phd health outcomes research

PhD in Health Economics & Outcomes Research

For the 2025 admissions cycle, GRE scores are required for all applicants.

Application Deadline: December 15, 2024

Phd information session.

In this session, you can learn more about the application process, program structure, core competencies, career outcomes, and more. The session is led by Professors Anirban Basu & Josh Carlson. Watch the recording of our October 2023 information session here . Access the webinar slides. 

Opportunity

The CHOICE Institute at the UW School of Pharmacy teaches you how to influence health policy and how to advance your research all the while modeling excellence.

Our program offers an exceptional educational experience alongside highly engaged peers , faculty, and alumni . Our program is selective, accepting up to four new doctoral students a year. This allows for extraordinary access to our world-class faculty as well as peers who will challenge and engage you.

At UW, the six health sciences disciplines are co-located, allowing for innovative cross-discipline collaborations. Based in the biotech center of Seattle, The CHOICE Institute partners with numerous affiliate institutes, such as the Bill and Melinda Gates Foundation, Fred Hutchinson Cancer Research Center, Institute for Health Metrics Evaluation, and many more . Faculty and students in pharmacy, medicine, dentistry, nursing, social work, and public health are uniquely positioned to take advantage of breakthrough research and medical technology opportunities.

Financial Support

Doctoral students admitted into the program are guaranteed to have their tuition funded for the first two years, through a combination of fellowships, research, or teaching assistantships. While students are responsible for securing the remainder of the funding for their program, funding opportunities are always available. See Funding Opportunities for more details. Research assistantship also provides health insurance at no charge for students; coverage is available for spouses and dependents for an additional fee. (You can find more information on the Graduate Appointee Insurance Program and other benefits through UW Human Resources .)

Students train in the academic disciplines essential to the comparative evaluation of medical interventions. This affects health outcomes as well as medication safety and effectiveness; students also train in the provision of economic value estimates and the applications of these to health policy. Students delve into pharmacoepidemiology and learn the importance of health technology assessment (HTA) in evaluating the consequences of different health technologies. The impact of these health technology evaluations is seen in fields across the board, from genomics to geriatrics.

CHOICE faculty, post-doctoral fellows and students conduct comparative effectiveness research, medication safety research and studies on the cost-effectiveness of healthcare interventions and health insurance, allowing them to estimate value propositions and improve decision making by patients, clinicians, and policymakers, creating a more personalized medicine experience. The program is patient-centered and relies on real-world evidence and data science, allowing students to delve into the depths of pharmacoeconomics. Students learn from leaders in the field and each other, all while enjoying the vibrant Pacific Northwest as a backdrop.

Graduate training in the program prepares students for career opportunities in:

• Academic and big data research, informatics and teaching
• Pharmaceutical, biotechnology, and medical device industries
• Professional associations, health care insurance providers, and governmental agencies
• Health-systems and managed care organizations
• Non-profit organizations geared toward global health or pharmaceutical policy change

Prerequisites

• Students with master’s degrees in related fields such as epidemiology, economics, statistics, or public health are encouraged to apply. Students with professional degrees in pharmacy, medicine, or a health-related field who have strong quantitative skills are also supported.
• The Graduate Record Examination (GRE) is required, and special weight is given to exceptional scores on the quantitative and analytical portions.
• Other admission prerequisites include meeting the minimum Graduate School requirements. 

See Application Information for more detailed requirements and instructions.

Doctoral Degree Program Requirements

Students complete courses in the fields of biostatistics, clinical trial design and analysis, health economics, epidemiology, and health policy in order to gain an in-depth understanding of the complex and interdisciplinary environment of outcomes research as a foundation.

Total minimum credits required: 115

• Minimum of 73 credits of core coursework (47) and seminar (12)
• 27 dissertation credits
• 14 Elective Credits
• Independent Study

Milestones:

• Preliminary exams
• General Exam (dissertation proposal defense)
• Dissertation Defense

An overview of our core program can be found in the Gr aduate Student Handbook . 

PhD Program Brochure

• Request Info
• Departments
• Community Service
• Patient Care
• Give to SLU Medicine
• Search & Directory

Health Outcomes Research, Ph.D.

• Learning Outcomes
• Requirements

Health outcomes research is a rapidly expanding, interdisciplinary field that provides evidence and guidance for understanding the endpoints of treatments, interventions and health care practices, be they clinical, functional, quality-of-life or economic. Saint Louis University’s Doctor of Philosophy (Ph.D.) in Health Outcomes Research is a program that trains researchers in the areas of health outcomes research, health services research and health data science to meet the changing needs of the health care system.

The goal of SLU's program is to prepare robust clinical and health outcomes researchers. Students receive a solid foundation in:

• Research methodology
• Data management
• Statistical analysis
• Data science
• Scientific writing and presentation

In addition to coursework, students work collaboratively with their mentor, research and clinical faculty and other students to produce high-quality research throughout their program.  

Curriculum Overview

The program requires a total of 48 credits for completion; 36 credits of coursework and 12 dissertation credits. Additionally, students must pass a written comprehensive exam, an oral examination/proposal of the dissertation and a public presentation and defense of the dissertation.

Fieldwork and Research Opportunities

The department partners with clinical faculty in the  SLU School of Medicine  and conducts research in numerous clinical areas, including diabetes, oncology, pediatrics, otolaryngology, infectious disease and health care quality. Additionally, our faculty have expertise in health data science, research methodology, biostatistics, epidemiology, survey design and outcomes measurement. Students have the opportunity to work with their primary mentor, our faculty and clinical faculty on both short- and long-term research projects.

Graduates are prepared to work as academics and researchers at universities, medical centers, government and nongovernment health agencies, hospital systems, insurance and other areas of the health industry.  

Admission Requirements

Applicants should have a master’s degree from an accredited college or university in social science, biomedical science, public health, or related discipline. Successful candidates will have maintained a minimum 3.5 GPA in graduate coursework and scored at least at the 50th percentile for GRE verbal and quantitative reasoning. Students must also demonstrate evidence of interest in an area of research and identify a willing and suitable faculty mentor.  

Application Requirements

Begin your application for this program at  www.slu.edu/apply . 

• Application form and fee
• Transcripts from most recent degree(s)
• Professional statement
• Résumé or curriculum vitae
• One letter of recommendation
• GRE required

Requirements for International Students

Along with the general admission requirements above, the following must be provided by prospective international students:

• Demonstration of  English Language Proficiency .
• A letter of financial support from the person(s) or sponsoring agency funding the time at Saint Louis University.
• A letter from the sponsor's bank verifying that the funds are available and will be so for the duration of study at the University.
• Academic records, in English translation, for postsecondary studies outside the United States. These must include the courses taken and/or lectures attended, practical laboratory work, the maximum and minimum grades attainable, the grades earned or the results of all end-of-term examinations, and any honors or degrees received. WES and ECE transcripts are accepted.

Application Deadline

Applications to the program are considered on a rolling basis.

Additional charges may apply. Other resources are listed below:

Net Price Calculator

Information on Tuition and Fees

Miscellaneous Fees

Information on Summer Tuition

Scholarships and Financial Aid

For priority consideration for graduate assistantship, apply by Feb. 1. 

For more information, visit the student financial services office online at https://www.slu.edu/financial-aid/index.php .

Accreditation 

Saint Louis University is accredited by the Higher Learning Commission (HLC) and has been continuously accredited since 1916.

• Graduates will be able to effectively review, summarize and synthesize literature related to clinical aspects of health outcomes.
• Graduates will be able to apply appropriate data management strategies related to clinical aspects of health outcomes.
• Graduates will be able to critically evaluate clinical aspects and health care-specific methodological designs.
• Graduates will be able to demonstrate a thorough and ethical approach to conducting academic research.
• Graduates will be able to effectively communicate study results related to clinical aspects of health outcomes.

Continuation Standards

Students must maintain a cumulative grade point average (GPA) of 3.00 in all graduate/professional courses.

Roadmaps are recommended semester-by-semester plans of study for programs and assume full-time enrollment unless otherwise noted.  

Courses and milestones designated as critical (marked with !) must be completed in the semester listed to ensure a timely graduation. Transfer credit may change the roadmap.

This roadmap should not be used in the place of regular academic advising appointments. All students are encouraged to meet with their advisor/mentor each semester. Requirements, course availability and sequencing are subject to change.

PhD Program in Health Services and Outcomes Research

The Health Services and Outcomes Research (HSOR) program emphasizes population-based, health services delivery and outcomes and policy research. Health services research examines how people get access to healthcare, how much care costs and what happens to patients as a result of this care. Outcomes research evaluates the effectiveness of health care interventions through changes in outcomes such as improvements in patient functional status, satisfaction with care, morbidity, and mortality. Data collected from outcomes research provide patients, health care providers, and payers of health services information about what does and does not work in real life settings. Areas of specialization include pharmacoeconomics, machine learning, data science, health services research, pharmacoepidemiology, health behavior and risk. Financial support: A tuition waiver, an annual stipend of $30,000 and health insurance is provided to full-time students. Average time to graduation: 4 to 5 years

• Request Info
• Browse Degrees
• Give to SLU
• Search & Directory Search SLU.edu Search Search for people Search Close

Health Outcomes Research, Ph.D.

Health outcomes research is a rapidly expanding, interdisciplinary field that provides evidence and guidance for understanding the endpoints of treatments, interventions and health care practices, be they clinical, functional, quality-of-life or economic. Saint Louis University’s Doctor of Philosophy (Ph.D.) in Health Outcomes Research is a program that trains researchers in the areas of health outcomes research, health services research and health data science to meet the changing needs of the health care system.

The goal of SLU's program is to prepare robust clinical and health outcomes researchers. Students receive a solid foundation in:

• Research methodology
• Data management
• Statistical analysis
• Data science
• Scientific writing and presentation

In addition to coursework, students work collaboratively with their mentor, research and clinical faculty and other students to produce high-quality research throughout their program.  

Curriculum Overview

The program requires a total of 48 credits for completion; 36 credits of coursework and 12 dissertation credits. Additionally, students must pass a written comprehensive exam, an oral examination/proposal of the dissertation and a public presentation and defense of the dissertation.

Fieldwork and Research Opportunities

The department partners with clinical faculty in the  SLU School of Medicine  and conducts research in numerous clinical areas, including diabetes, oncology, pediatrics, otolaryngology, infectious disease and health care quality. Additionally, our faculty have expertise in health data science, research methodology, biostatistics, epidemiology, survey design and outcomes measurement. Students have the opportunity to work with their primary mentor, our faculty and clinical faculty on both short- and long-term research projects.

Graduates are prepared to work as academics and researchers at universities, medical centers, government and nongovernment health agencies, hospital systems, insurance and other areas of the health industry.  

Admission Requirements

Applicants should have a master’s degree from an accredited college or university in social science, biomedical science, public health, or related discipline. Successful candidates will have maintained a minimum 3.5 GPA in graduate coursework and scored at least at the 50th percentile for GRE verbal and quantitative reasoning. Students must also demonstrate evidence of interest in an area of research and identify a willing and suitable faculty mentor.  

Application Requirements

Begin your application for this program at  www.slu.edu/apply . 

• Application form and fee
• Transcripts from most recent degree(s)
• Professional statement
• Résumé or curriculum vitae
• One letter of recommendation
• GRE required

Requirements for International Students

Along with the general admission requirements above, the following must be provided by prospective international students:

• Demonstration of  English Language Proficiency .
• A letter of financial support from the person(s) or sponsoring agency funding the time at Saint Louis University.
• A letter from the sponsor's bank verifying that the funds are available and will be so for the duration of study at the University.
• Academic records, in English translation, for postsecondary studies outside the United States. These must include the courses taken and/or lectures attended, practical laboratory work, the maximum and minimum grades attainable, the grades earned or the results of all end-of-term examinations, and any honors or degrees received. WES and ECE transcripts are accepted.

Application Deadline

Applications to the program are considered on a rolling basis.

Additional charges may apply. Other resources are listed below:

Net Price Calculator

Information on Tuition and Fees

Miscellaneous Fees

Information on Summer Tuition

Scholarships and Financial Aid

For priority consideration for graduate assistantship, apply by Feb. 1. 

For more information, visit the student financial services office online at https://www.slu.edu/financial-aid/index.php .

Accreditation 

Saint Louis University is accredited by the Higher Learning Commission (HLC) and has been continuously accredited since 1916.

• Graduates will be able to effectively review, summarize and synthesize literature related to clinical aspects of health outcomes.
• Graduates will be able to apply appropriate data management strategies related to clinical aspects of health outcomes.
• Graduates will be able to critically evaluate clinical aspects and health care-specific methodological designs.
• Graduates will be able to demonstrate a thorough and ethical approach to conducting academic research.
• Graduates will be able to effectively communicate study results related to clinical aspects of health outcomes.

Continuation Standards

Students must maintain a cumulative grade point average (GPA) of 3.00 in all graduate/professional courses.

Roadmaps are recommended semester-by-semester plans of study for programs and assume full-time enrollment unless otherwise noted.  

Courses and milestones designated as critical (marked with !) must be completed in the semester listed to ensure a timely graduation. Transfer credit may change the roadmap.

This roadmap should not be used in the place of regular academic advising appointments. All students are encouraged to meet with their advisor/mentor each semester. Requirements, course availability and sequencing are subject to change.

Measurement, Design, and Analysis Methods for Health Outcomes Research

Related articles, the value of applying health outcomes research to improve treatment results, how health care executives can use health outcomes research for business decision making, using health outcomes research to improve quality of care, september 23 – 27, 2024.

This program is ideal for anyone interested in getting an intensive view of the fundamentals of health outcomes research.

• —Michael Loechel
• President & Co-Founder, Axioma Group

Program Overview

• Objectives & Highlights

Credits and Logistics

Who should participate.

Health care systems around the world face growing pressures to provide more effective programs, treatments, and interventions. Health outcomes research is the scientific inquiry that provides the evidence required for optimally developing new therapies, implementing quality of care improvement protocols, and enhancing public health system capacity and capability.

In this online program, Harvard’s expert faculty in health outcomes research will guide you through the language and concepts needed to synthesize outcomes studies into useful knowledge for translation and implementation into practice. During this program you will learn the fundamentals for measuring, designing, and analyzing health outcomes research studies and data.

Why Health Outcomes Research is Important

Outcomes research is highly valued in public health due to the breadth of issues it addresses. A diverse and growing number of organizations – employers, health care delivery organizations, insurers, pharmaceutical companies, and governments – rely on health outcomes research for generating actionable data that will help them make better decisions about the value of different therapeutic and preventative options. Well-designed and executed health outcomes research studies can provide evidence for a broad range of medical and public health practices, such as:

• Incorporating patient-centered outcomes measures such as patient preference and quality of life into the drug and device development process
• Evaluating the impact of chronic disease therapies on physical, emotional and social functioning
• Determining the cost-effectiveness of comparative medical treatments for chronic diseases
• Assessing the population health risks and benefits associated with response and mitigation strategies for infectious diseases such as influenza and COVID-19

Objectives & Highlights

Learning objectives.

As a participant, you will learn to:

• Conceptually define the meaning and purpose of outcomes research and evaluation
• Understand the role of epidemiology, health economics, psychometrics and biostatistics in conducting outcomes research
• Evaluate the usefulness of outcomes measures and the application of new technologies in medical institutions and industries, health care organizations and public health systems
• Recognize the different types of measures used in outcomes research, including clinical, health status, quality of life, work/role performance, health care utilization, and patient satisfaction
• Adopt new methods for modeling responses obtained from individuals completing questionnaires and surveys
• Interpret and understand scale performance and measurement concepts such as reliability, validity, responsiveness, and sensitivity
• Understand statistical methods appropriate for analyzing health outcomes data, such as longitudinal methods
• Synthesize and interpret findings from different types of health outcomes research studies

Continuing Education Credit

The Harvard T.H. Chan School of Public Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Harvard T.H. Chan School of Public Health designates this live activity for a maximum of 16.25 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Harvard T.H. Chan School of Public Health will grant 1.6 Continuing Education Units (CEUs) for this program, equivalent to 16.25 contact hours of education. Participants can apply these contact hours toward other professional education accrediting organizations.

All credits subject to final agenda.

All participants will receive a Certificate of Participation upon completion of the program.

Current faculty, subject to change.

Donald C. Simonson, MPH, ScD, MD, MBA

Program director.

Marcia A. Testa, PhD, MPhil, MPH

Jakob b. bjørner, md, phd, garrett fitzmaurice, scd.

Matthias Rose, MD, PhD

Sebastian Schneeweiss, MD, ScD

Alexander turchin, ms, md, john e. ware jr., phd.

All Times are Eastern Time (ET).

This agenda is subject to change.

This program will be useful to anyone involved in improving health care cost, quality, or outcomes from across the health care industry. Ideal participants include:

• Clinicians, including physicians, nurses, and allied health professionals involved in utilizing outcomes data or assessing, measuring, and evaluating outcomes
• Health care executives and administrators who review and utilize outcomes data for clinical decision-making and improving quality of care
• Insurance, managed care, and other payer executives and researchers seeking to understand the relative value of procedures and interventions
• Pharmaceutical and biotechnology executives and researchers who need to measure patient-reported outcomes to support the benefit of their products
• Other health sector researchers who are new to outcomes research and need an overview of the latest information in the field

Registration Criteria

Participants must have an advanced degree (e.g., MD, PhD, MS, MPH, PharmD) in a relevant discipline. Proficiency in written and spoken English is essential for a successful learning experience in the program.

Health Services and Outcomes Research, Ph.D.

Degree offered.

• Doctor of Philosophy

Nature of the Program

What is health services and outcomes research.

The Health Services and Outcomes Research program emphasizes population-based, health services delivery and outcomes, and policy research.

Health services research examines how people get access to health care, how much care costs, and what happens to patients as a result of this care. The main goals of health services research are to identify the most effective ways to organize, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety. (AHRQ, 2002)

Outcomes research refers to the scientific design, data collection, and analysis of the end results of medical care. It focuses on quality, cost-effectiveness and the effect of treatment on quality of life in patients. Outcomes research evaluates the effectiveness of health interventions through changes in outcomes such as improvements in patient functional status, satisfaction with care, and mortality. Apart from traditional experimental and quasi-experimental designs, outcomes research methodology embraces epidemiological research designs (such as retrospective or prospective, longitudinal or cross-sectional, case-control or cohort study designs), pharmacoeconomic modeling (such as decision analysis, cost-benefit analysis, cost-effectiveness analysis), health data science (such as predictive modeling, machine learning), and survey research methods (such as quality of life measurements, satisfaction with care).

Why study Health Services and Outcomes Research?

With health care costs increasing five fold in the last two decades, there has been increasingly greater accountability demanded of health care systems and providers. There has been growing recognition that resources are limited, and health care interventions have to be cost-effective, and not just efficacious in clinical trials. Three particular factors have contributed to growing interest in determining effectiveness of health care interventions: (1) unexplained differences in quality of care or effectiveness by region, population, and type of systems; (2) the desire to control rising health care costs and spread the availability of services to those who do not currently have access; and (3) concern that cost-containment strategies and improving quality of health care are two competing goals.

How is Outcomes Research used?

Data collected from outcomes research provide patients, providers, payers, and decision makers information about what does and does not work in real life settings. It provides other measures of effectiveness such as what treatment provides the best return on investment, and from a patient perspective, what is the most preferred or satisfying treatment option. Comparative effectiveness research of technology and drugs; structure of healthcare delivery, process, quality and outcomes; pharmacovigilance; patient-centered care; and evaluating the intended and unintended consequences of health policy are some of the major aspects of outcomes research.  Overall, outcomes research will lead to better use of limited resources, informed decision-making by patients, providers, and payers; development of guidelines for better disease management - especially for chronic diseases, and better health policy decisions.

What are the goals of the graduate program in Health Services and Outcomes Research?

The focus of Health Services and Outcomes Research is to prepare highly qualified graduate students for careers in academia, industry, government, and institutional settings such as insurance companies through training in health outcomes and policy research. Areas of specialization include: pharmacoeconomics, health services research, machine learning, pharmacoepidemiology, health behavior and risk.  The core courses include pharmacoepidemiology, pharmacoeconomics, patient-centered outcomes, large data analysis, econometrics, social and behavioral theory, machine learning, survey methods and the evaluation of health policies, programs and interventions. Several courses include research projects that result in peer-reviewed publications. Based on your research experience and interests, you can select your area of emphasis, which include quantitative, behavioral, health policy, epidemiology, health management, disease management, data science and/or healthcare administration. The coursework and research experiences are designed to equip you with the conceptual thinking, analytical and problem-solving skills necessary to find innovative solutions to complex healthcare problems.

