do not use control groups, either.

Interrater reliability, variability and other “objectivity checks”

The concept of “interrater reliability” is sometimes used in qualitative research to assess to which extent the coding approach overlaps between the two co-coders. However, it is not clear what this measure tells us about the quality of the analysis [ 23 ]. This means that these scores can be included in qualitative research reports, preferably with some additional information on what the score means for the analysis, but it is not a requirement. Relatedly, it is not relevant for the quality or “objectivity” of qualitative research to separate those who recruited the study participants and collected and analysed the data. Experiences even show that it might be better to have the same person or team perform all of these tasks [ 20 ]. First, when researchers introduce themselves during recruitment this can enhance trust when the interview takes place days or weeks later with the same researcher. Second, when the audio-recording is transcribed for analysis, the researcher conducting the interviews will usually remember the interviewee and the specific interview situation during data analysis. This might be helpful in providing additional context information for interpretation of data, e.g. on whether something might have been meant as a joke [ 18 ].

Not being quantitative research

Being qualitative research instead of quantitative research should not be used as an assessment criterion if it is used irrespectively of the research problem at hand. Similarly, qualitative research should not be required to be combined with quantitative research per se – unless mixed methods research is judged as inherently better than single-method research. In this case, the same criterion should be applied for quantitative studies without a qualitative component.

The main take-away points of this paper are summarised in Table ​ Table1. 1 . We aimed to show that, if conducted well, qualitative research can answer specific research questions that cannot to be adequately answered using (only) quantitative designs. Seeing qualitative and quantitative methods as equal will help us become more aware and critical of the “fit” between the research problem and our chosen methods: I can conduct an RCT to determine the reasons for transportation delays of acute stroke patients – but should I? It also provides us with a greater range of tools to tackle a greater range of research problems more appropriately and successfully, filling in the blind spots on one half of the methodological spectrum to better address the whole complexity of neurological research and practice.

Take-away-points

Acknowledgements

Abbreviations.

Authors’ contributions

LB drafted the manuscript; WW and CG revised the manuscript; all authors approved the final versions.

no external funding.

Availability of data and materials

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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• What Is Quantitative Research? | Definition, Uses & Methods

What Is Quantitative Research? | Definition, Uses & Methods

Published on June 12, 2020 by Pritha Bhandari . Revised on June 22, 2023.

Quantitative research is the process of collecting and analyzing numerical data. It can be used to find patterns and averages, make predictions, test causal relationships, and generalize results to wider populations.

Quantitative research is the opposite of qualitative research , which involves collecting and analyzing non-numerical data (e.g., text, video, or audio).

Quantitative research is widely used in the natural and social sciences: biology, chemistry, psychology, economics, sociology, marketing, etc.

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Table of contents

Quantitative research methods, quantitative data analysis, advantages of quantitative research, disadvantages of quantitative research, other interesting articles, frequently asked questions about quantitative research.

You can use quantitative research methods for descriptive, correlational or experimental research.

• In descriptive research , you simply seek an overall summary of your study variables.
• In correlational research , you investigate relationships between your study variables.
• In experimental research , you systematically examine whether there is a cause-and-effect relationship between variables.

Correlational and experimental research can both be used to formally test hypotheses , or predictions, using statistics. The results may be generalized to broader populations based on the sampling method used.

To collect quantitative data, you will often need to use operational definitions that translate abstract concepts (e.g., mood) into observable and quantifiable measures (e.g., self-ratings of feelings and energy levels).

Note that quantitative research is at risk for certain research biases , including information bias , omitted variable bias , sampling bias , or selection bias . Be sure that you’re aware of potential biases as you collect and analyze your data to prevent them from impacting your work too much.

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Once data is collected, you may need to process it before it can be analyzed. For example, survey and test data may need to be transformed from words to numbers. Then, you can use statistical analysis to answer your research questions .

Descriptive statistics will give you a summary of your data and include measures of averages and variability. You can also use graphs, scatter plots and frequency tables to visualize your data and check for any trends or outliers.

Using inferential statistics , you can make predictions or generalizations based on your data. You can test your hypothesis or use your sample data to estimate the population parameter .

First, you use descriptive statistics to get a summary of the data. You find the mean (average) and the mode (most frequent rating) of procrastination of the two groups, and plot the data to see if there are any outliers.