What are the job opportunities for graduates of the program?

Job opportunities for individuals with a Ph.D. in this field are excellent and growing. Our students have had 100% job placements at reputable universities, pharmaceutical companies, government agencies, clinical research organizations and in the managed care industry. Please visit the Alumni section of our website at pharmacy.hsc.wvu.edu/PSPalumni to view job placements of our Ph.D. graduates. 

Frequently Asked Questions

Does this program offer a Master's degree? This program does not at this time have a terminal Master's degree.

How long does it take to finish a PhD degree in this field? Typically, a student starting without a research Master’s degree could take anywhere from 4 to 5 years to complete all of the degree requirements. Students who already have a research Master’s degree take less time, about 3 to 4 years.

Is financial assistance available? A limited number of teaching and research assistantships (with a stipend of $30,000 per year) are available within the department. Several fellowships may also be available to apply for depending on criteria for eligibility. These include an annual stipend and full tuition waiver with the student required to perform 20 hours/week of assistantship duties. Students with assistantships have to pay approximately $675/semester towards the use of the recreation center, the public rapid transport system (PRT), and other such conveniences. The assistantships are available to students for at least 3 years as long as they are performing well in their duties, and making satisfactory progress toward their degree objective. The stipends are sufficient for graduate students to live comfortably and devote sufficient time to their educational program and research training. These assistantships are awarded on a competitive basis each year with the highest ranked applicants given the first offer of available assistantships. Some qualified students may be also offered admission without an assistantship. These students are provided guidance to seeking other campus employment opportunities subject to Immigration and Naturalization Services’ regulations in case of foreign students.

Is a BS in Pharmacy or Pharm.D. degree (or a pharmacy background) required for admission? No. Generally, a professional degree in pharmacy, medicine, or a health-related discipline is preferred. Students with Master's Degrees in related fields such as epidemiology, economics, and public health are also encouraged to apply. Students with a Master’s degree in marketing management, psychology, or sociology with a demonstrated interest or experience in health care may also apply.

What is the entry date into the program? Because of the sequence of core courses, students are admitted in the Fall semester only, which typically begins in the middle or last week of August every year. In very rare instances, a student may be admitted in the Spring semester if they already have a research Master’s degree, and if the PSP faculty agree that the circumstances of his/her admission warrant special consideration.

How do I apply to the program and what is the application deadline? All application materials, transcripts, test scores, three letters of recommendation, curriculum vitae of educational qualifications and training and job experiences, and statement of purpose must be submitted to WVU Graduate Admissions ( https://app.applyyourself.com/AYApplicantLogin/fl_ApplicantConnectLogin.asp?id=wvugrad ) by February 1st  of the year for consideration of admission in the Fall semester of that year. It is best to start the admission process by September of the year before the Fall semester that you want to be considered to give yourself sufficient time to complete the process and not be affected by unexpected delays. Reviews are completed by the middle or end of March, and applicants are notified of acceptance or rejection with a signed acceptance from those offered an admission required no later than April 15.

How many applications do you receive each year? The number of applications we receive vary from year to year but has shown a dramatic increase in the last few years. In recent years the numbers have ranged from 25 to 40.

How many students are accepted each year? The number of students accepted each year vary depending on the number of students who have graduated in the preceding year. Typically, 3-4 students have been admitted per year in the recent past. A total number of 13-16 students are maintained in the program to enable close mentoring and training relationships with faculty advisors.

How is an application to the graduate program evaluated? An application to the graduate program along with all supporting materials is reviewed by all members of the department graduate faculty. Each application is holistically reviewed first in terms of meeting the minimum academic (a ‘B’ average or a 3.0 GPA on 4.0 scale) and TOEFL (550 on the paper-based exam, 79-80 on the Internet exam, or 213 on the computer-based exam) criteria. Applications not meeting these criteria are immediately rejected. The subsequent reviews take place in a committee meeting in which all applications are discussed and ranked through a consensus process. While individual faculty may weigh each criteria slightly different, sustained academic excellence, good to outstanding GRE scores, past work or research experience in areas of interest, well written statement of purpose, leadership and extracurricular activities are all considered important and considered in a holistic way. Telephone or personal interview are typically required by the graduate faculty. Students ranked according to merit are offered admission with an assistantship in the order of listing until no more assistantships are available. A few additional students may be offered admission without an assistantship. A verbal offer by telephone is made to students who are offered admission with assistantships, and upon verbal acceptance of the offer, are sent formal letters of acceptance.

How are grades and GRE scores considered in the overall admissions evaluation? While sustained academic excellence is considered to be among the best predictors of academic performance, GRE scores are also important to compare students from different domestic and international education systems. For students from English speaking parts of the world, quantitative and analytical scores are given more weight than the verbal scores. Faculty participating in application reviews typically look for overall educational achievements, competitive GRE scores, extracurricular and leadership activities, and demonstrated interest in research in the chosen area of study.

What role does TOEFL play in the admission process? Since all of the education process and research training is in English, students from non-English speaking parts of the world are required to provide TOEFL scores by the University with a score of 500 on the paper-based exam, 173 on the computer-based exam, 61 for TOEFL internet-based, and 60 for IELTS considered to be minimum University requirement. Once admitted, and if awarded a Teaching Assistantship, students are also required to pass a test of spoken English before they are allowed to teach in classes or labs.

Can English Language Proficiency test be waived? Students who have received a Bachelor’s degree in Australia, Canada, Republic of Ireland, New Zealand, United Kingdom, United States and its territories, Liberia, Nigeria, Ghana, Nepal, India, Pakistan, Commonwealth Caribbean Countries (Anguilla, Antigua, The Bahamas, Barbados, Belize, British Virgin Islands, Bermuda, Cayman Islands, Dominica, Grenada, Guyana, Jamaica, Montserrat, St. Kitts and Nevis, St. Lucia, St. Vincent, Trinidad and Tobago, Turks and Caicos) are not required to submit language proficiency scores. Language Proficiency Score waivers may be considered for individuals with graduate degrees from these countries.

What are acceptable GRE scores? Scores on the GRE are reported in terms of percentiles. So, for example, if a student scores at the 65th percentile, this means that he or she scored at or better than 65 percent of the students who took that test. We obviously want the best students who apply.

If my GRE or TOEFL scores are not good, should I retake these exams? These tests are standardized tests, and typically, student scores do not change much on retaking of these exams. Make sure that you are familiar with the format of these tests and the time constraints for their completion. Practice books are available to familiarize yourself with the exam. If you take these exams and are not satisfied with your scores, you should retake them only if you feel certain that retaking them will help you improve your test scores. If you do retake them, Educational Testing Service will report the results of all attempts within the previous three years.

Are applicants interviewed? Applicants chosen for interview may be interviewed either by video conference (e.g., Zoom) or in person in Morgantown.

Can I transfer graduate coursework from my current institution if I have not completed a Masters degree? Yes, on admission to the graduate program and upon forming a PhD committee with an advisor, the committee will take into consideration whatever recent graduate coursework you have completed that can contribute to your plan of study given your educational goals and program needs. WVU allows up to 18 credit hours of coursework to be transferred that are not part of a degree program. See Application for Transfer of Graduate Credit to WVU

Are there examples of completed PhD dissertations from recent graduates in the Health Services and Outcomes Research program? Yes, please visit Recent MS thesis and PhD dissertations for titles completed by recent graduates.

What is it like to study at West Virginia University (WVU) and live in Morgantown? West Virginia University, founded in 1867, is located in Morgantown, West Virginia, is one of only 46 public universities that serve their state as research and land-grant institutions. Through 15 colleges and schools, WVU offers 193 bachelors, master's, doctoral and professional degree programs. WVU was ranked in the top 3% of 19,000 universities worldwide by the Center for World University Rankings.

WVU is a Doctoral/ Research University - Extensive as classified by the Carnegie Classification of Institutions of Higher Education -- based on the complexity and breadth of the institution's mission. As West Virginia's major research and development center and only comprehensive doctoral-granting institution, WVU faculty conducts over $150 million in sponsored contracts and grants per year.

The WVU System spans the state, including 518 buildings on 15,880 acres (main campus 430 buildings/1,456 acres). Eleven main campus buildings are on the National Register of Historic Places, and WVU operates eight experimental farms and four forests throughout the state. The University's total operating budget is approximately $900 million. WVU's student body is comprised of over 31,524 students with 28,776 on the Morgantown campus. These students hail from all West Virginia counties, nearly all 50 states, and close to 100 foreign nations. Chartered in 1873, the WVU Alumni Association is made up of more than 190,000 graduates worldwide in some 135 nations. For more information about West Virginia University and a virtual tour of the campus, visit: http://www.wvu.edu/ .

Morgantown, W.Va., population 30,347 (US Census Bureau, 2021), was rated “No. 1 place to live in West Virginia” out of the best place to live in every state by Money  magazine. Morgantown was named one of the "South's Best Small Towns" by Southern Living . Morgantown is one of the "Best Affordable Places to Live" by Livability . Within easy traveling distance of Washington, D.C., to the east, Pittsburgh, Pa., to the north, and Cleveland and Columbus, Ohio, to the northwest. WVU has divisional campuses in Charleston, Keyser, Martinsburg and Montgomery.

Monongalia County in which Morgantown is located is a community of about 80,000 people in the Appalachian Mountains on West Virginia's northern border. While the state is rural and the community quiet, Morgantown is within easy traveling distance from Pittsburgh, which is 75 miles (115 kilometers) north, and Baltimore and Washington, both of which are 200 miles (325 kilometers) east. Two major four-lane highways, Interstate 79 and Interstate 68, pass through Morgantown. U.S. 19 and U.S. 119 also pass through Morgantown.

For information about the Morgantown area, students can visit the Greater Morgantown Convention and Visitors Bureau homepage at www.tourmorgantown.com/ or the City of Morgantown homepage at www.morgantownwv.gov .

What if I have more questions or concerns? If your question is not addressed anywhere in the list of frequently asked questions…

• For questions about other programs, life at WVU, and other information for prospective students please visit Graduate Education at http://graduate.wvu.edu/ .
• For questions about University policies on graduate programs at West Virginia University, please visit: Undergraduate, Graduate, and Health Sciences Center Catalogs .

For application related inquiries, status of application file, confirmation of materials, scores, received, admission status, or HSOR graduate program related inquiries etc., please contact:

Khalid Kamal, MPharm, PhD Professor and Chair Acting HSOR Graduate Program Director Pharmaceutical Systems & Policy E-mail: [email protected]

For more details about the PhD program in HSOR go to:  https://pharmacy.hsc.wvu.edu/pharmaceutical-systems-and-policy/phd-program-in-health-services-and-outcomes-research/

Admissions for 2025-2026

Applicants considered for admission to the doctoral program must meet the following minimum requirements.

• A professional degree in Pharmacy (Pharm.D.), Medicine (M.D.), or a Master's degree in pharmacy administration. Students with a Master’s degree in related fields such as epidemiology, public health, health care administration, are also encouraged to apply. Students with a Master’s degree in related fields such as marketing, management, economics, psychology, or sociology with a demonstrated interest or experience in health care may also apply.
• Outstanding students with a B.S. in pharmacy or pharmaceutical sciences may be considered for direct admission into the Doctoral program
• College transcript with a minimum of a B average (3.0 on a 4.0 scale)
• GRE or GMAT scores (International applicants must meet WVU's minimum score requirements for English language proficiency ) evaluating potential for graduate studies
• Supportive letters of recommendation (at least three)
• Satisfactory personal or telephone interview (whenever possible)
• Statement (one page) of personal goals describing background, academic/ research interests and career objectives
• A resume or curriculum vitae listing educational and employment history
• Application deadline is February 1st of each year

International Applicants

International students should also be aware of the following:

• International applicants must present the Test of English as a Foreign Language or TOEFL minimum score requirements if they are from a non-English speaking country or the official language of the country is not English.  Applicants are urged to arrange for one of these tests well in advance of the desired enrollment period.
• International students who have completed a M.S. degree or any degree in the U.S. may request a waiver for submitting TOEFL results.  They should contact the Office of International Students and Scholars for approval.
• International students should not plan to leave their country without a formal notification of admission from the Office of Admissions at WVU. International students admitted without an assistantship must submit a statement of financial status in order to be registered at WVU.
• International students admitted to the program must report to the Office of International Students and Scholars upon arrival at WVU. Students are responsible for making sure that they are in compliance with immigration requirements.

Application Process (Major Code 8980)

Deadline: february 1.

Application to the Health Services and Outcomes Research PhD program is completed electronically at https://wvu.my.site.com/wvugrad/TX_SiteLogin?startURL=%2Fwvugrad%2FTargetX_Portal__PB

Please choose Major Code: 8980.

West Virginia University requires the following information for application through the WVU online application portal. Please note that all materials are submitted through the portal. Do not send materials to the School of Pharmacy unless instructed to do so by the Office of Student Services. 

• One copy of official transcripts (original or certified; minimum of a B average or a 3.0 GPA on a 4.0 scale) in a sealed envelope from each college you have attended.
• Original or certified copies of all degrees/diplomas/certificates received in the original language.
• Translation of an applicant’s foreign transcripts and diplomas/certificates may be sent directly to a foreign transcript service for evaluation. If using a foreign transcript service, please have the evaluated documents submitted the WVU Office of Graduate Admissions.
• Official GRE Scores and TOEFL or IELTS scores.
• Statement of personal goals describing your background, academic interests, and career objectives.
• A resume or curriculum vitae listing educational and employment history.
• Three letters of recommendation from persons who are in a position to evaluate your potential for graduate school. At least one recommendation must be from a person at the last school you attended for full-time study, unless you have been out of school for five years or longer.

Direct admission related inquiries to: Khalid Kamal, MPharm, PhD Professor and Chair Acting HSOR Graduate Program Director Pharmaceutical Systems & Policy E-mail: [email protected]

Students considered for admission will participate in an interview and will be notified of their candidacy in the spring prior to admission.

See more at:  http://pharmacy.hsc.wvu.edu/department-of-pharmaceutical-systems-and-policy/phd-program-in-health-services-and-outcomes-research/

Major Code: 8980

Curriculum Requirements

Suggested Electives

Major Learning Outcomes

The overall goals of the PhD program in Health Services and Outcomes Research are:

• To educate and train highly qualified individuals to pursue independent research in health services and outcomes research (HSOR) within interdisciplinary teams, and to function and contribute as a member of a research team.
• To prepare competent scientists able to contribute to health-related research, industrial research and development, pharmaceutical education, and scholarship.
• To advance research in pharmaceutical and healthcare delivery.
• To provide leadership for the pharmacy profession in research, graduate education, and health policy making.

The program is designed to prepare students to become independent researchers. Students will develop competencies in the scientific research process through didactic studies and conceptualizing, designing, conducting, and reporting original research.

Didactic Studies

• To learn basic principles and apply these principles to specific disciplines and related fields to cultivate a broad background of knowledge.
• To develop research skills, including scientific communication and critical thinking/problem solving abilities by participating in seminars and designated research skill courses.

Research Training

• To acquire practical experience in conducting original research, including acquisition of background information (e.g. literature research), problem development, experimental design and experimentation, collecting primary data and using secondary data, and data analyses.
• To foster research communication skills by writing abstracts for research presentations, manuscripts for publication, research grant proposals, and a thesis or dissertation.
• To gain additional insight into research and scholarship by participating in scholarly exchanges with faculty and students in the WVU School of Pharmacy, the Health Sciences Center (HSC), as well as the national and international healthcare community.

WVU Morgantown

Graduate/Professional Catalog Information

• Academic and Professional Standards
• Advising, Enrollment and Evaluation
• Degree Regulations
• Financial Aid
• Graduate Certificates
• Programs, Courses and Credits
• Tuition, Fees and Residency

Print Options

Send Page to Printer

Print this page.

Download Page (PDF)

The PDF will include all information unique to this page.

Download Complete 2023-24 PDF Catalogs

• WVU Morgantown - Graduate/Professional
• WVU Morgantown - Undergraduate
• WVU Keyser - Potomac State College
• WVU Beckley - WVU Tech
• WVU Morgantown - Law

Download 2023-24 PDF Courses Catalogs

• WVU Morgantown - Graduate/Professional Courses
• WVU Morgantown - Undergraduate Courses
• WVU Keyser - Potomac State College Courses
• WVU Beckley - WVU Tech Courses

Download PDF of this page

Download Complete 2020-21 PDF Catalogs

Download 2020-21 PDF Courses Catalogs

Temple University

• Undergraduate
• Graduate & Professional
• International Admissions
• Degrees and Programs
• Schools & Colleges
• Interdisciplinary Academics
• Honors Program
• Continuing Education & Summer Sessions
• International Study
• Courses & Schedules
• Dual Degrees
• Arts & Culture
• Sustainability
• Clubs & Organizations
• Diversity & Inclusivity
• Housing & Dining
• Health and Well-being Division
• Visiting Temple
• Temple Food Trucks
• Student Resources
• Tobacco Free Temple
• Centers & Institutes
• Research Divisions
• Faculty & Research News
• Grants & Funding
• Clinical Trials
• Technology Development
• History & Traditions
• Temple Health
• News & Media
• University Offices
• University Events
• Public Information
• Faculty & Staff Resources
• Campus Development
• Internal Audits
• Ethics & Compliance

Health Policy and Health Services Research PhD

The Health Policy and Health Services Research PhD program in Temple’s College of Public Health emphasizes the use of economics, health services and outcomes research—as well as healthcare administration and leadership—to study today’s challenging health policy issues. Students graduate from this doctoral degree program ready to pursue careers as academic researchers in universities or as policymakers who can help address critical questions in healthcare and public health.

Health Policy and Health Services Research PhD students work closely with faculty on key public health topics, such as

• eliminating health disparities;
• examining healthcare costs;
• improving the quality and the outcomes of healthcare services; and
• developing policy initiatives that target areas of population health such as aging, chronic diseases, mental health, risk behaviors, substance use and violence/injury prevention.

Students have opportunities to improve community health and reduce public health inequities in one of the largest urban settings in the nation. Many doctoral students in the Health Policy and Health Services Research PhD program collaborate with community-based and healthcare delivery organizations in Philadelphia while they conduct research projects for their dissertations. The Health Policy and Health Services Research PhD program allows you to work closely with faculty and peers to collaborate on research studies, develop collegial bonds, meet potential mentors and collaborators, and prepare for your future in health policy.

Health Policy and Health Services Research PhD graduates enter academic research and teaching positions, or work in private and public institutional settings to develop, evaluate and implement health policy at local, state, national and global levels. These institutions may include health foundations, government agencies, pharmaceutical companies and public health departments.

What sets apart our Health Policy and Health Services Research PhD?

• Collaboration with renowned faculty : Our faculty are experts in emergency management, health policy analysis, healthcare organization leadership, patient experience and quality of care, population health, and primary and long-term care.
• Interdisciplinary opportunities : The College of Public Health incorporates healthcare and health services disciplines as well as traditional public health fields. Students can learn from and collaborate with expert faculty across 17 disciplines ranging from social work to physical therapy and nursing.
• Preparation for academic teaching : Our students may enroll in the Teaching for Higher Education certificate program, offered by Temple’s Center for the Advancement of Teaching, while pursuing their PhD.
• Applied experience : All students participate in a Grantsmanship in Health Research course, which culminates with a student-authored grant submission. The mentored grant-writing experience is the first step to becoming an independent investigator with a funding record.

Program Format

The PhD is a full-time doctoral program. The curriculum is 45 credits, including essential courses in health policy, such as comparative policy, health economics, legal issues and policy making, with an emphasis on training in research methodology, grant writing and teaching.

See a full list of program courses .

Funding for Doctoral Students

The College of Public Health offers all PhD students a competitive level of support, including tuition, stipend and health insurance, for four years. Graduate assistantships sponsored by the College of Public Health are outlined below.

• Research assistants  perform supervised research activities and work with faculty on grant proposals and ongoing research. Through these experiences, you will develop both research and grant writing competencies.
• Teaching assistants  are assigned to assist in teaching courses, including grading exams and papers or teaching lab sections. Teaching assistants learn current pedagogies that prepare them for academic teaching. They can also receive certification in higher education teaching.

Highly qualified candidates are nominated for university fellowships, and candidates from minority groups can be nominated for  Temple’s Future Faculty Fellow program .

The College of Public Health offers personalized advising services to students in each department. PhD candidates may seek academic and program support from their faculty advisors.

You can engage with peers and find leadership opportunities in student-led clubs and organizations in the College of Public Health. 

Learn more about student clubs and organizations .

Additional Program Information

Go back to academics more in health policy and health services research phd.

• Departmental Research
• Our Faculty
• Scholarships & Financial Aid

• Quick Links

Tools & Resources

• Events Calendar
• Strauss Health Sciences Library
• Department A-Z Directory
• Campus Directory
• Faculty & Staff Resources
• Supporter & Alumni Resources
• Student Resources
• Mental Health Resources
• University Policies

CU Campuses

Cu anschutz medical campus.

• CU Colorado Springs
• School of Dental Medicine
• Graduate School
• School of Medicine
• College of Nursing

Skaggs School of Pharmacy and Pharmaceutical Sciences

• Colorado School of Public Health

PhD in Pharmaceutical Outcomes Research

Pharmaceutical Outcomes Research is a PhD program in the graduate program in Clinical Pharmacy. This program is housed in the Center for Pharmaceutical Outcomes Research (CePOR, SEE-por), a school-wide center in the Skaggs School of Pharmacy. Our doctoral curriculum is designed to provide competent and highly skilled researchers in the study of patient, provider, or population-level health care and health system interventions. We most often focus on economic, clinical, and humanistic outcomes such as clinical or cost effectiveness or safety. Areas of focus available to students undertaking this course of study include pharmacoeconomics, pharmacoepidemiology, health services research, and drug policy.​​​

Core faculty are methodological experts and provide collaborative linkage to clinical experts in all pharmacy, medicine, nursing, and public health. Programs of study are tailored to student interests in disease or drug areas, such as cardiology, psychiatry, neurology, and cancer. Opportunities exist to link to more basic science colleagues depending on your topic of interests. For example, students interested in drug safety might link with toxicology faculty, or in gene-environment interactions might link with pharmacogenomics faculty.

Applications for all doctoral programs are submitted electronically through the Graduate School of the University of Colorado Denver. After signing up for an account, select 'PhD' under the 'Academic Interests' menu and scroll down to 'Skaggs School of Pharmacy and Pharmaceutical Sciences' and select "PhD in Pharmaceutical Outcomes Research."

Application requirements are:

• A completed Graduate School application and $50.00 application fee (Domestic) $75.00 application fee (International)
• A baccalaureate degree of arts or science from an accredited college or university with a minimum GPA of 3.0.** One (1) official transcript of all academic work completed to date with awarded baccalaureate degree. University transcripts from other countries must include a transcript evaluation from World Education Services ( WES ). Applicants who complete a transcript evaluation with WES will have their application fee waived automatically.
• All applicants for the program should complete a year of study in the following subjects: general chemistry, organic chemistry, calculus, biology, English and physics. In addition, courses in the following subjects are highly recommended to supplement the student's background: physiology, biochemistry, statistics, cell biology, physical chemistry, and computer science.
• Three (3) letters of recommendation from professors or research supervisors familiar with your aptitude for graduate study

Additionally:

• The GRE (Graduate Record Examination) is not required but is optional.
• The TOEFL is required of applicants for whom English is not their first language, Duolingo and IELTS also accepted (more information on this  here )
• Please use 4875 as the Institution Code so that the test results will be sent directly to our institution
• Under special circumstances, deficiencies in important areas may be made up within the first year after entrance into the program. Normally, admission to the program will be based on an undergraduate GPA of 3.0 or better. However, applicants' recommendations, research experience and additional individual accomplishments will also be considered in the admissions process.

Application opens September 1, 2023. Applications will not be reviewed until all required materials have been received. The application deadline for Fall 2024 admission is December 1, 2023 for all students.

Admission to the program may include financial support via a stipend awarded on a 12-month basis.

Although a priority of the School of Pharmacy is to provide financial support to its graduate students, payment of stipend, tuition and any fees by the School of Pharmacy or by grants, contracts or gifts to the School of Pharmacy faculty is contingent upon availability of funding, satisfactory academic progress (as defined by the UCD Graduate School, Graduate Student Handbook) and completion of required teaching duties, core courses, and examinations. The School of Pharmacy also reserves the right to review and adjust its funding policies at any time. All students are expected to work full-time toward program requirements for 12 months of the year.

Generally, the first year of financial support will be in the form of stipend support for working as a teaching assistant. Depending on availability, teaching assistantships may be offered beyond one year to students. Faculty may choose to offer research assistant scholarships to students as well. Other funding opportunities in the form of external student grants and awards also exist. Students are encouraged to talk to the faculty about funding and scholarship opportunities. Funds for travel to one meeting where students are presenting a poster or giving a podium presentation are limited to $500 per fiscal year.

Students who do not remain in good graduate standing (3.0 GPA or above) or maintain satisfactory academic progress are placed on academic probation. Probation and suspension policies are described in the UCD Graduate School, Graduate Student Handbook. Payment of stipend, tuition, insurance and fees for a student while on academic probation is at the discretion of the graduate program committee.​​

What does "pharmaceutical outcomes research" mean?

What kind of students should pursue a phd degree in pharmaceutical outcomes research why should you apply to this program.

We are looking for students who want to influence healthcare but do not want to be a provider. With the belief that the research done will allow for the application of new knowledge towards health improvement.

What makes the Pharmaceutical Outcomes Research PhD program at the University of Colorado different from other PhD programs?

The benefits of this program are multi-faceted. Housed on a major medical campus, students will be able to collaborate with the schools of pharmacy, medicine, nursing, and public health. Also the University of Colorado Hospital, Children's Hospital, and the Veterans Affairs Medical Center are located on campus.

By having a small group of graduate students, they are allowed more time with the faculty members. With two faculty members from each component, students will be able to have the support necessary to complete their degree.

What are the job prospects for a graduate with a PhD degree in the pharmaceutical sciences? What can you do with this career?

Graduates of the program will have many career options within these areas:

• Pharmaceutical industry
• Government agencies
• Contract research organization (CROs)
• Organized healthcare systems

There is a critical need for individuals who are able to conduct rigorous, credible, and relevant population and patient-based research within stringent ethical and regulatory guidelines; the demand for such researchers is expected to grow given the developing health care reform and the investment in federal development and expansion on comparative effectiveness research.

Past graduates have gone on to be an interim dean at a Regis University and the director of pharmacy at the University of Colorado Hospital

How are current students doing?

Our students often win awards at regional and national symposium (such as Julia Slejko at ISPOR or SMDM). One holds a prestigious pre-doctoral dissertation award in health outcomes from the PhRMA Foundation. Two have completed comprehensive exams are working on defending their dissertation proposals. All these more advanced students have published manuscripts in peer-reviewed journals as first authors with the mentorship of the CePOR faculty.

Faculty comments on the program.

Heather Anderson, PhD What's great about this campus is that we are able to collaborate with other schools such as public health, nursing, and medicine. While many Pharmaceutical Outcomes Research programs have a major focus on economics, we do that and more. Our program has a strong focus on epidemiology and policy too. I actually got my PhD in epidemiology from our School of Public health and can link up students with the best courses and advise on exciting local opportunities for research assistantships.

Kelly Anderson, PhD Training at a world-class medical campus allows PhD students in the Center for Pharmaceutical Outcomes Research to engage with faculty in the center with expertise in outcomes research, drug pricing, economics, epidemiology, and health policy, and also have the opportunity to learn from and collaborate with faculty throughout the Schools of Pharmacy, Public Health, Medicine, Dentistry, and Nursing. For anyone who loves big data, our faculty also work with numerous large data sets: Medicare claims, linked EHR-claims data, and all-payer data just to name a few. As a lot of my work is focused on payment policy, I welcome the opportunity to engage students as they think about the real-world implications of their research for policy makers, health insurers, patients, clinicians, and drug companies and disseminate their findings to these key stakeholders.

R. Brett McQueen, PhD Pharmaceutical outcomes research includes aspects of multiple disciplines including math, economics, and epidemiology. I joined the faculty at CU to contribute to comparative- and cost-effectiveness research and to education both for the PhD and the PharmD programs. Our PhD program emphasizes quality over quantity. We maintain a very favorable student to faculty ratio, we offer competitive student financial support, and we strive to graduate scientific leaders in the field of outcomes research.

Kavita V. Nair, PhD Our expectations for graduate students are high and we have structured the education and training requirements to help you meet these goals. I will require a lot of you as a student but will also be your strongest advocate!

Robert Valuck, PhD, RPh I believe that the strengths of our program are the skills and the diversity of the faculty, and size and connectedness of our program with others on campus and in the state and region. With a smaller number of graduate students in our program, they are able to spend more time with faculty members. Our program is well connected with others on the Anschutz campus, and students have opportunities to collaborate both across campus, and with state agencies, provider groups, and others that have an interest in outcomes research and its applications to patient care and policy.

Advance the science of pharmaceutical outcomes research by training scientists who generate and synthesize evidence to inform practice and policy.

The goal of the PhD n pharmaceutical outcomes research is to develop methodological experts. Graduates will have the knowledge and extensive skills necessary to conduct pharmacoeconomic, pharmacoepidemiologic, health services, and drug policy research. We train individuals who can contribute to T3-T4 clinical translational pharmacy and pharmaceutical sciences, specifically on effective, population health, and policy studies. These contributions should ultimately benefit pharmacists and society with safe, effective, and efficient use of pharmaceutical care.​​

The Pharmaceutical Outcomes Research PhD program trains graduate students to become proficient and successful investigators who are able to:

• demonstrate an in-depth knowledge of central concepts in Pharmaceutical Outcomes Research, including the areas of pharmacoeconomics, pharmacoepidemiology, and/or drug policy.
• critically appraise existing literature and sources of information.
• formulate hypotheses based on current concepts in the field and accurately and correctly design, conduct, and interpret their own research projects.
• present research results in peer-reviewed publications and in a dissertation.
• perform research that adheres to the principles and guidelines of ethical conduct.
• communicate research results effectively through oral presentations at scientific seminars, conferences, and other venues

The program’s strengths in outcomes research are emphasized in 35 credits of several areas:

• Biostatistics
• Epidemiology
• Health Policy
• Research/Study Design
• Doctoral Thesis

The program has experience in accessing a multitude of data such as MEPS, PHARMetrics, University Health-System, Consortium and MarketScan. Students are encouraged to utilize these datasets as well as primary data collection. Students may enroll in courses not listed (e.g courses in downtown campuses and/or newly developed courses) by consulting with the program director.

Pharmacoepidemiology

Heather Anderson PhD

Robert Valuck PhD, RPh

Pharmacoeconomics.

Mike J. DiStefano PhD, MBE

Kelly Anderson PhD, MPP

R. Brett McQueen PhD

Pharmaceutical and drug related policy.

Kavita Nair PhD

Antal Zemplényi

Antal Zemplényi, PhD, is an Associate Professor at the Center for Health Technology Assessment at the University of Pécs and a senior researcher at the Syreon Research Institute, an international research corporation specializing in health policy, health economic modeling, and technology assessment. He has experience in value assessment, HTA, health economics and outcomes research, and real-world data analysis. He is the past president of the ISPOR Hungary Chapter. Antal is currently a Fulbright Scholar at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences working as a visiting research associate in the Pharmaceutical Value (pValue) initiative.

Monica Bianchini

Monica Bianchini is originally from Indianapolis, Indiana. She received a PharmD and MPH from the University of Wisconsin-Madison in 2017. She subsequently completed a hospital pharmacy residency (PGY-1) and Infectious Diseases PGY-2 at Henry Ford Hospital in Detroit, Michigan. Monica joined CePOR in 2019 and currently works as a clinical inpatient pharmacist. Her dissertation will evaluate opportunities to decrease syphilis rates and improve syphilis care in Colorado. Outside of work, she enjoys reading, live music, cooking, and anything outside (running, hiking, backpacking, skiing). 

Sue is a fifth year PhD student at CePOR. Her dissertation focuses on characterizing the burden of MS and treatment strategies using real-world claims data. Prior to grad school, she studied Neuroscience in Pomona College. In her free time, Sue enjoys taking her puppies on adventures.

Mahesh Maiyani

Mahesh Maiyani was born and raised in India. He earned his Bachelor of Pharmacy (BPharm) from India in 2006 and then he came to the US to pursue his Master’s in Business administration. He completed his MBA from The University of Findlay in Ohio. He has work experience in clinical trials and heath care research. He joined the Pharmaceutical Outcomes Research PhD program in Fall-2021. His research interests are focused around cost effectiveness in real-world clinical settings. Mahesh enjoys hiking and spending time with family and friends.

Nick Mendola

Nick Mendola was born and raised in Buffalo, New York. He graduated from The University of Akron with a BS in Exercise Science in 2016. He then moved to Washington D.C. to attend The George Washington University Milken Institute School of Public Health, where he obtained his MPH in Epidemiology, in 2018. During this time, he worked researching the impact of the pharmaceutical industry’s marketing to healthcare professionals, and its influence on prescribing practices and population level drug utilization. Nick joined the Pharmaceutical Outcomes Research program in the fall of 2018. Nick’s current work with Dr. Robert Brett McQueen, explores the use of Multi-Criteria Decision Analysis (MCDA) as a novel health technology value assessment tool. His work specifically explores MCDA in evaluating treatments for neuromyelitis optica spectrum disorder (NMOSD), a rare neurological disorder.

Vanessa Paul Patterson

Vanessa Patterson is originally from Kansas City. She graduated from Tulane University School of Public Health and Tropical Medicine with an MPH concentrating in Epidemiology and Maternal and Child Health in 2012. Vanessa went on to work as an applied epidemiologist for government public health agencies for six years. She joined the Pharmaceutical Outcomes Research program at CU in the fall of 2018. Working under the mentorship of Dr. Heather Anderson, Vanessa is currently a PhRMA Foundation Predoctoral Fellow and a PhD candidate. Her dissertation focuses on the utilization of cardioprotective medications among women with a history of breast cancer. In her free time, Vanessa enjoys making pottery and spending time outdoors with family and friends.

Nai-Chia (Sammi) Chen

Sammi is originally from Taiwan. She holds a bachelor’s degree in Pharmacy from Kaohsiung Medical University. After graduation, she had worked in pharmaceutical companies and clinical research organizations for several years before coming to the US. She completed her Master’s training at the University of Pittsburgh, Pharmaceutical Outcomes and Policy Research, in 2022. And then she joined Pharmaceutical Outcomes Research PhD program at CU Anschutz in Fall 2022. Her research interest lies in the intersection of pharmacoeconomics, real-world evidence, and pharmaceutical outcomes. Outside the schoolwork, she enjoys cooking, baking, and snowboarding/skiing in winter.

Mouna Dardouri

Mouna was born and raised in Tunisia. She graduated with a PharmD from the University of Pharmacy of Monastir in 2016. She then worked for two years at a consulting company focusing on pharmaceuticals’ Pricing, Reimbursement and Market Access (PRMA) in Europe. After that, she was awarded with the Fulbright Foreign student scholarship and moved to Colorado, where she obtained her MPH in Global Health Systems, management, and Policy in 2022. Mouna joined the Pharmaceutical Outcomes Research program in the fall of 2022. Her research interests include evaluating the use of Health Technology Assessment in the context of low- and middle- income countries and developing tools that permit equitable patients’ access to cost-effective technologies. In her free time, Mouna enjoys learning new languages, improv theatre and cooking. 

Why CU's Pharmaceutical Outcomes Research PhD Program?

“One key reason I chose to join CePOR at CU was the tight-knit group of faculty and students. Given the program is smaller, the faculty has a better opportunity to stay in touch with all the students and provide support for everyone's research, regardless if they're on the student's committee or not. The student group is also very close as we are together for weekly seminars and enjoy out-of-school gatherings when possible. Another draw of CU's POR program is the diverse expertise of our faculty and alumni. Our current faculty have a range of expertise including: pharmacoepidemiology using big data sources, pharmacoeconomics and drug pricing, rare diseases, opioid use disorder and treatment, and Medicare payment models. Recent alumni have found work in a variety of different fields from consulting to academia to the pharmaceutical industry and the public health department. The wide range of backgrounds and areas of expertise covered by our faculty and alumni provide so many resources for mentorship and future career planning. Finally, there are so many unique opportunities within CePOR to work with different data sources (e.g. electronic health records, national claims data, Medicaid claims data) and different methodology experts, so I am confident that our program could be a great fit for prospective PhD students of all backgrounds.” – Monica Bianchini, PharmD, MPH

“CU's Pharmaceutical Outcomes Research Program produces robust interdisciplinary research that spans from pharmacoepidemiology to pharmaceutical economics with a variety of collaborators, such as Institute for Clinical and Economic Review (ICER) and Colorado Department of Public Health & Environment (CDPHE).” – Sue Kwon, BA

“I joined the POR program because my previous research was focused on population drug utilization and the pharmaceutical industry’s impact on prescribing practices, and the POR program seemed like a natural fit for me to be able to keep learning about the areas of pharmacoepidemiology and drug related policy. What I like most about the program so far has been the core faculty in our program. They seem to truly care about student success and how we progress both academically and professionally. ” – Nick Mendola, MPH 

PhD Student Research Projects

• Comparative Effectiveness of Rare Disease Therapies Using Multi-Criteria Decision Analysis: Case Example in Neuromyelitis Optica Spectrum Disorder, a Rare Neurological Disorder
• Characterizing Real-world Burden of Multiple Sclerosis and Treatment Strategies in a Colorado-representative Population
• Utilization of Cardioprotective Medication Strategies Among Women with a History of Breast Cancer
• Opportunities to Improve Syphilis Care in Colorado

Mission: To educate, increase awareness and promote growth within the 'Pharmacoeconomics and Outcomes Research' field in general and to increase the CU Denver presence among the international society ISPOR. To collaborate across different sciences on campus and different departments worldwide.

Description: Promote pharmacoeconomics and outcomes research education by holding regular seminars on current issues in the field and presenting research at least once a year at the annual meeting in the US-Canada region.

Membership requirements: We expect members to be passionate about the kind of research that is involved related to public health, epidemiology, pharmacoeconomics, and policy. Also, attending our regular educational seminars/webinars is highly encouraged.

Activities: Details will be emailed to members soon!

Benefits: The opportunity to present research, network and collaborate with faculty from different universities around the world, professionals from industry and research organizations at a global level.

Julia Slejko, PhD ('12) Associate Professor Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy

R. Brett McQueen, PhD ('13) Associate Professor Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences University of Colorado Anschutz Medical Campus

William Padula, PhD ('13) Assistant Professor of Pharmaceutical and Health Economics, School of Pharmacy Fellow, Leonard D. Schaeffer Center for Health Policy & Economics University of Southern California

David Tabano, PhD ('18) Principal Health Economist Evidence for Access (E4A) | Public Affairs & Access Genentech, Inc.

Katie Sullivan, PhD ('18) Prescription Drug Epidemiologist Colorado Department of Public Health and Environment

Angela Czaja, MD, PhD ('19) Associate Professor Pediatrics-Critical Care Medicine Children’s Hospital Colorado Anschutz Medical Campus

Chong Kim, PhD ('20) Associate Director Global Value & Access | HEOR Gilead Sciences

Katia Hannah, PhD ('21) Lead HEOR Specialist Dexcom

Kimberly Deininger, PhD ('22) HEOR Manager Amgen

For questions regarding graduate school programs contact:

Isabella Jaramillo Email:  [email protected]     Phone:  303.724.7263 ​​​​​

Kelly Anderson, PHD, MPP

Assistant Professor; Director, Pharmaceutical Outcomes Research PhD Program Email: [email protected] Phone: 434-466-1990

CU Anschutz

Pharmacy and Pharmaceutical Sciences Building

12850 East Montview Boulevard

Aurora, CO 80045

303-724-2882

• Pharmacy Directory
• Continuing Education
• Academic Calendar
• Request information
• Virtual Advising
• Scholarships & Financial Aid
• Career Services
• Experiential Program
• CORE for Students
• UCD-Access Portal
• Zoom Web Conferencing
• Payroll and Benefits
• Campuswide Directory
• University Laws and Policies
• CORE for Preceptors, Faculty, and Staff

• English Language Programs
• Postdoctoral Affairs
• Training Grant Support
• Request Information

THE GRADUATE SCHOOL

• Academic Programs
• Explore Programs

Health Services and Outcomes Research

Degree requirements.