You can also assess the reliability and validity of your data collection methods to indicate how consistently and accurately your methods actually measured what you wanted them to.

Quantitative research is often used to standardize data collection and generalize findings . Strengths of this approach include:

• Replication

Repeating the study is possible because of standardized data collection protocols and tangible definitions of abstract concepts.

• Direct comparisons of results

The study can be reproduced in other cultural settings, times or with different groups of participants. Results can be compared statistically.

• Large samples

Data from large samples can be processed and analyzed using reliable and consistent procedures through quantitative data analysis.

• Hypothesis testing

Using formalized and established hypothesis testing procedures means that you have to carefully consider and report your research variables, predictions, data collection and testing methods before coming to a conclusion.

Despite the benefits of quantitative research, it is sometimes inadequate in explaining complex research topics. Its limitations include:

• Superficiality

Using precise and restrictive operational definitions may inadequately represent complex concepts. For example, the concept of mood may be represented with just a number in quantitative research, but explained with elaboration in qualitative research.

• Narrow focus

Predetermined variables and measurement procedures can mean that you ignore other relevant observations.

• Structural bias

Despite standardized procedures, structural biases can still affect quantitative research. Missing data , imprecise measurements or inappropriate sampling methods are biases that can lead to the wrong conclusions.

• Lack of context

Quantitative research often uses unnatural settings like laboratories or fails to consider historical and cultural contexts that may affect data collection and results.

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If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Chi square goodness of fit test
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Inclusion and exclusion criteria

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

In mixed methods research , you use both qualitative and quantitative data collection and analysis methods to answer your research question .

Data collection is the systematic process by which observations or measurements are gathered in research. It is used in many different contexts by academics, governments, businesses, and other organizations.

Operationalization means turning abstract conceptual ideas into measurable observations.

For example, the concept of social anxiety isn’t directly observable, but it can be operationally defined in terms of self-rating scores, behavioral avoidance of crowded places, or physical anxiety symptoms in social situations.

Before collecting data , it’s important to consider how you will operationalize the variables that you want to measure.

Reliability and validity are both about how well a method measures something:

• Reliability refers to the  consistency of a measure (whether the results can be reproduced under the same conditions).
• Validity   refers to the  accuracy of a measure (whether the results really do represent what they are supposed to measure).

If you are doing experimental research, you also have to consider the internal and external validity of your experiment.

Hypothesis testing is a formal procedure for investigating our ideas about the world using statistics. It is used by scientists to test specific predictions, called hypotheses , by calculating how likely it is that a pattern or relationship between variables could have arisen by chance.

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50 years ago, sugar industry quietly paid scientists to point blame at fat.

Camila Domonoske

A newly discovered cache of internal documents reveals that the sugar industry downplayed the risks of sugar in the 1960s. Luis Ascui/Getty Images hide caption

A newly discovered cache of internal documents reveals that the sugar industry downplayed the risks of sugar in the 1960s.

In the 1960s, the sugar industry funded research that downplayed the risks of sugar and highlighted the hazards of fat, according to a newly published article in JAMA Internal Medicine.

The article draws on internal documents to show that an industry group called the Sugar Research Foundation wanted to "refute" concerns about sugar's possible role in heart disease. The SRF then sponsored research by Harvard scientists that did just that. The result was published in the New England Journal of Medicine in 1967, with no disclosure of the sugar industry funding.

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The sugar-funded project in question was a literature review, examining a variety of studies and experiments. It suggested there were major problems with all the studies that implicated sugar, and concluded that cutting fat out of American diets was the best way to address coronary heart disease.

The authors of the new article say that for the past five decades, the sugar industry has been attempting to influence the scientific debate over the relative risks of sugar and fat.

"It was a very smart thing the sugar industry did, because review papers, especially if you get them published in a very prominent journal, tend to shape the overall scientific discussion," co-author Stanton Glantz told The New York Times .

Money on the line

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In the article, published Monday, authors Glantz, Cristin Kearns and Laura Schmidt aren't trying make the case for a link between sugar and coronary heart disease. Their interest is in the process. They say the documents reveal the sugar industry attempting to influence scientific inquiry and debate.

The researchers note that they worked under some limitations — "We could not interview key actors involved in this historical episode because they have died," they write. Other organizations were also advocating concerns about fat, they note.