Learn more about the program by visiting the Health Services and Outcomes Research Program

See related Interdisciplinary Clusters and Certificates

Error retrieving program data from Academic Catalog .

Program Statistics

Visit Master's Program Statistics for statistics such as program admissions, enrollment, student demographics and more.

Program Contact

Contact Elizabeth Wolfson Program Director 312-503-1744

The following requirements are in addition to, or further elaborate upon, those requirements outlined in  The Graduate School Policy Guide .

Master's Requirements

Total Units Required: 10.5

Last Updated: September 12, 2023

PhD in Health Economics

• Admission and Financial Aid
• Requirements for Degree Completion

Located in Los Angeles on the USC University Park Campus, the USC PhD program in health economics offers students the opportunity to help shape the future of health care through groundbreaking research and innovative policy solutions. Our multidisciplinary program offers rigorous training in microeconomics, econometrics, cost effectiveness analysis, welfare economics, public finance, epidemiology and health status measurement. Students in the program work closely with our world-renowned faculty, gaining the practical research experience needed to launch their careers.

Our program offers numerous benefits to help position our students for future success. All of our PhD students are fully funded, including tuition remission and stipend, for up to five years through teaching and research assistantships or competitive fellowships.  Many of our students participate in internships that offer real world experience and networking opportunities in industry, policy analysis and consulting.  Our department’s affiliation with the Leonard D. Schaeffer Center for Health Policy & Economics provides opportunities for students to work closely with distinguished faculty from across USC on impactful projects. Bolstered in part by our strong alumni network, our students are highly sought after for positions in academia, government and industry.

“I chose the Health Economics PhD program at USC for three reasons: the strong concentration of health economics faculty here as compared to traditional economics departments, the rigor of economics training compared to other applied programs, and quality of life (i.e., location in sunny Southern California and funding from a USC School of Pharmacy fellowship).”

Laura Henkhaus

Phd, health economics ’19, data scientist, hill physicians medical group.

• Director's Welcome
• Mission, Values & Goals
• What is Public Health?
• Accreditation
• News & Accomplishments
• Who Should Apply
• MPH Application Requirements
• MHA Application Requirements
• PhD Application Requirements
• Tuition & Financial Aid
• Information Sessions
• Degree Options
• Course Descriptions
• MPH Program
• Mission, Vision & Values
• Accreditation & Competencies
• Advisory Board
• Program Outcomes
• Research Mentors and Funding
• Graduate Bulletin
• Graduate School
• Health Education and Promotion
• Orientation
• Past Graduation
• Delta Omega Honor Society
• Upsilon Phi Delta
• Student Spotlight
• Alumni Association
• Make a Gift
• Careers in Health Administration
• Careers in Public Health
• Professional Development Fund for Students
• Program in Public Health Leadership and Administrative Staff
• Core and Full Time Faculty
• Instructional Faculty
• Post Docs & Research Scientists
• Publications & Active Grant Awards
• Research Highlights
• Faculty & Staff Resources
• About Giving

PhD Program

The PhD in Population Health and Clinical Outcomes Research Program in the Program in Public Health  is designed to meet the training needs of PhD-prepared scientists in the fields of both population health and clinical outcomes research.  The program draws upon both the expertise of our faculty to deliver the curriculum successfully and the resources available at Stony Brook University to implement and sustain the program. 

This program   provides a multidisciplinary, integrated, applied problem-solving approach to support students in addressing the important issues within the field. The purpose of this small and highly specialized graduate degree program is to train population health and clinical outcomes researchers , academicians, and practitioners–who will advance the field on a local, regional, and national level. 

There is a growing need for well-trained researchers with the skills in population health and clinical outcome research. For example, the Affordable Care Act places great emphasis on population-based approaches to the obesity epidemic and clinical outcomes approaches to establishing comparative efficacy of treatments. We believe that these skills will be in great demand in the public, private and, academic sectors. By focusing on human subject studies and trials, in combination with best practices in clinical care and community interventions, the PhD program will extend knowledge in the areas of safety, quality, efficiency, accessibility, accountability, and equity of care by supporting opportunities for the development of new knowledge about health and disease prevention, diagnosis, treatment, and prognosis.

Students will gain knowledge, skills, and experience by means of a series of a rigorous quantitative and analytical courses designed to develop advanced problem-solving skills. Working under faculty mentor guidance, student projects will focus on substantive current health care problems affecting population health, health policy, clinical practice, and patient-based health care decisions. Graduates will be competent in the design, conduct, and evaluation of research studies that will improve the future public health and medical care provided.

For questions and inquiries, please contact us at  [email protected] .

College of Pharmacy

Phd in pharmacotherapy outcomes research.

Students in the Doctor of Philosophy in Pharmacotherapy Outcomes Research Program are highly motivated with backgrounds in a pharmacy and pharmaceutical sciences, health economics, or other healthcare fields.

Contact Admissions

Welcome  

The University of Utah College of Pharmacy is part of the University of Utah Health Sciences Center, with state-of-the-art classroom, research and library facilities available to students pursuing graduate education. The Department of Pharmacotherapy has a long, rich history in the provision of high quality post-graduate training for pharmacy practitioners and outcomes researchers. Students in the Doctor of Philosophy in Pharmacotherapy Outcomes Research Program are highly motivated with backgrounds in a pharmacy and pharmaceutical sciences, health economics, or other healthcare fields.

International students

Final deadline december 31st , us residents, why choose the pharmacotherapy phd program at the university of utah, students graduate with core competencies in health economics, epidemiology, research design, and statistics. they are also prepared to be independent outcomes researchers trained to generate evidence to support health policy decisions regarding pharmaceuticals and related technologies., graduates of our program currently apply these skills in a broad range of career settings including the pharmaceutical industry, academia, institutional pharmacy, community pharmacy, and managed care organizations..

PhD Program Curriculum

Download phd program student handbook, awards & financial aid information.

Nathorn Chaiyakunapruk

Director, Graduate Program, PhD

Linda O'Connor

Education Coordinator

Phone: 801.585.1065

• Alumni & Giving
• Faculty & Staff Resources
• Academic Programs
• Pharmacy Student Emergency Fund
• Prospective Pharm.D. Students
• UGA Pre-Pharmacy Students
• Recently Admitted Pharm.D. Students
• Current Pharm.D. Students
• Scholarships
• Diversity Affairs
• Professional Degree (Pharm.D.)
• Master of Science
• Bachelor of Science
• Certificates
• Dual Degrees
• Experience Programs
• Interprofessional Education
• Residency Programs
• Stay In Touch
• Stay Engaged
• Accreditation & Assessment
• Administration
• Employment Opportunities
• Frequently Asked Questions (FAQ)
• Strategic Plan 2025: Our Prescription for the Future
• Vision, Mission, & Core Values
• Administrative Offices
• Faculty / Staff Directory
• College of Pharmacy Bulletin Archive
• Executive Committee Minutes
• Faculty Council Minutes
• Faculty Meeting Minutes
• Grants on the Edge
• University Council Members
• Research Directory
• Research Grant Resources
• UGA Center for Drug Discovery
• UGA Drug Discovery Group
• UGA Institute for International Biomedical Regulatory Sciences
• Latest News
• Publications

Connect with us:

• Pharmaceutical Health Services, Outcomes & Policy
• Academic Programs >

Mission, Vision and Values

Mission : We discover, evaluate, and communicate to improve the health and well-being of society

Vision : To be an internationally recognized interdisciplinary program, advancing patient care, education, and research

Values : Diversity, Trust, Collaboration, Rigor, Creativity, Discovery

Pharmaceutical Health Services, Outcomes, and Policy (PHSOP) graduate program is an interdisciplinary program leading to the Ph.D. degree.

The increasing complexity of drug utilization in the modern world creates complex problems in pharmaceutical care delivery. Practitioners and researchers need to investigate and understand how changes in the health care system will affect the structure, process and outcomes of pharmaceutical care.

Increasingly, society has been called upon to maximize health outcomes subject to some type of budget constraint, and the need to identify and select efficient health inputs is paramount. Changes in products (goods and services), access to care, freedom of choice, reimbursement policy, direct-to-consumer advertising, third party considerations and government regulation are a few examples of the issues which will impact on the delivery of pharmaceutical care.

These issues will require researchers skilled in a broad spectrum of disciplines including, but not limited to, economics, administration, finance, marketing, epidemiology, and psychology.

The objective of the graduate program in Pharmaceutical Health Services, Outcomes, and Policy is to educate students to perform meaningful independent research and to develop scholarly characteristics preparing them for professional careers in academia, research, government, institutional pharmacy, and industry. Having accomplished the academic and research requirements, students find career opportunities with universities, industry, pharmaceutical associations, local, state and national health agencies, health care delivery organizations, managed care organizations, pharmaceutical industry, state boards of pharmacy, and medical media organizations.

Research Opportunities in PHSOP The faculty members involved in the PHSOP Program have made significant accomplishments in their respective areas of interest. Their ongoing projects are supported in part by grants from the private and public funding agencies, the pharmaceutical industry, and various private foundations.

The expertise of PHSOP faculty includes:

Quality of life Medication Adherence Pharmaceutical marketing Pharmacoeconomics Pharmacoepidemiology Health Policy Evaluation Social and Behavioral Sciences

Upon entering the PHSOP graduate program, the student will be assigned a graduate faculty advisor until the student selects a major professor.

The faculty advisor will assist the student in establishing a course of study during the first academic year, which will include correcting any deficiencies, incomplete prerequisites and required graduate courses.

In addition, this mentoring relationship is intended to assist the student in selecting their particular research focus.

Ph.D. Program

Follow this link to view the PHSOP handbook:

PHSOP Handbook

Program Faculty

Click on the links below to view Program Faculty bio pages:

Joshua Caballero, Pharm.D., BCPP, FCCP

Niying Li, Ph.D., MSc

Elisabeth Sattler, Ph.D.

Randall L. Tackett, Ph.D.

Lorenzo Villa-Zapata, Ph.D., Pharm.D.

Henry Young, Ph.D.

PHSOP Program Handbook and Student Forms

PHSOP Program Handbook

Permission to be Absent Form

Graduate Student Activity Report

Grad Status Forms for PhD Students

Contact the Program Director

Lorenzo Villa-Zapata, Ph.D., Pharm.D. Email: [email protected] Phone: 706-542-4305

Recent Graduates and Dissertation Titles

Summer 2023 Ijeoma Azih, MD, MPH., PhD The Effect of Adjuvant and Neoadjuvant Systemic Therapy on the Treatment Outcomes of Renal Cell Carcinoma Patients

Spring 2023 Rupal Trivedi, PhD, MS, RDN Cardiovascular Disease Management in the South: An Implementation Science Approach

Fall 2022 Smita Rawal, Pharm.D., Ph.D.  Assessing Community Pharmacists’ Beliefs and Practices Regarding Naloxone Counseling

Summer 2021 Asma Ali, Pharm.D., Ph.D. Assessment of Factors Associated with Health Outcomes and Access to Prescription Medications in Patients with Diabetes Treated at Federally Qualified Health Centers

Ibrahim M. Asiri, Ph.D. Comparative Effectiveness of Oral Androgen Signaling Inhibitors in Castration-Resistant Prostate Cancer Patients With and without Pre-Existing Cardiovascular Comorbidities

Farah Pathan, Ph.D. Factors Associated with Asthma-Related Health Services Utilizations in the Adult US Population: A Mixed-Methods Approach

Fall 2017 Shada Kanchanasuwan, Ph.D. Impact of the Affordable Care Act’s Dependent Coverage Provision

Spring 2017 Surbhi Shah, Ph.D. Comparative Effectiveness and Costs of Conservative Management and Cryotherapy in Patients with Localized Prostate Cance

Spring 2016 Samah Al-Shatnawi, Ph.D. Alcohol Use Behaviors and Outcomes in Professional Student Pharmacists

Spring 2015 Rian Marie Extavour, Ph.D. Prescribing of Potentially Inappropriate Psychotrophic Medications for Older, Community-Dwelling Adults

Summer 2014 Palak Krunal Kumar Patel, Ph.D. Prostrate Cancer Burden: Addressing Issues of Diagnosis and Development

Summer 2013 J. Heath Ford, Ph.D., Pharm.D. Pharmacists in Disasters

Spring 2013 Anne Kangethe, Ph.D., Pharm.D., MPh. Cost Benefit Analysis of a Diabetes Prevention Program in Rural Kenya Chakita Williams, Ph.D.  Applying a Model of Risk Information Seeking to a Newly Discovered Drug Risk

Fall 2011 Ming-Yi Haung, Ph.D.  Utilization of Conjoint Analysis to Elicit Preferences for Genetic Testing for Alzheimer’s Disease

Current Student Directory

PHSOP Students

CET Students

Information For Prospective Students- How to Apply

If you are interested in applying to the PHSOP graduate program, please  click here  and scroll to the “How to Apply” tab.

• Billie Wickliffe ’49, ’59, ’63, ’67
• BSPS Convocation
• College of Pharmacy 60 at 60
• Commencement
• Digital Displays
• Faculty and Staff Wellness Resources
• Joy Wilson Retires After 30+ Years at CoP
• Pinning Ceremony Program
• SPAC Conference
• Student Transcript Request
• Student Wellness Resources
• Submit a Complaint
• Timeline Molecules
• Alumni Award Nominations
• Class Reunion Social Hours
• Online CE Classes
• PharmDawg Phlea Market
• Videos and Flyers
• Pumpkin Painting Contest
• Submit Your Points
• White Coat Ceremony 2023
• Maps & Directions
• Where to Park—Athens
• Where to Park—Augusta
• Strategic Direction I: Teaching & Learning
• Strategic Direction II: Innovative Research
• Strategic Direction III: Collaboration
• Strategic Direction IV: Investing in People
• Strategic Direction V: Diversity, Equity, & Inclusion
• BS/MS Dual Degree Program
• Experiential Learning Opportunities
• PBS Undergraduate Research Central
• Scholarships, Awards & Employment
• Clinical Trials Management Master’s Degree
• Master of Science in Clinical & Experimental Therapeutics (MCET)
• Master of Science in Pharmaceutical Health Services, Outcomes, & Policy
• Pharmaceutical & Biomedical Sciences
• Regulatory Sciences Master’s Degree
• Toxicology (Pharmaceutical & Biomedical Sciences)
• Cancer & Vascular Biology Lab
• Pneumonia Research Lab
• Vision Research Lab
• Albany Residency Program
• Athens Residency Program
• Augusta Residency Programs
• Savannah Residency Programs
• Chemistry, Manufacturing, & Controls Graduate Certificate Program
• Clinical Trials Certificate Program
• DRUG SAFETY AND PHARMACOVIGILANCE CERTIFICATE PROGRAM
• Regulatory Sciences Graduate Certificate Program
• Current Preceptor Information
• Prospective Preceptor Information
• Current Student Information
• Prospective Student Information
• About Our Programs & Locations
• Clinical & Experimental Therapeutics (CET) Student Directory
• Ambulatory Care Collaborative (AC2)
• Fluid Stewardship
• Hemodynamics
• MRC-ICU Score
• Future Graduate Students
• Pharmaceutical Health Services, Outcomes & Policy (PHSOP) Student Directory
• Residency Program Student Directory
• BS/MS in Pharmaceutical Sciences Student Directory
• Pharmaceutical & Biomedical Sciences (PBS) Student Directory
• Pharmaceutical Sciences Advisory Board
• SCBDDS Symposium
• International Biomedical Regulatory Sciences
• Business Affairs
• Marketing & Communications Office
• Development & Alumni Relations
• Information and Instructional Technology (IIT)
• Office of Instructional Innovation and Research
• Summer Science Institute
• Business Resources
• Job Openings
• IIT, Facilities, & Marcomm Resources
• Supervisor Resources
• Teaching Resources
• Student Publications
• Career in Pharmacy: Job & Salary Outcomes
• International Application Guidelines
• Pharm.D. Admissions Blog
• Request for Information Form
• Scholarships for New Doctor of Pharmacy Students
• Supplemental Application for UGA College of Pharmacy
• Peer Tutoring
• Career Development & Opportunities
• Student Organizations
• Student Research Portal
• TRANSCRIPTS
• How to Give
• Impact Stories
• Annual Giving
• Endowed Giving
• List of Endowed Funds
• Planned Giving
• Matching Gifts
• Undergraduate Program
• Professional Program
• Clinical & Administrative Pharmacy
• International Biomedical Regulatory Sciences & Clinical Trials
• UGA College of Pharmacy COVID-19 Experts and Researchers

Department Contact

LORENZO VILLA-ZAPATA, Ph.D., Pharm.D.

Clinical and Administrative Pharmacy Director of Pharmaceutical Health Services, Outcomes and Policy (PHSOP) Assistant Professor

R.C. Wilson, Rm 260H Office: 706-542-4305 [email protected]

HENRY N. YOUNG, Ph.D., FAPhA

Clinical and Administrative Pharmacy Professor Kroger Professor Department Head

R.C. Wilson, Rm 270J Office: 706-542-0720 [email protected]

Ready to apply to PHSOP?

Get Started >

Quick Links

• How to Apply
• View Departments

Why Pharmacy at UGA?

Ranked 15th out of 141 pharmacy programs in the country by US News & World Report, UGA Pharmacy is at the top of its class. Learn more below:

Accreditation

Start your pharmacy journey.

Apply Today Get More Info

The University of Georgia College of Pharmacy

250 W. Green Street Athens, Georgia 30602

Phone: (706) 542-1911 Fax: (706) 542-5357

• Departments
• News & Events
• Faculty & Staff
• Submit a KACE Ticket

Graduate Programs

Health services research.

Doctoral students in Health Services Research improve population health by focusing on health care delivery systems, providers, the economic forces that shape consumer and provider behavior, and the policy environment in which these relationships exist.

Additional Resources

Health Services Research faculty are members of the Department of Health Services, Policy, and Practice and at the  School of Public Health , and are aligned with world-class research centers, such as the Center for Gerontology and Healthcare Research, the Center for Evidence Synthesis in Health and the Center for Long-Term Quality and Innovation, and the Center for Health System Sustainability and Information Futures Lab. 

Major areas of faculty activity include long term care research, pharmaceutical health services research, eliminating racial disparities, evaluation of state and national policies, and end of life care. Strengths of the program include its student-centric approach to learning, high faculty-to-student ratio, and hands-on experience conducting supervised research.

Application Information

Application in  SOPHAS

Application Requirements

Gre subject:.

Not required

GRE General:

Official transcripts:, letters of recommendations:, personal statement:, additional requirements:.

• Application Fee

International Applicants:

• Language Proficiency (TOEFL or IELTS if applicable)
• Transcript Evaluation (if applicable)

Comprehensive application requirements are detailed on the School of Public Health's  admissions requirements website .

Dates/Deadlines

Application deadline, completion requirements.

24 credits (or 16 with a prior relevant graduate degree), successful completion of written comprehensive exams in methods and a substantive area, and successful defense of an independent dissertation.

Alumni Careers

Contact and Location

Department of health services, policy & practice, mailing address.

• Program Faculty
• Program Handbook
• Graduate School Handbook
• Public Health Career Outcomes

Skip to Content

• Campus Directory
• Events Calendar
• Human Resources
• Student Services
• Auraria Library
• CU Denver Police
• University Policies

Schools and Colleges

• College of Architecture and Planning
• College of Arts & Media
• Business School
• School of Education & Human Development
• College of Engineering, Design and Computing
• Graduate School
• College of Liberal Arts and Sciences
• School of Public Affairs

Campus Affiliates

• CU Anschutz Medical Campus
• CU Colorado Springs

Other ways to search:

• University Directory

Ph.D. in Health Economics

The Ph.D. in Health Economics is designed to train scientists to engage in modern economic research related to questions pertinent to the health care sector and to personal and public health.  It is an on-campus program. Students take courses both from the Economics Department, which is housed in the College of Liberal Arts and Sciences, and from the Health Systems, Management & Policy (HSMP) Department, which is housed in the Colorado School of Public Health. The ECON coursework grounds students in rigorous economic theory and modern statistical methods, whereas the HSMP coursework connects students to institutional details of the health care sector, administrative data methods, grant writing, and the development of interdisciplinary health care research.

• All our econ programs are classified as STEM fields.
• The Ph.D. program in Health Economics is an in-person program.  Students cannot complete the degree remotely.

Learning Outcomes

Upon completing the Ph.D. degree in Health Economics, students will be able to:

• Understand the economic approach to studying the healthcare sector, health behaviors, and health outcomes.
• Understand how different markets function in the health care sector, such as the market for health care, health insurance, health labor (such as physicians and nursing), and pharmaceuticals.
• Understand the challenges in identifying causal relationships using health data. 
• Use and develop statistical and econometric models, based on economic theory, to analyze various economic issues and make policy recommendations.
• Communicate, in written form and verbally, theoretical and econometric findings to an audience of economics professionals and to a general audience. 

The Emphasis of the Program

Students begin the program with extensive training in microeconomic theory along with substantial exposure to applied econometrics and quantitative analysis. This training includes working with large and diverse data sets, and becoming proficient using statistical software. The Ph.D. core and elective courses provides the foundation for students to engage in innovative and original research in health economics, including evaluating the effectiveness of health interventions and health policy, and conducting economic cost-benefit analysis.

Financial Aid

General financial aid is managed and awarded to students through the CU Denver Office of Financial Aid (FAFSA code: 004508). You can find more information  here . The department offers specific financial assistance to Ph.D. students in form of partial tuition scholarships, teaching assistantships (TAs), research assistantships (RAs), and grader positions. These positions are awarded on a competitive basis, and are initially based on information provided in the student’s application to the Ph.D. program. Students admitted to the Ph.D. program are automatically considered for a gradaute assistantship position. No separate application or further information is needed.

Note: The University of Colorado Denver is a member of Western Regional Graduate Program . Qualified students admitted to this program who are residents of one of the 15 WICHE states may be eligible for in-state tuition.

Ph.D. Program Resources

• Degree Requirements
• Admission Requirements / How to Apply
• Ph.D. Student Directory

M.S. in Health Economics

Certificate Programs

Contact Information

For general admissions questions contact the Graduate School at [email protected] or 303-315-0049.

For questions about the Ph.D. in Health Economics program contact the Graduate Advisor at [email protected]

• Website Feedback
• Privacy Policy
• Legal Notices
• Accreditation

© 2021  The Regents of the University of Colorado , a body corporate. All rights reserved.

Accredited by the Higher Learning Commission . All trademarks are registered property of the University. Used by permission only.

What Is Health Outcomes Research?

Industry Advice Healthcare

Health outcomes research plays a key role in promoting a patient’s quality of life and has become increasingly popular for healthcare professionals working to improve the quality of care. It reveals the value of health data through large-scale analytics, showing what works for whom and at what cost.

Read on to learn about the importance of health outcomes research and its connection to real-world evidence.

What Are Health Outcomes?

Health outcomes are changes in health as a result of a specific healthcare intervention.

According to Kristin Kostka, director of the OHDSI Center at Northeastern University’s Roux Institute, “Anything that happened to you that describes your health state could be considered a potential health outcome.”

For instance, will getting the Johnson & Johnson one-dose vaccine keep me from getting severe COVID, or will diet and exercise help me live longer? These are examples of health outcomes.

Health outcomes research, sometimes called health economics or outcomes research, is the methodology used to measure the results of various healthcare interventions. Simply put, it helps determine what works and what doesn’t. The objective of health outcomes research is to improve health-related quality of life.

Health outcomes research can come from a variety of sources:

• Clinical observations from clinical trials
• Patient-reported outcomes from patients’ own observations and experiences
• Financial impacts of what the financial outcomes are
• Measurable data , such as mortality rates and other measurable outcomes

Why Is Health Outcomes Research Important?

Health outcomes research is an important part of working to prevent adverse medical events and reduce a patient’s risk of harm.

“A lot of the time we’re reactive, but good, systematic, large-scale health outcomes research is  the framework for how we improve health outcomes overall,” Kostka says.

The data collected allows both researchers and consumers to have good information to work with regarding the best quality of care.

Health Outcomes Research and Real-World Evidence

So how does health outcomes research connect to real-world evidence? According to the U.S. Food and Drug Administration (FDA), real-world evidence (RWE) is the culmination of clinical evidence regarding the usage and potential benefits or risks of a procedure or medical product derived from analysis of real-world data. Health outcomes research and RWE work together by turning the data into evidence.

“It’s the rigor and process by which health outcomes researchers take information generated by patients or in their routine healthcare services and turn that into a rigorously validated piece of information that can be used for decision making,” Kostka notes.

Kostka explains that doesn’t mean health outcomes research doesn’t inform decision making, but generally, RWE indicates that something can pass a regulatory grade assessment, which is a stringent bar. For example, in the context of therapies on market: are they working, not working; is it safe, not safe?

Health outcomes researchers could be looking at a whole number of other things like disability research or social determinants of health. While not all of these get turned into evidence, they’re still important to know.

Is A Career in Health Outcomes Research for You?

Now that you’ve learned more about health outcomes research and how it relates to real-world evidence, are you interested in becoming a health outcomes researcher? If so, Northeastern can help.

Most health outcomes researcher jobs—roughly 66 percent—require at least a master’s degree. If you’re ready to get started in this exciting field, consider Northeastern’s Master of Science in Real-World Evidence in Healthcare and Life Sciences.

Subscribe below to receive future content from the Graduate Programs Blog.

About shayna joubert, related articles.

3 Reasons Why You Need a Real-World Evidence Degree

What Is Real-World Evidence and How Is It Used?

Top Real-World Evidence Careers

Did you know.

Advanced degree holders earn a salary an average 25% higher than bachelor's degree holders. (Economic Policy Institute, 2021)

Northeastern University Graduate Programs

Explore our 200+ industry-aligned graduate degree and certificate programs.

Most Popular:

Tips for taking online classes: 8 strategies for success, public health careers: what can you do with an mph, 7 international business careers that are in high demand, edd vs. phd in education: what’s the difference, 7 must-have skills for data analysts, in-demand biotechnology careers shaping our future, the benefits of online learning: 8 advantages of online degrees, how to write a statement of purpose for graduate school, the best of our graduate blog—right to your inbox.

Stay up to date on our latest posts and university events. Plus receive relevant career tips and grad school advice.

By providing us with your email, you agree to the terms of our Privacy Policy and Terms of Service.

Keep Reading:

Healthcare Leadership: What Is It and Why Is It Important?

How To Develop a Project Scope Statement in 8 Steps

What Do Pharmacists Do? Roles and Responsibilities

Should I Go to Grad School: 4 Questions To Consider

Boston University Academics

Boston University

• Campus Life
• Schools & Colleges
• Degree Programs
• Search Academics

PhD in Health Services & Policy Research

For contact information, please visit the School of Public Health website .

The Doctor of Philosophy in Health Services & Policy Research (PhD) degree program offered by the Department of Health Law, Policy & Management is designed to provide individuals with excellent research skills for use in academic, industry, or government settings. Students have the opportunity to collaborate with senior faculty in innovative research crucial to the improvement of healthcare delivery, treatment outcomes, and government policies. Graduates are known for their excellent methodological skills and substantive knowledge of healthcare settings and policies, competencies that enable students to translate research findings into practical applications.

The doctoral program supports a focus on quantitative methods and qualitative methods, while fostering facility with mixed methods designs.

Learning Outcomes

Upon completion of the PhD in Health Services & Policy Research (HSPR), the graduate is able to:

• Analyze key factors that have the potential to influence health and provision and use of health services. These may include policy, organization, and financing of healthcare services. They may also include social, economic, cultural, political, and biological factors that influence population health, health equity, and the use of services.
• Critique, adapt, and develop theoretical analyses of health services and policies, including explanations of their structures and processes, the use of health services, the effectiveness and implementation of health policies, and the effects of health services and policies on individual and population health and health equity. This may be done by drawing upon the foundational fields of sociology, economics, anthropology, political science, psychology, demography, epidemiology, management, and/or organizational science.
• Develop original, relevant, and important research questions to pursue in HSPR that are grounded in both a critical analysis of prior HSPR literature and relevant theoretical perspectives.
• Identify and analyze the strengths and weaknesses of a variety of possible study designs that can appropriately address specific HSPR questions. Appropriate methods may employ experimental or observational approaches, qualitative or quantitative analytic techniques, and a variety of data types.
• Based on relevant theory and selected research question(s), develop an HSPR design, specifying study constructs, research objectives, hypotheses, and methods that reliably and validly measure outcomes of interest. Select optimal analytical approaches, in combination as necessary, to investigate hypotheses.
• Acquire and manage appropriate data to answer HSPR questions. Collect and manage primary health and healthcare utilization data and/or assemble and manage existing data from public and private data sources in accordance with an original research design.
• Apply appropriate analytical techniques to data in order to investigate HSPR questions. Utilize appropriate combinations of analytic techniques to enrich data analysis and interpretation.
• Develop, document, and employ procedures that ensure the reproducibility of the science, the responsible use of resources, mutual accountability with collaborators, and the ethical treatment of research subjects.
• Effectively communicate the process, findings, and implications of HSPR using multiple modes, including via peer-reviewed publications, oral presentations, and electronic media. Translate findings to multiple stakeholders and audiences including funders, research participants, colleagues, policymakers, news media, and managers.

Program Requirements

The doctoral program includes the coursework requirements outlined below, which typically total at least 42 units. Students with an earned master’s degree may take fewer courses, if course waivers are granted based on previous relevant graduate coursework. However, in all cases, students are required to take no fewer than 32 units of PhD coursework in residence at Boston University post-matriculation into the PhD program. A minimum grade of a B is required in all PhD coursework.

Foundations of Public Health

Effective public health requires expertise from many disciplines, and students need to have a broad foundation of knowledge across these diverse disciplines in order to collaborate effectively with other health professionals.

SPH PH 700 Foundations of Public Health (0 units) is an online course designed to provide students with foundational knowledge in the profession and science of public health and factors related to public health. PH 700 meets the foundational knowledge criteria (as outlined by CEPH) for all SPH students.

Core PhD Courses

• SPH PH 842 Research Theory and Design (2 units)
• SPH PH 843 Quantitative Methods for Health and Social Policy Research (2 units)
• SPH PH 844 Introduction to Qualitative Methods for Health and Social Policy Research (2 units)
• SPH PM 820 Introduction to Quality Measurement and Evaluation (2 units)
• SPH PM 822 Advanced Quantitative Methods for Health and Social Policy Research (4 units)
• SPH PM 828 Advanced Qualitative Methods (4 units)
• SPH PM 842 Health Economics for Health and Social Policy Research or equivalent (4 units)
• SPH PM 846 Advanced Quantitative Policy and Program Implementation and Evaluation (4 units)
• SPH PM 864 Contemporary Structures of Health Services (2 units)
• SPH PM 866 Theory in the Analysis of Health Services (2 units)

Additional Course Requirements

• Healthcare Policy
• Implementation Science/Organizational Change
• Quality/Outcomes

Students are required to complete all the requirements for graduation within seven years of matriculation. PhD students are required to successfully complete the qualifying process, and complete and orally defend a dissertation.

Students who have completed the PhD coursework must register for SPH PM 980 Continuing Study each fall and spring term until the dissertation is defended and accepted. PM 980 is ungraded and 0 units; it allows a student to be certified as full time and carries the equivalent of a 2-unit tuition charge plus the fee for student health insurance (unless waived). Students must adhere to dissertation submission deadlines and requirements.

All PhD students must adhere to the Doctoral Graduation Calendar in preparing and submitting the dissertation.

All SPH students will need a laptop or tablet for classes, purchased according to the recommendations of the Medical Campus Information Technology professionals.

Related Bulletin Pages

• Abbreviations and Symbols

Beyond the Bulletin

• School of Public Health
• SPH Admissions
• SPH Academic Calendar
• Master of Public Health
• Health Equity
• Dual Degree Programs
• Business Administration & Public Health
• Genetic Counseling & Public Health MS/MPH
• Medical Sciences & Public Health MS/MPH
• Medicine & Public Health MD/MPH
• Social Work & Public Health MSW/MPH
• Doctor of Public Health in Leadership, Management & Policy
• Applied Biostatistics
• Biostatistics
• Climate and Health
• Environmental Health
• Epidemiology
• Global Health Research
• Health Services & Policy Research
• Population Health Research
• Public Health Data Science
• Translation and Implementation Science
• Boston Consortium
• Departments

Terms of Use

Note that this information may change at any time. Read the full terms of use .

related websites

Accreditation.

Boston University is accredited by the New England Commission of Higher Education (NECHE).

• © Copyright
• Mobile Version

• Skip to main content
• Skip to main navigation

PhD in Health Services Research

Become a thought leader in the healthcare profession.

The purpose of the PhD program in Health Services Research in the Hankamer School of Business is to train researchers in cutting edge data analysis skills. The individuals completing the program will primarily work in large health systems and provide detailed and rigorous analysis that will help managers make decisions to improve the quality and/or lower the cost of health services delivered. Why a Baylor PhD?

Distinctives

The PhD Program is unique among many health services and health policy oriented doctoral programs as it is designed with the inclusion of a Master of Science (MS) in Economics degree to be completed prior to entering the dissertation phase of the program. This component of the PhD curriculum reflects the strong emphasis on economic theory and empirical techniques to guide students' research.

The Hankamer School of Business is also home to other health care-focused academic endeavors, including the Robbins Institute for Health Policy and Leadership , which supports the schools’ healthcare MBA program. Additionally, Baylor is a proud member of the Business School Alliance for Health Management ( BAHM ), a consortium of business-school healthcare programs at 17 leading universities.

BAHM journal: Health Management, Policy, and Innovation

Is This the Program for You?

Our program is highly selective, and most or all students receive considerable financial support. Admission with an offer of financial support typically requires a strong academic record — ideally with considerable training in Statistics, Mathematics, and Economics. If you have this background and a strong desire to acquire cutting-edge research skills and use them to improve health care delivery in the US and around the world, we encourage you to apply. Learn more about our admissions processes .

More About Our Faculty:

• Featured Publications

Program Directors

Dr. Michael Richards [email protected]

Dr. Scott Cunningham [email protected]

• Hankamer School of Business

Paul L. Foster Campus for Business and Innovation 1621 S 3rd St. Waco, TX 76706

One Bear Place #98001 Waco, TX 76798

• General Information
• Academics & Research
• Administration
• Gateways for ...
• About Baylor
• Give to Baylor
• Pro Futuris
• Social Media
• College of Arts & Sciences
• Diana R. Garland School of Social Work
• George W. Truett Theological Seminary
• Graduate School
• Honors College
• Louise Herrington School of Nursing
• Research at Baylor University
• Robbins College of Health and Human Sciences
• School of Education
• School of Engineering & Computer Science
• School of Music
• University Libraries, Museums, and the Press
• More Academics
• Compliance, Risk and Safety
• Human Resources
• Marketing and Communications
• Office of General Counsel
• Office of the President
• Office of the Provost
• Operations, Finance & Administration
• Senior Administration
• Student Life
• University Advancement
• Undergraduate Admissions
• Graduate Admissions
• Baylor Law School Admissions
• Social Work Graduate Programs
• George W. Truett Theological Seminary Admissions
• Online Graduate Professional Education
• Virtual Tour
• Visit Campus
• Alumni & Friends
• Faculty & Staff
• Prospective Faculty & Staff
• Prospective Students
• Anonymous Reporting
• Annual Fire Safety and Security Notice
• Cost of Attendance
• Digital Privacy
• Legal Disclosures
• Mental Health Resources
• Web Accessibility

• News & Events
• Faculty & Staff

A world-class city filled with art and culture and an incredible campus that offers cutting edge resources–that’s what students receive at Penn Nursing. And that’s just the start. Penn Nursing and the wider university offer something for everyone, as well as a lifelong community.

Penn Nursing is globally known for educating dynamic nurses—because our School values evidence-based science and health equity. That’s where our expertise lies, whether in research, practice, community health, or beyond. Everything we do upholds a through-line of innovation, encouraging our exceptional students, alumni, and faculty share their knowledge and skills to reshape health care.

Penn Nursing students are bold and unafraid, ready to embrace any challenge that comes their way. Whether you are exploring a career in nursing or interested in advancing your nursing career, a Penn Nursing education will help you meet your goals and become an innovative leader, prepared to change the face of health and wellness.

Penn Nursing is the #1-ranked nursing school in the world. Its highly-ranked programs help develop highly-skilled leaders in health care who are prepared to work alongside communities to tackle issues of health equity and social justice to improve health and wellness for everyone.

Penn Nursing’s rigorous academic curricula are taught by world renowned experts, ensuring that students at every level receive an exceptional Ivy League education . From augmented reality classrooms and clinical simulations to coursework that includes experiential global travel to clinical placements in top notch facilities, a Penn Nursing education prepares our graduates to lead.

David (Hyunmin) Yu, PhD, RN, AGACNP-BC

Preferred pronouns, cohort year, faculty advisor.

Matthew D. McHugh, PhD, JD, MPH, RN, CRNP, FAAN

David (Hyunmin) Yu, PhD, RN, AGACNP-BC, is a postdoctoral fellow at the Center for Health Outcomes and Policy Research. His research focuses on health equity for LGBTQ+ individuals, particularly within healthcare settings. For his PhD dissertation, conducted under the mentorship of Dr. José Bauermeister, he utilized Healthcare Equality Index data from the Human Rights Campaign to explore multilevel factors, including hospital and state-level influences, that affect LGBTQ+ inclusivity in policies and practices in U.S. health systems. Additionally, he conducted qualitative interviews with chief nursing officers and chief executive officers nationwide to gather their insights on facilitators, barriers, and effective strategies for implementing LGBTQ+ inclusive practices in health systems. As a postdoctoral fellow, Dr. Yu plans to expand his research by investigating how hospitals’ inclusive policies and practices impact diverse nurse and patient outcomes.

Dr. Yu received his BSN from Inje University in South Korea and his MSN in Adult-Gerontology Acute Care Nurse Practitioner, as well as his PhD, from the University of Pennsylvania School of Nursing.

Selected Publications

• Yu, H. , Bonett, S., Oyiborhoro, U., Aryal, S., Kim, A., Kornides, M.L., Jemmott, J.B., Glanz, K., Villarruel, A.M., & Bauermeister, J.A. (2024). Psychosocial correlates of parents’ willingness to vaccinate their children against COVID-19. PLoS ONE , 19 (6), e0305877. https://doi.org/10.1371/journal.pone.0305877 .
• Yu, H. , Bauermeister, J.A., Oyiborhoro, U., Aryal, S., Lipman, T.H., Tan, A.S.L., Glanz, K., Villarruel, A. & Bonett, S. (2024). Trust in federal COVID-19 vaccine oversight and parents’ willingness to vaccinate their children against COVID-19: A cross-sectional study. BMC Public Health , 24 (1), 830. https://doi.org/10.1186/s12889-024-18342-y .
• Yu, H. , Flores, D.D., Bonett, S., & Bauermeister, J.A. (2023). LGBTQ+ cultural competency training for health professionals: A systematic review. BMC Medical Education, 23, 558. https://doi.org/10.1186/s12909-023-04373-3 .
• Yu, H. , Bauermeister, J.A., & Flores, D.D. (2023). LGBTQ+ health education interventions for nursing students: A systematic review. Nurse Education Today , 121 , 105661. https://doi.org/10.1016/j.nedt.2022.105661 .
• Gomez, S., Anderson, B.J., Yu, H. , Gutsche, J., Jablonski, J., Martin, N., Kerlin, M.P., & Mikkelsen, M.E. (2020). Benchmarking critical care well-being: Before and after the COVID-19 pandemic. Critical Care Explorations , 2 (10):e0233. https://doi.org/10.1097/CCE.0000000000000233 .