There's no evidence that the SRF directly edited the manuscript published by the Harvard scientists in 1967, but there is "circumstantial" evidence that the interests of the sugar lobby shaped the conclusions of the review, the researchers say.

For one thing, there's motivation and intent. In 1954, the researchers note, the president of the SRF gave a speech describing a great business opportunity.

If Americans could be persuaded to eat a lower-fat diet — for the sake of their health — they would need to replace that fat with something else. America's per capita sugar consumption could go up by a third .

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But in the '60s, the SRF became aware of "flowing reports that sugar is a less desirable dietary source of calories than other carbohydrates," as John Hickson, SRF vice president and director of research, put it in one document.

He recommended that the industry fund its own studies — "Then we can publish the data and refute our detractors."

The next year, after several scientific articles were published suggesting a link between sucrose and coronary heart disease, the SRF approved the literature-review project. It wound up paying approximately $50,000 in today's dollars for the research.

One of the researchers was the chairman of Harvard's Public Health Nutrition Department — and an ad hoc member of SRF's board.

"A different standard" for different studies

Glantz, Kearns and Schmidt say many of the articles examined in the review were hand-selected by SRF, and it was implied that the sugar industry would expect them to be critiqued.

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In a letter, SRF's Hickson said that the organization's "particular interest" was in evaluating studies focused on "carbohydrates in the form of sucrose."

"We are well aware," one of the scientists replied, "and will cover this as well as we can."

The project wound up taking longer than expected, because more and more studies were being released that suggested sugar might be linked to coronary heart disease. But it was finally published in 1967.

Hickson was certainly happy with the result: "Let me assure you this is quite what we had in mind and we look forward to its appearance in print," he told one of the scientists.

The review minimized the significance of research that suggested sugar could play a role in coronary heart disease. In some cases the scientists alleged investigator incompetence or flawed methodology.

"It is always appropriate to question the validity of individual studies," Kearns told Bloomberg via email. But, she says, "the authors applied a different standard" to different studies — looking very critically at research that implicated sugar, and ignoring problems with studies that found dangers in fat.

Epidemiological studies of sugar consumption — which look at patterns of health and disease in the real world — were dismissed for having too many possible factors getting in the way. Experimental studies were dismissed for being too dissimilar to real life.

One study that found a health benefit when people ate less sugar and more vegetables was dismissed because that dietary change was not feasible.

Another study, in which rats were given a diet low in fat and high in sugar, was rejected because "such diets are rarely consumed by man."

The Harvard researchers then turned to studies that examined risks of fat — which included the same kind of epidemiological studies they had dismissed when it came to sugar.

Citing "few study characteristics and no quantitative results," as Kearns, Glantz and Schmidt put it, they concluded that cutting out fat was "no doubt" the best dietary intervention to prevent coronary heart disease.

Sugar lobby: "Transparency standards were not the norm"

In a statement, the Sugar Association — which evolved out of the SRF — said it is challenging to comment on events from so long ago.

"We acknowledge that the Sugar Research Foundation should have exercised greater transparency in all of its research activities, however, when the studies in question were published funding disclosures and transparency standards were not the norm they are today," the association said.

"Generally speaking, it is not only unfortunate but a disservice that industry-funded research is branded as tainted," the statement continues. "What is often missing from the dialogue is that industry-funded research has been informative in addressing key issues."

The documents in question are five decades old, but the larger issue is of the moment, as Marion Nestle notes in a commentary in the same issue of JAMA Internal Medicine:

"Is it really true that food companies deliberately set out to manipulate research in their favor? Yes, it is, and the practice continues. In 2015, the New York Times obtained emails revealing Coca-Cola's cozy relationships with sponsored researchers who were conducting studies aimed at minimizing the effects of sugary drinks on obesity. Even more recently, the Associated Press obtained emails showing how a candy trade association funded and influenced studies to show that children who eat sweets have healthier body weights than those who do not."

As for the article authors who dug into the documents around this funding, they offer two suggestions for the future.

"Policymaking committees should consider giving less weight to food industry-funded studies," they write.

They also call for new research into any ties between added sugars and coronary heart disease.

• heart disease

New study finds 'lengthened supersets' can lead to 43.3% more muscle growth

Get results with this newly studied, cutting-edge method

The methods

The results, the conclusion, what this means for us.

From DOMS to concentric and eccentric exercises , fitness lingo is a minefield. The latest terms to have gained attention? 'Stretch-mediated hypertrophy ' and 'long-length partials'. Nope, you haven't landed in a foreign country - these concepts are the topic of the moment for bodybuilders and evidence-based fitness influencers, as emerging research is shedding light on the benefits of training muscles at longer lengths for optimised muscle growth .

Now, a new pre-print study adds to this growing body of evidence, suggesting that training muscles in these extended positions could significantly enhance hypertrophy (i.e. muscle growth) without the need to completely overhaul your existing workout routine.

We break down how a simple tweak at the end of your sets could help you train past failure and maximise hypertrophy.

The study (pre print) conducted by Larsen et al investigated the effects of different training techniques on muscle hypertrophy, specifically focusing on the medial gastrocnemius muscle – a part of the calf . The main objective of the study was to determine whether performing Smith machine calf raises to dorsiflexion (with your foot in a backward bending position, toes flexed towards you) would lead to greater muscle hypertrophy compared to performing the same exercise to plantarflexion (pointing your foot downwards).

The researchers were interested in whether this extended (dorsiflexion) lengthened position during the calf raises would lead to greater muscle growth than the shortened (plantarflexion) position.

Lasting 12 weeks, the study followed a within participant design with 23 untrained men taking part:

• Each participant had their right and left limb randomly allocated to one of two conditions: momentary failure (complete muscular failure) reached in peak plantarflexion range of motion, or volitional failure (no motivation to finish set) reached in peak dorsiflexion range of motion.
• All participants performed standing calf raises using a Smith machine with an individualised range of motion.
• One familiarisation session was performed to introduce the participants to the techniques.
• Between weeks 2 and 5, participants trained each leg with 3 sets per workout. In weeks 6 to 11, all participants performed 4 sets during each workout.
• During the pre- and post- training analysis sessions, medial gastrocnemius (calf) muscle thickness was assessed via ultrasonography.

In this study, participants performing Smith machine calf raises to dorsiflexion lifted their toes upward toward their shins while lowering their heels. This movement lengthens the calf muscle, resulting in a deeper stretch compared to the plantarflexed position, where the toes are pushed downward and the heel is raised off the ground

The results of the study revealed a significant difference between the two training techniques. The group that performed calf raises to dorsiflexion experienced greater increases in muscle thickness of the calf compared to the group that performed calf raises to plantarflexion.

The stretched position led to 43.3% greater relative muscle growth in the medial gastrocnemius.

The researchers concluded that calf muscle hypertrophy was greater when Smith machine calf raises were performed to dorsiflexion compared with plantarflexion. When the goal is to increase calf muscle hypertrophy, they suggest performing Smith machine calf raises in peak dorsiflexion.

This is another compelling study supporting the efficacy of long-length partial reps or training muscles in the lengthened position for muscle growth. So, if the evidence is clear that we should be using lengthened supersets to gain more muscle, how do we do them?

While it's not a traditional superset, according to an Instagram post from one of the researchers, Dr. Milo Wolf : 'You can do a regular set with full ROM until you reach the target RPE . Then, without rest, do another set to the target RPE — but only do the more lengthened half or so of the full range of motion. Make sure you accurately assess range of motion during the second set, or you might push too hard.'

This could look like:

• Performing all your sets of calf raises to full range of motion.
• When you get to failure, or close to, perform partial reps of the exercise.
• This means you perform the bottom half of calf raises to, or close to failure.

Dr. Wolf adds that, 'out of all the techniques [e.g pre-exhaust, regular supersets, etc.] I think this one has the potential to be one of the best ones. I’d surmise that it would be most helpful for body parts that usually don’t get trained very well in the lengthened positions [back, biceps and side/rear delts jump to mind].'

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Kate is a fitness writer for Men’s Health UK where she contributes regular workouts, training tips and nutrition guides. She has a post graduate diploma in Sports Performance Nutrition and before joining Men’s Health she was a nutritionist, fitness writer and personal trainer with over 5k hours coaching on the gym floor. Kate has a keen interest in volunteering for animal shelters and when she isn’t lifting weights in her garden, she can be found walking her rescue dog.

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