Related Stories

Advocating for Implementing a Nurse Practitioner System in Korea

In April 2023, David (Hyunmin) Yu, MSN, RN, AGACNP-BC, CCRN, TCRN, Nurse Practitioner in the PPMC Medical Intensive Care Unit, was invited to Seoul, South Korea, to speak at the largest national critical care medicine conference in South Korea, organized by the Korean Society of Critical Care Medicine. By Sara Rubins and Bridget McQuate, Penn Presbyterian Medical Center 5 Things to Know Newsletter

See Yourself Here

The Role of Patient-Reported Outcomes to Measure Treatment Satisfaction in Drug Development

• Leading Article
• Open access
• Published: 08 July 2024

Cite this article

You have full access to this open access article

• Carolina Navas   ORCID: orcid.org/0000-0002-3717-398X 1 ,
• Alexandra Palmer Minton 2 &
• Ana Maria Rodriguez-Leboeuf 1  

170 Accesses

2 Altmetric

Explore all metrics

Treatment satisfaction is a person’s rating of his or her treatment experience, including processes and outcomes. It is directly related to treatment adherence, which may be predictive of treatment effectiveness in clinical and real-world research. Consequently, patient-reported outcome (PRO) instruments have been developed to incorporate patient experience throughout various stages of drug development and routine care. PRO instruments enable clinicians and researchers to evaluate and compare treatment satisfaction data in different clinical settings. It is important to select fit-for-purpose PRO instruments that have demonstrated adequate levels of reliability, validity, and sensitivity to change to support their use. Some of these instruments are unidimensional while some are multidimensional; some are generic and can be applied across different therapeutic areas, while others have been developed for use in a specific treatment modality or condition. This article describes the role of treatment satisfaction in drug development as well as regulatory and Health Technology Assessment (HTA) decision making and calls for more widespread use of carefully selected treatment satisfaction PRO instruments in early- and late-phase drug development.

Similar content being viewed by others

One programme, four stakeholders: an overview of the utilisation of patient-reported outcomes in intervention development to meet the needs of regulators, payers, healthcare professionals and patients, fit for purpose and modern validity theory in clinical outcomes assessment.

Using Individual Experiences With Experimental Medications to Predict Medication-Taking Behavior Postauthorization: A DIA Study Endpoints Workstream

Avoid common mistakes on your manuscript.

1 Introduction

In the era of patient-centered drug development, it is critical for drug developers, regulators, payers, and researchers to collect and understand the patients’ perspectives on drugs (and other treatments) during their development [ 1 , 2 ]. When a treatment is approved and made available for clinical use, data on how patients feel whilst taking the treatment provides healthcare professionals and patients with valuable insights, enabling the delivery of evidence-based medicine. Evidence-based medicine refers to the application of the best available research to clinical care, which requires the integration of evidence with clinical expertise and patient values [ 3 ]. The measurement of treatment satisfaction using a PRO instrument offers a standardized way of generating such data during treatment development.

2 Treatment Satisfaction Definition

Treatment satisfaction is defined as the individual’s rating of important attributes of the process and outcomes of their treatment experience [ 4 , 5 ]. An individual’s satisfaction with a treatment will be influenced by their knowledge and experience of the treatment. Specifically, perceived or experienced treatment effectiveness, administration complexity and convenience, discomfort and side effects (see the Decisional Balance Model of Treatment Satisfaction [ 6 ]; Fig. 1 a), as well as cost of the treatment will inform how satisfied or dissatisfied an individual is with a treatment [ 7 ]. Patient expectations, demographic characteristics (age and education), and personal preferences can also affect treatment satisfaction, as can prior experience with disease and with treatment [ 8 ].

Treatment satisfaction framework: a Decision balance model of treatment satisfaction. b Adaptation of Weaver and colleagues' conceptual model of treatment satisfaction [ 9 ]

Treatment satisfaction can be a useful concept for researchers, intervention developers, and healthcare professionals wishing to understand the patient experience with treatment, and to differentiate among alternative treatments. Understanding treatment satisfaction can also help with understanding the likelihood of adherence and persistence to treatment [ 4 ]. This can ultimately lead to improved health status as depicted in the conceptual framework of treatment satisfaction developed by Weaver and colleagues [ 9 ] (Fig. 1 b).

The association between treatment satisfaction, adherence, and persistence is clinically intuitive. If a patient is not satisfied with treatment, this feeling may negatively affect his or her behavior in terms of regimen execution as well as his or her willingness to persist with the treatment [ 6 ]. The connection between treatment satisfaction and persistence is even more important in chronic diseases where up to one half of patients make medication-related decisions without seeking medical advice [ 10 ]. Indeed, in chronic diseases, patient dissatisfaction (rather than clinical consultation and decision making) is one of the main drivers of treatment discontinuation [ 6 , 11 , 12 , 13 ], which in turn can lead to an increased rate of complications, deterioration in health, and ultimately death [ 6 , 14 , 15 ].

Understanding treatment satisfaction across multiple treatments can also help to predict patient preferences for alternative treatments—an important consideration when there are several options for treatment that involve alternate routes of administration, types of medication, or drug regimens [ 16 ] [ 17 ]. Research in oncology has shown, for instance, that treatment satisfaction and adherence are highest when people are offered treatment that is in line with their own preferences [ 18 ].

3 Treatment Satisfaction Measurement

Treatment satisfaction is a highly individual and personal experience. To understand this concept, researchers as well as healthcare providers must rely on patients’ reports [ 4 ]. Patient reports can be generated in two ways: through narrative exploration (i.e., by talking to patients to qualitatively understand their experiences) or through PRO instruments (i.e., using standardized questionnaires to generate quantitative data).

Qualitative research offers the opportunity to explore satisfaction in depth, including drivers of satisfaction and implications of being satisfied/dissatisfied in terms of feelings and behaviors. Qualitative research can, however, be intrusive; reactive to personalities, moods and interpersonal dynamics between interviewer and interviewee; expensive; and time consuming [ 19 ].

PRO instruments are measures of a patient’s perspective as reported directly from the patient without added interpretation by a healthcare worker or anyone else [ 20 ]. PRO instruments offer a way to collect patient information quickly and in a standardized manner and are thus frequently used to evaluate the impact of disease and treatments on the patient’s functioning, well-being, and everyday life in clinical trials [ 4 ].

There are a large number of PRO instruments measuring treatment satisfaction [ 21 ]. They differ on a number of parameters, including number of items, measurement properties, and targeted use.

3.1 Number of Items

Some treatment satisfaction PRO instruments consist of a single item measuring global treatment satisfaction [ 22 ]. Other intruments include multiple items, some of which may contribute to one overall rating of satisfaction, or they may measure different dimensions of satisfaction (efficacy, side effects, convenience) [ 23 ]. Single-item measures offer simplicity and speed. However, use of a single item can mean the loss of important information about how patients view a treatment. Most of the patients that answer single-item questionnaires, for example, report high levels of satisfaction regardless of other negative information [ 24 ].

3.2 Measurement Properties

PRO instruments need to demonstrate that they measure what they were designed to measure in a reliable, valid, and an interpretable way in order to be considered ‘fit for purpose’ to support regulatory, payer, and healthcare decision making. A ‘fit for purpose’ PRO instrument demonstrates the following measurement properties: reliability (internal consistency and test re-test), validity (content and construct), and responsiveness (sensitivity to change) [ 25 ]. Sound measurement properties are not just critical for PRO instruments but rather applicable to all measurement methodologies for data collection [ 26 ]. Without evidence of reliability, validity, and sensitivity to change, the PRO instrument may produce inconsistent results that cannot be replicated or compared across studies, leading to inaccurate or misleading study results and a risk of misattribution of outcomes to the treatment under investigation [ 26 ].

3.3 Targeted Use

Treatment satisfaction PRO instruments can be generic (i.e., designed for use across different disease/therapeutic populations) or disease/context-specific (i.e., built to address those aspects of satisfaction that are important for a particular and specific group of patients) [ 27 ] [ 28 ]. Generic instruments allow for comparisons between diseases, across different populations, or across medication types and patient conditions [ 29 ]. Whereas disease/context-specific instruments arguably possess greater potential for showing differences between competing therapies, they cannot be applied across populations [ 30 ]. Examples of generic and disease-specific questionnaires developed for use in routine care and drug development to assess treatment satisfaction from patients are presented in Tables 1 and 2 , respectively [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].

4 Treatment Satisfaction in Drug Development

The measurement of treatment satisfaction should not be prioritized over efficacy, safety, or survival data (which have been frequently used as primary indicators for drug development [ 52 ]). However, as barriers to developing new products increase, and the number of markets with generic competition or at least multiple alternative treatments grow, satisfaction can be an important secondary endpoint to provide information about how people feel about the treatment they took in the trial and provide evidence of the value (or concerns) of certain treatments. This can support key efficacy, safety, and survival endpoints [ 53 ].

Thus, treatment satisfaction has become an important outcome for drug development [ 54 ], particularly in trials (1) comparing treatments that present differences in terms of efficacy or side effects; (2) comparing treatments that are similar in terms of efficacy but have different routes of administration or dosing schedules; or (3) where demonstration of satisfaction with a medication relative to a comparator is considered to indicate adherence benefits [ 16 ] and/or treatment effectiveness [ 55 ]. Generic and disease-specific, multidimensional, and single-item PRO instruments can be useful to measure treatment satisfaction in clinical trials for novel drugs in development. But to do so, they must have demonstrated evidence of reliability, validity, and responsiveness for the intended use.

The use of PRO treatment satisfaction instruments in clinical research has increased in recent years, in line with various initiatives focusing on increasing the patient perspective in drug development [ 56 ]. From the authors’ recently completed review of clinicaltrials.gov data , it was found that 4978 clinical studies assessed a treatment satisfaction endpoint between 2004 and 2015, and 8488 clinical studies assessed a treatment satisfaction endpoint between 2016 and 2023 (data on file). The evaluation of treatment satisfaction as an outcome in drug development, however, only represents a small fraction of the total studies undertaken during this time (3.3%). The recent development of clear guidelines from regulators for the use of PRO instruments to support clinical trial evidence (e.g., the FDA Patient-Focused Drug Development [PFDD] [ 20 ] guidance), an increased concern towards patient centricity throughout the product evidence lifecycle, and an increase in the development of drugs that differentiate through non-efficacy parameters (e.g., by frequency or modality of administration, side-effect profiles, etc.) suggests that treatment satisfaction endpoints in clinical trials are likely to increase in coming years.

Where treatment satisfaction has been measured in clinical trials, it has tended to be in the later phases of drug development. An analysis of clinicaltrials.gov data on the use of the Treatment Satisfaction Questionnaire for Medication (TSQM) over the 5-year period between 2016–2021 demonstrates that TSQM has been more frequently used in phase III interventional studies than in phase II or phase I trials [ 54 ]. Its use in later phase trials makes sense. Once the safety and efficacy of a drug have been explored in an early phase study, measuring domains of satisfaction helps researchers and sponsors understand why one compound, dose, or method of administration may be preferred over another, predict adherence, and support messages regarding the value of the product to patients. However, treatment satisfaction may also have an important role to play in earlier phases of drug development. Treatment satisfaction in dose finding research (phase I/II) can inform the selection of doses for later trials, especially for products used for the treatment of chronic conditions that require adherence to medication over long periods of time. In such trials, an understanding of satisfaction with treatment can offer some insight and hypotheses [ 24 ]. For example, treatment satisfaction data can evaluate medical treatment in clinical trials, contributes to quality assurance, and facilitates product differentiation [ 57 ]. Specifically, in the field of cancer clinical trials, reported levels of treatment satisfaction added a unique view for the evaluation of treatment efficacy [ 58 ].

Treatment satisfaction data is also important in post-registration (phase IIIb/IV) real-world settings because it can provide valuable insight into the economic valuations and cost-effectiveness assessments of medical products, such as whether or not a treatment is worthy of reimbursement [ 59 ]. Real-world evidence (RWE) studies involve a greater number of diverse patients and in general a more representative population [ 60 ], which can further help inform regulatory decisions, reimbursement, and health policy-making. There are several measures of treatment satisfaction that have been used in RWE studies. For example, the TSQM has been used to measure treatment satisfaction in amyotrophic lateral sclerosis [ 61 ] [ 62 ], the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in acromegalia patients [ 63 ], the Diabetes Treatment Satisfaction Questionnaire (DTSQ) in patients with type 2 diabetes [ 64 ], and the Cancer Therapy Satisfaction Questionnaire (CTSQ) in metastatic squamous cell carcinoma of the head and neck [ 65 ].

Patient-centered drug development is a shift in the way that drugs are developed, involving patients in all phases of drug development. In patient-centered research, patients are considered co-researchers informing the decisions about unmet needs, trial endpoints, trial design, and execution. Drug development companies that incorporate patient voice through treatment satisfaction PRO instruments are more likely to ensure a fit of their product to the patients’ needs in routine practice and provide the benefits patients are seeking. Specifically, treatment satisfaction measures allow for treatment comparison in clinical trials or the identification of the need to switch a patient's treatment in clinical practice. Additionally, these measures can address, among other outcomes, the willingness of patients to accept the negative effects of their treatment, adherence to the prescribed medication, and can be related to the overall effectiveness of their treatment [ 23 ]. Therefore, we highly recommend assessing treatment satisfaction in the different stages of drug development: during the initial development and validation, as well as at the point of implementation and communication of the results. Furthermore, it is more probable that this data can be proactively utilized to aid in regulatory decision making.

5 Treatment Satisfaction in Regulatory Decision Making

The regulatory environment is primed to consider data on treatment satisfaction from drug development. Both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have noted the critical importance of involving patients in the identification of health priorities and the outcomes desired from health interventions and in understanding the patient experience with these interventions [ 66 ]. Data from reliable, valid, and responsive PRO instruments can be considered as ‘fit for purpose’ and help regulators make approval decisions [ 49 , 50 , 51 ].

The EMA has a long history of working with patients and patient data. In 2005, a reflection paper was developed as a framework for interaction between EMA and patients, consumers, and consumer organizations to encourage the collection of PRO data [ 67 ]. In EMA’s ‘Regulatory Science Strategy to 2025,’ one core recommendation is to “ensure the patient voice is incorporated all along the regulatory lifecycle of a medicine”, reflecting the importance the Agency places on such engagement [ 67 ]. The FDA also has a long history of patient engagement, starting from 1988 with the formation of an office to work with patient advocates [ 66 ]. In 2009, the FDA developed the PRO Guidance that outlines the rigor used by regulators to review and evaluate existing, modified, or newly developed PRO instruments to support label claims [ 68 ]. More recently, the FDA launched its PFDD initiative as a commitment to capture and submit patient experience data and other relevant information from patients for drug development and regulatory decision making more systematically [ 20 ].

At the FDA and EMA, evidence supporting efficacy and safety of the medication being developed is included in the ‘label’ at the point of approval (FDA ‘label’ is the US Prescribing Information; EMA label is the Summary of Product Characteristics). The primary purpose of drug labeling is to give healthcare professionals the information they need to prescribe the medicine appropriately [ 69 ]. The label cannot include promotional, false, or misleading statements [ 69 ]. It can, however, include other information deemed to be relevant and important in understanding the medication, assuming that the data is derived from fit-for-purpose measurement in adequate and well-controlled clinical investigations. The EMA considers both single and multidimensional domains—such as health status and satisfaction with treatment—for inclusion in labelling [ 70 ]. While traditionally more focused on core signs and symptoms of disease, recent PFDD guidance and workshop discussion from FDA proposes satisfaction as one component of a benefit–risk appraisal [ 20 ] [ 71 ].

Data extracted from 2010 until 2023 indicates that 57 drugs or medical products have included treatment satisfaction claims in their label, all using PRO instruments [ 43 ]. The EMA has approved 19 drugs (33.3%) and 38 (66.6%) have been approved by the FDA. Various PRO instruments have been used to support these claims, including the aforementioned TSQM which meets the evidence needed by regulators to support label decisions in certain contexts of use [ 57 ]. The TSQM supported six of the aforementioned treatment satisfaction label claims (5/19 drugs the EMA approved with treatment satisfaction claims in their label and 1/38 drugs the FDA approved with treatment satisfaction claims in their label) [ 72 , 73 , 74 , 75 , 76 , 77 ]. However, this represents only a small fraction of drugs approved in this timescale.

Therefore, treatment satisfaction is appealing to agencies because of its utility as a well-known patient-reported endpoint that captures patient experience [ 54 , 57 ]. The assessment of treatment satisfaction plays an increasingly important role in regulatory decision making which ultimately improves the quality and value of health care [ 78 ] [ 79 ].

6 Treatment Satisfaction in Health Technology Assessment (HTA)

HTA agencies play a vital role in assessing the safety, efficacy, cost, and benefits of new treatments [ 80 ], which requires consideration of the patient experience with the given treatment. Patients are going to be the first beneficiaries of health innovation and are best suited to evaluate treatment satisfaction. Therefore, some HTA agencies have been utilizing PRO instruments to capture the patient's voice when evaluating pharmacotherapies or medical technologies.

PRO instruments are a key component of decision making during the benefit–risk appraisal of new drugs or biologic products across different therapeutic areas [ 81 ]. Data from reliable, valid, and responsive (i.e., ‘fit for purpose’) PRO instruments can help HTA bodies make access decisions [ 49 , 50 , 51 ]. For example, when assessing the effectiveness of a drug, not only are the clinical outcomes significant to regulatory and reimbursement agencies, but also the drug's influence on patients’ daily lives, functional status, treatment satisfaction, preferences, and adherence [ 82 ]. The inclusion of treatment satisfaction measures is an effective way to assess and evaluate patient experience with the new treatment by HTA agencies. For example, treatment satisfaction measures can help HTA bodies choose between two treatments that have similar biomedical effects but present differences in terms of side effects, convenience, and mode of administration. Moreover, HTAs look for evidence to help inform formulary decisions, both at launch and during post-launch reviews. They may find that treatment satisfaction data can support and complement the traditional efficacy and safety data available from classical clinical endpoints [ 82 ]. However, there are substantial differences in HTA reimbursement decisions that could be explained by the different processes and policies in place at different HTA agencies, such as criteria for the extent of added value versus cost effectiveness [ 83 ]. Such discrepancies across countries make it challenging for sponsors not only to identify and utilize appropriate PRO instruments to capture the patient experience but also to develop appropriate methodologies for capturing these data within both clinical trial and real-world settings. However, HTA bodies have recognized treatment satisfaction can confirm clinical benefits and support reimbursement recommendations, and thus it is essential to continue to include treatment satisfaction as a key assessment throughout the drug development and commercialization process.

7 A Call to Action

Patients are in a unique position to provide treatment satisfaction assessment as they are the ones who experience the effectiveness and side effects of the therapy. Several PRO instruments offer robust fit-for-purpose (reliable, valid, sensitive) measurement of treatment satisfaction, and research has shown these can predict the likelihood of patients continuing to use their medication, the correct usage of the medication, and adherence to the treatment. It is also known that treatment satisfaction can support drug development and needs to be considered by most of the stakeholders involved in the healthcare system, from development to launch of a product and within routine clinical practice use. Moreover, the FDA and EMA have approved treatment satisfaction in label claims of certain medications. Measuring treatment satisfaction more frequently in clinical trials and studies will give us a comprehensive understanding of patient health status, facilitating appropriate and optimal treatment decisions and improving future drug development.

We encourage measuring treatment satisfaction across the phases of interventional studies and RWE studies as doing so can be beneficial for the different stakeholders involved in drug development and regulatory decision making: (1) for pharmaceutical companies, satisfaction with a specific type of medication should lead to a differential advantage in the marketplace, product success, manufacturer profitability, and better market access; (2) for healthcare systems, understanding patient satisfaction is a critical pillar to develop more efficient and effective care models; (3) for patients, higher treatment satisfaction can lead to increased treatment adherence and better clinical outcomes.

Algorri M, Cauchon NS, Christian T, O’Connell C, Vaidya P. Patient-centric product development: a summary of select regulatory CMC and device considerations. J Pharm Sci. 2023;112(4):922–36. https://doi.org/10.1016/j.xphs.2023.01.029 . ( Epub 2023 Feb 3 ).

Article   CAS   PubMed   Google Scholar  

van Overbeeke E, Vanbinst I, Jimenez-Moreno AC, Huys I. Patient centricity in patient preference studies: the patient perspective. Front Med. 2020;7:93.

Article   Google Scholar  

Reena Pattani, Sharon E. Straus. What is EBM?.BMJ Best Practice. 2023. https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-ebm/ . Accessed 10 Oct 2023.

Revicki D. Patient assessment of treatment satisfaction: methods and practical issue. Gut. 2004. https://doi.org/10.1136/gut.2003.0343225 .

Article   PubMed   PubMed Central   Google Scholar  

Salame N, Perez-Chada LM, Singh S, CallisDuffin K, Garg A, Gottlieb AB, et al. Are your patients satisfied a systematic review of treatment satisfaction measures in psoriasis. Dermatology. 2018;234(5–6):157–65.

Article   PubMed   Google Scholar  

Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, et al. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;2(1):12.

Barbosa CD, Balp MM, Kulich K, Germain N, Rofail D. A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence. Patient Prefer Adherence. 2012;6:39–48.

Kravitz RL. Patients’ expectations for medical care: an expanded formulation based on review of the literature. Med Care Res Rev MCRR. 1996;53(1):3–27.

Weaver M, Patrick DL, Markson LE, Martin D, Frederic I, Berger M. Issues in the measurement of satisfaction with treatment. Am J Manag Care. 1997;3(4):579–94 ( PMID: 10169526 ).

CAS   PubMed   Google Scholar  

Lemay J, Waheedi M, Al-Sharqawi S, Bayoud T. Medication adherence in chronic illness: do beliefs about medications play a role? Patient Prefer Adherence. 2018;12:1687–98.

Fernandez-Lazaro CI, García-González JM, Adams DP, Fernandez-Lazaro D, Mielgo-Ayuso J, Caballero-Garcia A, et al. Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC Fam Pract. 2019;20(1):132.

Schoemaker JH, Vingerhoets AJJM, Emsley RA. Factors associated with poor satisfaction with treatment and trial discontinuation in chronic schizophrenia. CNS Spectr. 2019;24(4):380–9.

Baryakova TH, Pogostin BH, Langer R, McHugh KJ. Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nat Rev Drug Discov. 2023;22(5):387–409.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Fenton JJ, Jerant AF, Bertakis KD, Franks P. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med. 2012;172(5):405–11.

Hamine S, Gerth-Guyette E, Faulx D, Green BB, Ginsburg AS. Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. J Med Internet Res. 2015;17(2): e3951.

Shikiar R, Rentz AM. Satisfaction with medication: an overview of conceptual, methodologic, and regulatory issues. Value Health J Int Soc Pharmacoecon Outcomes Res. 2004;7(2):204–15.

Lindhiem O, Bennett CB, Trentacosta CJ, McLear C. Client preferences affect treatment satisfaction, completion, and clinical outcome: a meta-analysis. Clin Psychol Rev. 2014;34(6):506–17.

Fallowfield L, Osborne S, Langridge C, Monson K, Kilkerr J, Jenkins V. Implications of subcutaneous or intravenous delivery of trastuzumab; further insight from patient interviews in the PrefHer study. Breast. 2015;24(2):166–70. https://doi.org/10.1016/j.breast.2015.01.002 . ( Epub 2015 Jan 24 PMID: 25623753 ).

Matrisch L, Rau Y, Karsten H, Graßhoff H, Riemekasten G. The Lübeck medication satisfaction questionnaire—a novel measurement tool for therapy satisfaction. J Pers Med. 2023;13(3):505.

Research C for DE and. FDA Patient-Focused Drug Development Guidance Series for Enhancing the Incorporation of the Patient’s Voice in Medical Product Development and Regulatory Decision Making. FDA [Internet]. 2023; https://www.fda.gov/drugs/development-approval-process-drugs/fda-patient-focused-drug-development-guidance-series-enhancing-incorporation-patients-voice-medical . Accessed 10 Oct 2023

Churruca K, Pomare C, Ellis LA, Long JC, Henderson SB, Murphy LED, et al. Patient-reported outcome measures (PROMs): A review of generic and condition-specific measures and a discussion of trends and issues. Health Expect Int J Public Particip Health Care Health Policy. 2021;24(4):1015–24.

Google Scholar  

Waltz TJ, Campbell DG, Kirchner JE, Lombardero A, Bolkan C, Zivin K, et al. Veterans with depression in primary care: provider preferences, matching, and care satisfaction. Fam Syst Health. 2014;32(4):367–77.

Speight J. Assessing patient satisfaction: concepts, applications, and measurement. Value Health. 2005;8:S6-8.

Hareendran A, Abraham L. Using a treatment satisfaction measure in an early trial to inform the evaluation of a new treatment for benign prostatic hyperplasia. Value Health. 2005;8(Suppl 1):S35-40. https://doi.org/10.1111/j.1524-4733.2005.00074.x . ( PMID: 16336487 ).

Ahmed I, Ishtiaq S. Reliability and validity importance in medical research. J Pak Med Assoc. 2021;8(71):2403.

Clinton-McHarg T, Yoong SL, Tzelepis F, Regan T, Fielding A, Skelton E, et al. Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: a systematic review. Implement Sci. 2016;11(1):148.

Liberato ACS, Rodrigues RCM, São-João TM, Alexandre NMC, Gallani MCBJ. Satisfaction with medication in coronary disease treatment: psychometrics of the Treatment Satisfaction Questionnaire for Medication. Rev Lat Am Enfermagem. 2016;24(e2705):S0104-11692016000100334.

PubMed   Google Scholar  

Usmani SZ, Mateos MV, Hungria V, Iida S, Bahlis NJ, Nahi H, et al. Greater treatment satisfaction in patients receiving daratumumab subcutaneous vs. intravenous for relapsed or refractory multiple myeloma: COLUMBA clinical trial results. J Cancer Res Clin Oncol. 2021;147(2):619–31.

Delestras S, Roustit M, Bedouch P, Minoves M, Dobremez V, Mazet R, et al. Comparison between two generic questionnaires to assess satisfaction with medication in chronic diseases. PLoS ONE. 2013;8(2): e56247.

McKenna SP. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science. BMC Med. 2011;14(9):86.

Ruiz MA, Pardo A, Rejas J, Soto J, Villasante F, Aranguren JL. Development and validation of the “Treatment Satisfaction with Medicines Questionnaire” (SATMED-Q). Value Health J Int Soc Pharmacoecon Outcomes Res. 2008;11(5):913–26.

Rejas J, Ruiz M, Pardo A, Soto J. Detecting changes in patient treatment satisfaction with medicines: the SATMED-Q. Value Health. 2013;16(1):88–96.

Atkinson MJ, Kumar R, Cappelleri JC, Hass SL. Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM Version II) among Outpatient Pharmacy Consumers. Value Health. 2005;8:S9-24.

Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009;7(1):36.

Regnault A, Balp MM, Kulich K, Viala-Danten M. Validation of the treatment satisfaction questionnaire for medication in patients with cystic fibrosis. J Cyst Fibros Off J Eur Cyst Fibros Soc. 2012;11(6):494–501.

Zyoud SH, Al-Jabi SW, Sweileh WM, Morisky DE. Relationship of treatment satisfaction to medication adherence: findings from a cross-sectional survey among hypertensive patients in Palestine. Health Qual Life Outcomes. 2013;11(1):191.

Contoli M, Rogliani P, Di Marco F, Braido F, Corsico AG, Amici CA, et al. Satisfaction with chronic obstructive pulmonary disease treatment: results from a multicenter, observational study. Ther Adv Respir Dis. 2019;13:1753466619888128.

Hao J, Pitcavage J, Jones JB, Hoegerl C, Graham J. Measuring adherence and outcomes in the treatment of patients with multiple sclerosis. J Osteopath Med. 2017;117(12):737–47.

Khdour MR, Awadallah HB, Al-Hamed DH. Treatment satisfaction and quality of life among type 2 diabetes patients: a cross-sectional study in West Bank, Palestine. J Diabetes Res. 2020;25(2020):1834534.

Abdshah A, Parsaeian M, Nasimi M, Ghiasi M. Validating the “Treatment Satisfaction Questionnaire for Medication” in Persian and Evaluating Treatment Satisfaction Among Patients With Psoriasis. Value Health Reg Issues. 2022;29:16–20.

Fijen LM, Klein PCG, Cohn DM, Kanters TA. The disease burden and societal costs of hereditary angioedema. J Allergy Clin Immunol Pract. 2023;11(8):2468-2475.e2.

Peipert JD, Beaumont JL, Bode R, Cella D, Garcia SF, Hahn EA. Development and validation of the functional assessment of chronic illness therapy treatment satisfaction (FACIT TS) measures. Qual Life Res. 2014;23(3):815–24.

ePROVIDE TM -Online Support for Clinical Outcome Assessments [Internet]. ePROVIDE - Mapi Research Trust. https://eprovide.mapi-trust.org/ . Accessed 10 Oct 2023

Bradley C, Plowright R, Stewart J, Valentine J, Witthaus E. The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) evaluated in insulin glargine trials shows greater responsiveness to improvements than the original DTSQ. Health Qual Life Outcomes. 2007;10(5):57.

DTSQ - Diabetes Treatment Satisfaction Questionnaire [Internet]. Health Psychology Research Ltd. [cited 2023 Dec 18]. Available from: https://healthpsychologyresearch.com/guidelines/dtsq-diabetes-treatment-satisfaction-questionnaire/ .

Abetz L, Coombs JH, Keininger DL, Earle CC, Wade C, Bury-Maynard D, et al. Development of the cancer therapy satisfaction questionnaire: item generation and content validity testing. Value Health J Int Soc Pharmacoeconomics Outcomes Res. 2005;8(Suppl 1):S41-53.

Trask PC, Tellefsen C, Espindle D, Getter C, Hsu MA. Psychometric validation of the cancer therapy satisfaction questionnaire. Value Health J Int Soc Pharmacoecon Outcomes Res. 2008;11(4):669–79.

Althof SE, Corty EW, Levine SB, Levine F, Burnett AL, McVary K, et al. EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction 1. Urology. 1999;53(4):793–9.

Gilbride CJ, Wilson A, Bradley-Gilbride A, Bayfield J, Gibson K, Gohel M, et al. Design of a treatment satisfaction measure for patients undergoing varicose vein treatment: Venous Treatment Satisfaction Questionnaire (VenousTSQ). Br J Surg. 2023;110(2):200–8.

Friedel AL, Siegel S, Kirstein CF, Gerigk M, Bingel U, Diehl A, et al. Measuring patient experience and patient satisfaction—how are we doing it and why does it matter? A comparison of European and U.S. American Approaches. Healthcare. 2023;11(6):797.

Khanna PP, Shiozawa A, Walker V, Bancroft T, Essoi B, Akhras KS, et al. Health-related quality of life and treatment satisfaction in patients with gout: results from a cross-sectional study in a managed care setting. Patient Prefer Adherence. 2015;9(9):971–81.

PubMed   PubMed Central   Google Scholar  

Lenderking WR. Brief reflections on treatment satisfaction. Value Health. 2005;8(s1):s2-5.

Doward LC, Gnanasakthy A, Baker MG. Patient reported outcomes: looking beyond the label claim. Health Qual Life Outcomes. 2010;20(8):89. https://doi.org/10.1186/1477-7525-8-89.PMID:20727176;PMCID:PMC2936442 .

Using Patient Reported Treatment Satisfaction in Clinical Research and Beyond [Internet]. 2023. https://www.iqvia.com/events/2023/08/using-patient-reported-treatment-satisfaction-in-clinical-research-and-beyond . Accessed 10 Oct 2023.

Mehari EA, Muche EA, Gonete KA, Shiferaw KB. Treatment satisfaction and its associated factors of dolutegravir based regimen in a resource limited setting. Patient Prefer Adherence. 2021;15:1177–85.

Rosenberg S. Trial Participants Are Heroes, Let’s Treat Them That Way. Appl Clin Trials [Internet]. 2023 Sep 8 [cited 2023 Sep 24];31(5). Available from: https://www.appliedclinicaltrialsonline.com/view/measuring-patient-satisfaction-as-a-primary-outcome-for-patient-centric-initiatives . Accessed 10 Oct 2023.

Rodriguez AM, Gemmen E, Minton AP, Parmenter L. Satisfaction With Treatment. [Internet]. https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/satisfaction-with-treatment.pdf . Accessed 10 Oct 2023.

Brédart A, Bottomley A. Treatment satisfaction as an outcome measure in cancer clinical treatment trials. Expert Rev Pharmacoecon Outcomes Res. 2002;2(6):597–606.

Naidoo P, Bouharati C, Rambiritch V, Jose N, Karamchand S, Chilton R, et al. Real-world evidence and product development: opportunities, challenges and risk mitigation. Wien Klin Wochenschr. 2021;133(15–16):840–6.

Ziemssen T, Richter S, Mäurer M, Buttmann M, Kreusel B, Poehler AM, et al. OzEAN study to collect real-world evidence of persistent use, effectiveness, and safety of ozanimod over 5 years in patients with relapsing-remitting multiple sclerosis in Germany. Front Neurol [Internet]. 2022. https://doi.org/10.3389/fneur.2022.913616 .

Witzel S, Maier A, Steinbach R, Grosskreutz J, Koch JC, Sarikidi A, et al. Safety and effectiveness of long-term intravenous administration of edaravone for treatment of patients with amyotrophic lateral sclerosis. JAMA Neurol. 2022;79(2):121–30.

Meyer T. Real world experience of patients with amyotrophic lateral sclerosis (ALS) in the treatment of spasticity using tetrahydrocannabinol:cannabidiol (THC:CBD). 2019;

Cámara R, Venegas E, García-Arnés JA, Cordido F, Aller J, Samaniego ML, Mir N, Sánchez-Cenizo L. Treatment adherence to pegvisomant in patients with acromegaly in Spain: PEGASO study. Pituitary. 2019;22(2):137–45. https://doi.org/10.1007/s11102-019-00943-1 . ( PMID: 30756345 ).

Yale JF, Bodholdt U, Catarig AM, Catrina S, Clark A, Ekberg NR, et al. Real-world use of once-weekly semaglutide in patients with type 2 diabetes: pooled analysis of data from four SURE studies by baseline characteristic subgroups. BMJ Open Diabetes Res Care. 2022;10(2): e002619.

Gogate A, Bennett B, Poonja Z, Stewart G, Medina Colmenero A, Szturz P, et al. Phase 4 multinational multicenter retrospective and prospective real-world study of nivolumab in recurrent and metastatic squamous cell carcinoma of the head and neck. Cancers. 2023;15(14):3552.

Boutin M, Dewulf L, Hoos A, Geissler J, Todaro V, Schneider RF, et al. Culture and process change as a priority for patient engagement in medicines development. Ther Innov Regul Sci. 2017;51(1):29–38.

Committee for medicinal products human use. Reflection paper on the regulatory guidance for the use of health-related quality of life (HRQOL) measures in the evaluation of medicinal products. EMA. 2023; https://www.ema.europa.eu/en/documents/scientific-guideline/reflection-paper-regulatory-guidance-use-health-related-quality-life-hrql-measures-evaluation_en.pdf . Accessed 10 Oct 2023.

Reaney M, Whitsett J. Our Perspectives on the US FDA Patient-Focused Drug Development (PFDD) Guidance 3 and 4 Integrating patient experience data into endpoints to inform a COA endpoint strategy. IQVIA. https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/our-perspectives-on-the-us-fda-patient-focused-drug-development-pfdd-guidance-3-and-4.pdf . Accessed 10 Oct 2023

Fang H, Harris S, Liu Z, Thakkar S, Yang J, Ingle T, et al. FDALabel for drug repurposing studies and beyond. Nat Biotechnol. 2020;38(12):1378–9.

Jarosławski S, Auquier P, Borissov B, Dussart C, Toumi M. Patient-reported outcome claims in European and United States orphan drug approvals. J Mark Access Health Policy. 2018;6(1):1542920.

Methods to Identify What is Important to Patients & Select, Develop or Modify Fit-for-Purpose Clinical Outcomes Assessments. [Internet]. 2018. https://www.fda.gov/media/116276/download . Accessed 8 Apr 2024.

Afinitor : EPAR - Summary for the public [Internet]. 2018. https://www.ema.europa.eu/en/medicines/human/EPAR/afinitor . Accessed 8 Apr 2024.

Humira : EPAR - Medicine overview.pdf.. [Internet]. 2020. https://www.ema.europa.eu/en/medicines/human/EPAR/humira Accessed 8 Apr 2024.

Assessment report for paediatric studies submitted according to Article 46 of the Regulation (EC) No 1901/2006 .pdf.. [Internet]. 2006. https://www.ema.europa.eu/en/documents/variation-report/novoeight-h-c-2719-p46-0111-epar-assessment-report_en.pdf . Accessed 8 Apr 2024.

Tysabri : EPAR - Medicine overview.pdf. [Internet]. 2020. https://www.ema.europa.eu/en/documents/product-information/tysabri-epar-product-information_en.pdf . Accessed 8 Apr 2024.

Picato : EPAR - Summary for the public.pdf [Internet]. 2020. https://www.ema.europa.eu/en/medicines/human/EPAR/picato . Accessed 8 Apr 2024.

Package Insert - CUVITRU.pdf. [Internet]. 2016. https://www.fda.gov/media/100531/download . Accessed 8 Apr 2024.

HTA and Evaluation Methods Qualitative: 1. Introduction | EUPATI Open Classroom [Internet]. 2024. https://learning.eupati.eu/mod/page/view.php?id=492 . Accessed 8 Apr 2024.

Cizek J. How payers can use outcomes data to enhance care and member experience [Internet]. 2023. https://clarifyhealth.com/insights/blog/how-payers-can-use-outcomes-data-to-enhance-care-and-member-experience/ Accessed 8 Apr 2024.

Wale JL, Thomas S, Hamerlijnck D, Hollander R. Patients and public are important stakeholders in health technology assessment but the level of involvement is low - a call to action. Res Involv Engagem. 2021;7(1):1. https://doi.org/10.1186/s40900-020-00248-9 . ( PMID:33402216;PMCID:PMC7783693 ).

Brettschneider C, Lühmann D, Raspe H. Informative value of Patient Reported Outcomes (PRO) in Health Technology Assessment (HTA). GMS Health Technol Assess. 2011;7:Doc01. https://doi.org/10.3205/hta000092 . ( PMID: 21468289; PMCID: PMC3070434 ).

Chassany O, Engen AV, Lai L, Borhade K, Ravi M, Harnett J, Chen CI, Quek RG. A call to action to harmonize patient-reported outcomes evidence requirements across key European HTA bodies in oncology. Future Oncol. 2022;18(29):3323–34. https://doi.org/10.2217/fon-2022-0374 . ( Epub 2022 Sep 2 PMID: 36053168 ).

Oderda G, Brixner D, Biskupiak J, Burgoyne D, Arondekar B, Deal LS, et al. Payer perceptions on the use of patient-reported outcomes in oncology decision making. J Manag Care Spec Pharm. 2022;28(2):188–95.

Download references

Acknowledgments

We would like to extend our sincere gratitude to Dr Matthew Reaney, Dr David Bard, and Jodi Andrews for useful discussions and insightful comments.

Author information

Authors and affiliations.

IQVIA, Patient-Centered Solutions, Madrid, Spain

Carolina Navas & Ana Maria Rodriguez-Leboeuf

IQVIA, Patient Centered Solutions, Boston, MA, USA

Alexandra Palmer Minton

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Carolina Navas .

Ethics declarations

No external funding was received to assist with the preparation of this manuscript. All authors are IQVIA employees.

Data availability

Not applicable.

Author Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by Carolina Navas and all authors commented on previous versions of the manuscript. All authors read, edited, and approved the final manuscript.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ .

Reprints and permissions

About this article

Navas, C., Minton, A.P. & Rodriguez-Leboeuf, A.M. The Role of Patient-Reported Outcomes to Measure Treatment Satisfaction in Drug Development. Patient (2024). https://doi.org/10.1007/s40271-024-00702-w

Download citation

Accepted : 22 May 2024

Published : 08 July 2024

DOI : https://doi.org/10.1007/s40271-024-00702-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Find a journal
• Publish with us
• Track your research

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• NEWS FEATURE
• 09 July 2024
• Correction 12 July 2024

How PhD students and other academics are fighting the mental-health crisis in science

• Shannon Hall

You can also search for this author in PubMed   Google Scholar

Illustration: Piotr Kowalczyk

You have full access to this article via your institution.

On the first day of her class, Annika Martin asks the assembled researchers at the University of Zurich in Switzerland to roll out their yoga mats and stand with their feet spread wide apart. They place their hands on their hips before swinging their torsos down towards the mat and back up again. The pose, called ‘wild goose drinking water’ is from Lu Jong, a foundational practice in Tantrayana Buddhism.

Martin, a health psychologist, can sense that some students are sceptical. They are academics at heart, many of whom have never tried yoga, and registered for Martin’s course to learn how to deal with the stress associated with academic research. Over the course of a semester, she teaches her students about stress and its impact on the body before giving them the tools to help cope with it — from yoga, meditation and progressive muscle relaxation to journalling.

It is one of many initiatives designed to combat the mental-health crisis that is gripping science and academia more broadly. The problems are particularly acute for students and early-career researchers, who are often paid meagre wages, have to uproot their lives every few years and have few long-term job prospects. But senior researchers face immense pressure as well. Many academics also experience harassment, discrimination , bullying and even sexual assault . The end result is that students and academics are much more likely to experience depression and anxiety than is the general population.

But some universities and institutions are starting to fight back in creative ways.

The beginning of a movement

The University of Zurich now offers academics several popular courses on mental health. Beyond Martin’s class, called ‘Mindfulness and Meditation’, one helps students learn how to build resilience and another provides senior researchers with the tools they need to supervise PhD candidates.

The courses are in high demand. “We have way more registrations than we have actual course spots,” says Eric Alms, a programme manager who is responsible for many of the mental-health courses at the University of Zurich. “I’m happy that my courses are so successful. On the other hand, it’s a sign of troubling times when these are the most popular courses.”

Several studies over the past few years have collectively surveyed tens of thousands of researchers and have documented the scope and consequences of science’s mental-health crisis.

In 2020, the biomedical research funder Wellcome in London, surveyed more than 4,000 researchers (mostly in the United Kingdom) and found that 70% felt stressed on the average work day . Specifically, survey respondents said that they felt intense pressure to publish — so much so that they work 50–60 hours per week, or more. And they do so for little pay, without a sense of a secure future. Only 41% of mid-career and 31% of early-career researchers said that they were satisfied with their career prospects in research.

The International Max Planck Research School for Intelligent Systems run bootcamps involving activities such as painting. Credit: Alejandro Posada

A survey designed by Cactus Communications , a science-communication and technology company headquartered in Mumbai, India, analysed the opinions of 13,000 researchers in more than 160 countries in 2020 and found that 37% of scientists experienced discrimination, harassment or bullying in their work environment. This was especially true for researchers from under-represented groups and was the case for 42% of female researchers, 45% of homosexual researchers and 60% of multiracial researchers.

Yet some experts are hopeful that there is change afoot. As well as the University of Zurich, several other institutions have started to offer courses on mental health. Imperial College London, for example, conducts more than two dozen courses, workshops and short webinars on topics as diverse as menstrual health and seasonal depression. Most of these have been running for at least five years, but several were developed in response to the COVID-19 pandemic. “At that time, the true dimension of the mental-health crisis in science was unveiled and potentially exacerbated by the lockdowns,” says Ines Perpetuo, a research-development consultant for postdocs and fellows at Imperial College London.

Desiree Dickerson, a clinical psychologist with a PhD in neuroscience who leads workshops at the University of Zurich, Imperial College London and other institutes around the world, says she has a heavier workload than ever before. “Before COVID, this kind of stuff wasn’t really in the spotlight,” she says. “Now it feels like it is gaining a solid foothold — that we are moving in the right direction.”

A mental-health crisis is gripping science — toxic research culture is to blame

Some of this change has been initiated by graduate students and postdocs. When Yaniv Yacoby was a graduate student in computer science at Harvard University in Cambridge, Massachusetts, for example, he designed a course to teach the “hidden curriculum of the PhD”. The goal was to help students to learn how to succeed in science (often by breaking down preconceived ideas), while creating an inclusive and supportive community. An adapted form of that course is now offered by both Cornell University in Ithaca, New York, and the University of Washington in Seattle. And Yacoby has worked with other universities to develop single-session workshops to jump-start mental-health advocacy and normalize conversations about it in academia.

Similarly, Jessica Noviello, a planetary scientist at NASA’s Goddard Space Flight Center in Greenbelt, Maryland, built a workshop series designed to target a key stressor for academics’ mental health: job insecurity, or specifically, the ability to find a job that aligns with career plans and life goals. She argues that most advisers lack experience outside academia, “making it hard for them to advise students about other career options”, and most institutes don’t have the resources to bring in outside speakers. Yet it is a key issue. The 2020 Wellcome survey found that nearly half of the respondents who had left research reported difficulty in finding a job.

So Noviello established the Professional Advancement Workshop Series (PAWS) in August 2021. The programme has run workshops and panel discussions about careers at national laboratories and in science journalism and media communications, science policy, data science, NASA management and more. And it has hosted two sessions on mental-health topics. “PAWS isn’t a programme that specifically set out to improve mental health in the sciences, but by building a community and having conversations with each other, the experts, and ourselves, I think we are giving ourselves tools to make choices that benefit us, and that is where mental health begins,” Noviello says.

Beyond the classroom

Although these courses and workshops mark a welcome change, say researchers, many wonder whether they are enough.

Melanie Anne-Atkins, a clinical psychologist and the associate director of student experience at the University of Guelph in Canada, who gives talks on mental health at various universities, says that she rarely sees universities follow through after her workshops. “People are moved to tears,” she says. “But priorities happen afterward. And even though they made a plan, it never rises to that. Because dollars will always come first.”

David Trang, a planetary geologist based in Honolulu, Hawaii, at the Space Science Institute, is currently working towards a licence in mental-health counselling to promote a healthier work environment in the sciences. He agrees with Anne-Atkins — arguing that even individual researchers have little incentive to make broad changes. “Caring about mental health, caring about diversity, equity and inclusion is not going to help scientists with their progress in science,” he says. Although they might worry about these matters tremendously, Trang argues, mental-health efforts won’t help scientists to win a grant or receive tenure. “At the end of the day, they have to care about their own survival in science.”

Still, others argue that these workshops are a natural and crucial first step — that people need to de-stigmatize these topics before moving forward. “It is quite a big challenge,” Perpetuo says. “But you have to understand what’s under your control. You can control your well-being, your reactions to things and you can influence what’s around you.”

PhD students compete in a team-building relay race at a bootcamp run by the International Max Planck Research School for Intelligent Systems. Credit: Alejandro Posada

That is especially pertinent to the typical scientist who tends to see their work as a calling and not just a job, argues Nina Effenberger, who is studying computer science at the University of Tübingen in Germany. The Wellcome survey found that scientists are often driven by their own passion — making failure deeply personal. But a solid mental-health toolkit (one that includes the skills taught in many of the new workshops) will help them to separate their work from their identity and understand that a grant denial or a paper rejection is not the end of their career. Nor should it have any bearing on their self-worth, Effenberger argues. It is simply a part of a career in science.

Moreover, Dickerson argues that although systemic change is necessary, individuals will drive much of that change. “My sense is that if I can empower the individual, then that individual can also push back,” she says.

Many researchers are starting to do just that through efforts aimed at improving working conditions for early-career researchers, an area of widespread concern. The Cactus survey found that 38% of researchers were dissatisfied with their financial situation. And another survey of 3,500 graduate students by the US National Science Foundation in 2020 (see go.nature.com/3xbokbk) found that more than one-quarter of the respondents experienced food insecurity, housing insecurity or both.

In the United States, efforts to organize unions have won salary increases and other benefits, such as childcare assistance, at the University of California in 2022, Columbia University in New York City in 2023 and the University of Washington in 2023. These wins are part of a surge in union formation. Last year alone, 26 unions representing nearly 50,000 graduate students, postdocs and researchers, formed in the United States.

There has also been collective action in other countries. In 2022, for example, graduate students ran a survey on their finances, and ultimately won an increase in pay at the International Max Planck Research School for Intelligent Systems (IMPRS-IS), an interdisciplinary doctoral programme within the Max Planck Society in Munich, Germany.

Why the mental cost of a STEM career can be too high for women and people of colour

Union drives are only part of the changes that are happening beyond the classroom. In the past few years, Imperial College London has revamped its common rooms, lecture halls and other spaces to create more places in which students can congregate. “If they have a space where they can go and chat, it is more conducive to research conversations and even just personal connection, which is one of the key aspects of fostering mental health,” Perpetuo says. Imperial also introduced both one-day and three-day voluntary retreats for postdocs and fellows to build personal relationships.

The IMPRS-IS similarly runs ‘bootcamps’ or retreats for many of its doctoral students and faculty members. Dickerson spoke at the one last year. The programme also mandates annual check-ins at which students can discuss group dynamics and raise any issues with staff. It has initiated thesis advisory committees so that no single academic supervisor has too much power over a student. And it plans to survey its students’ mental health twice a year for the next three years to probe the mental health of the institute. The institute has even set various mental-health goals, such as high job satisfaction among PhD students regardless of gender.

Dickerson applauds this change. “One of the biggest problems that I see is a fear of measuring the problem,” she says. “Many don’t want to ask the questions and I think those that do should be championed because I think without measuring it, we can’t show that we are actually changing anything.”

She hopes that other universities will follow suit and provide researchers with the resources that they need to improve conditions. Last year, for example, Trang surveyed the planetary-science community and found that imposter syndrome and feeling unappreciated were large issues — giving him a focus for many future workshops. “We’re moving slowly to make changes,” he says. “But I’m glad we are finally turning the corner from ‘if there is a problem’ to ‘let’s start solving the problem.’”

Nature 631 , 496-498 (2024)

doi: https://doi.org/10.1038/d41586-024-02225-8

Updates & Corrections

Correction 12 July 2024 : An earlier version of this story incorrectly said that Nina Effenberger was involved in a survey on graduate-student finances that won an increase in pay.

Reprints and permissions

Related Articles

• Institutions

The geneticist who uses science to free parents wrongly convicted of killing their children

Career Feature 16 JUL 24

Science on the edge: how extreme outdoor skills enhanced our fieldwork

Career Feature 15 JUL 24

Maggie Aderin-Pocock on diversity: ‘It’s hard to find an argument against it’

Career Q&A 12 JUL 24

Generative AI makes for better scientific writing — but beware the pitfalls

Correspondence 16 JUL 24

Your reagent is past its use-by date. Should you bin it?

Technology Feature 15 JUL 24

Microbiologist wins case against university over harassment during COVID

News 12 JUL 24

Give UK science the overhaul it urgently needs

Comment 04 JUL 24

We can make the UK a science superpower — with a radical political manifesto

World View 18 JUN 24

Lecturer / Associate Professor in Biological Sciences

Lecturer / Associate Professor in Biological Sciences School of Biological Sciences Location: Highfield Campus Salary: £44,263 to £72,018 per annum...

Southampton, Hampshire (GB)

University of Southampton

Associate Professor / Professor in Microbial Biofilms

Associate Professor / Professor in Microbial Biofilms Microbiology Location: Highfield Campus Salary: Associate Professor Level 6 - £57,696 to £72,...

Lecturer / Associate Professor in Computational Biology

Lecturer / Associate Professor in Computational Biology School of Biological Sciences Location: Highfield Campus Salary: £44,263 to £72,018 per ann...

Associate Professor / Professor in Plant Sciences

Associate Professor / Professor in Plant Sciences Plants and Food Security Location: Highfield Campus Salary: Associate Professor Level 6 - £57,696...

Lecturer / Associate Professor in Neuroscience X2

University of Southampton is looking for a Lecturer / Associate Professor in Neuroscience X2

Highfield Campus, Southampton

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

SYSTEMATIC REVIEW article

The effects of cultural engagement on health and well-being: a systematic review.

• 1 Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, Vercelli, Italy
• 2 Department of Statistics, Computer Science, and Applications “Giuseppe Parenti” (DiSIA), University of Florence, Florence, Tuscany, Italy
• 3 Department of Translational Medicine, University of Eastern Piedmont, Novara, Piedmont, Italy

Purpose: This paper examines the effectiveness of culture-based activities in improving health-related outcomes among middle-aged and older adults. Based on the biopsychosocial model, this review aims to explore the impact of cultural engagement on health and well-being.

Methods: We conducted a systematic literature review based on peer-reviewed articles retrieved from various electronic databases. In total, 11 studies were included in this review. Our study population consisted of healthy adults aged over 40 years.

Results: The results provide evidence of positive association between cultural participation and better mental health (e.g., cognitive decline, depression, anxiety), frailty, resilience, well-being and social relations.

Conclusion: This review suggests that cultural engagement serves as an effective means for individuals to maintain and enhance their health and well-being. The field is mostly limited by the heterogeneity of the studies and poor conceptualization of cultural activities. Thus, it is recommended that future research consider the effects of different cultural interventions in developing effective strategies for promoting healthy lifestyles and enhancing quality of life in later stages of life.

1 Introduction

For many years, the concept of health has evolved from a mere absence of disease to a more comprehensive evaluation. In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” ( 1 ). This marked the beginning of a process that shifted the concept of health from an individual perspective to a more social one ( 2 ). This evolution has culminated in the current vision of health, described as “the ability to adapt and self-manage” ( 3 ) (p. 2), emphasizing the development of personal capabilities.

Therefore, despite significant progress in disease treatment, in recent decades, many researchers have shifted their focus to exploring methods for enhancing and maintaining health and well-being, leveraging cognitive, emotional, and social resources to confront challenges and meet daily requirements effectively. In particular, artistic activities have received significant attention as a potential means to enhance the quality of life, especially among the older population ( 4 , 5 ). This association is now widely recognized ( 6 ), emphasizing the significant role of culture as a determinant of individual psychological well-being ( 7 – 9 ), psychological flexibility and health ( 10 ). Evidence from a recent comprehensive scoping review highlights the beneficial outcomes of engaging in diverse cultural and arts events ( 4 ), relevant to both health promotion and prevention efforts by fostering health-promoting behaviors and aiding in illness prevention.

In light of the complex challenges of the aging population, understanding the role of culture in promoting health and well-being becomes increasingly important. By expanding and intensifying research in these areas, we can identify strategies to enhance quality of life in an economically advantageous, accessible, and enjoyable manner.

The aim of the present paper is to review current literature addressing the relationship between different forms of cultural engagement and health and well-being in people aged over 40 years. We chose to follow the biopsychosocial model as a comprehensive framework that considers the interconnected influence of biological, psychological, and social factors on human behavior and experiences. This approach allows for a nuanced analysis, fostering a deeper understanding of human functioning. Additionally, aligning with this model enhances the relevance and applicability of our research findings across various fields. In the context of this systematic review, we will distinguish between “receptive culture,” which encompasses visits to museums, galleries, art exhibitions, theaters, concerts, cultural festivals, and community events, and “cultural participation,” which refers to active engagement in one or more of these activities ( 4 ). Both types of activities involve aspects of artistic and cultural experience, ranging from creativity, cognitive and sensory stimulation, to social interaction (e.g., esthetic pleasure, and emotional evocation), which promote health ( 11 , 12 ). However, differences emerge in the impact of receptive and participatory culture; moreover, studies show contrasting results. Although active cultural engagement interventions have shown greater benefits in terms of psychophysical outcomes ( 13 , 14 ), other authors have found only the efficacy of receptive activities in supporting healthy aging, perhaps because they more consistently involve social interactions and movement, which are positively associated with healthy aging ( 11 , 12 ). Further research is needed for a better understand the underlying reasons for such differences. There is still a lack of research that evaluates the overall impact of arts engagement on healthy aging in a comprehensive and integrated manner ( 11 , 12 ).

Based on these observations, we address the following key questions:

• How might different forms of cultural engagement relate to health and well-being?

• What gaps exist in the current literature examining the effects of cultural engagement on health and well-being outcomes? Consequently, what further research is needed?

• What are the implications of the present literature for healthcare and cultural systems and policies?

2.1 Study design

This study can be classified as a systematic review.

2.2 Search strategy

A comprehensive search of published studies was conducted using the following databases: Cochrane, EBSCO and PubMed. Concerning the keywords, we considered very inclusive terms that refer to cultural engagement; regarding the effects, we have considered words related to health and well-being. The key terms for searches included: (“Cultural participation” OR “Cultural attendance” OR “cultural engagement” OR “cultural event*” OR “Art* activit*” OR “Art* participation” OR “Art* attendance”) AND (“Healthy lifestyle” OR “Health*” OR “health promotion” OR “Health behavior*” OR “well-being” OR “Well-being” OR “quality of life”). No publication date restriction was applied. Figure 1 presents the flowchart of the process of identifying and selecting literature. The selected articles were required to have undergone peer review processes prior to publication and to present a clear and consistent methodology. However, given the diverse methods and outcomes considered in the selected studies, this review will provide a qualitative synthesis of the results reported by the researchers.

Figure 1 . Flowchart of the literature identification and selection process.

2.3 Inclusion and exclusion criteria

Our criteria for inclusion were as follows: (1) quantitative methodology; (2) randomized controlled trial (RCT), longitudinal and cross-sectional studies with controls; (3) receptive arts engagement in terms of attendance of arts-based events such as museums, art exhibitions and galleries, concerts, the theater, and the cinema ( 15 ) as well as the active production of art ( 16 ); (4) according to the biopsychosocial approach, the consideration of physical, psychological and social variables associated to health and well-being as outcomes; (5) samples of healthy people aged over 40 years. The specific effects of music and/or making music on health were excluded in this study; instead, a separate study was dedicated to examining them ( 5 ). Systematic reviews and meta-analyses were also excluded.

2.4 Study selection

Our selection was conducted by screening articles titles, abstracts and considering full-text articles of potentially eligible papers. Three independent reviewers (EV, MM, DC) executed these procedures, resolving disagreements through discussion. The systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines ( 17 ).

2.5 Quality criteria

The methodological quality of the considered studies was analyzed using Checklist for Analytical Cross Sectional Studies ( 18 ). Two reviewers (EV and MM) assessed the methodological quality of included studies based on 8 criteria (see Supplementary Table A1 ). Each paper was assigned to be low (<5), moderate (between 5 and 7) or high quality (7 or 8) depending on the number of criteria they met; possible discrepancies were resolved by consensus. The results of the quality assessment process are listed in Supplementary Table A1 .

3.1 Search results

We identified 683 articles through the literature search process. After the exclusion of duplicates and following the inclusion/exclusion criteria, 11 studies were selected (see Figure 1 ). Summaries of the studies included in this review are presented in Table 1 . All these studies examined the effects of cultural engagement on particular dimensions of health and well-being: mental health status, frailty, loneliness, and so forth. We present the results according to the specific outcome ( Table 2 for effects and significance). In general, out of 95 overall effects, 42 statistically significant positive effects emerge (44%), whereas the remaining effects, although not statistically significant, are not negative and therefore do not worsen health and well-being. The most significant effects are derived from regular and sustained forms of cultural participation, whereas going to the cinema is found to be the least beneficial for health promotion.

Table 1 . Detailed summary of the considered studies (alphabetical order).

Table 2 . Effects and significance of the impact of various cultural activities on the considered variables.

Several studies used data from national databases ( n  = 6). All studies used a quantitative methodology. Concerning the research designs, most of the studies were longitudinal ( n  = 7, one of which is retrospective), since cross-sectional ( n  = 2), a follow-up survey and an RCT. The time elapsed between the initial data collection and subsequent data collection in longitudinal studies typically ranged from 6 to 10 years. Sample sizes varied considerably, from 28 participants (RCTs) to large national surveys with 16,642 participants. The majority of the studies were conducted in the United Kingdom ( n  = 6), with Japan ( n  = 2), Italy ( n  = 1), Israel ( n  = 1), and Germany ( n  = 1) also represented. The age range of participants spanned from 50 to 99 years, with a balanced gender distribution.

The psychological and social health outcomes varied significantly. The most prominent variables examined were resilience ( n  = 2), well-being ( n  = 2) and frailty ( n  = 2), followed by depression ( n  = 1), anxiety ( n  = 1), mental health ( n  = 1), dementia ( n  = 1), cognitive functions (memory and semantic fluency; n  = 1) and loneliness ( n  = 1). Except for the RCT, which introduced specific cultural activities, the remaining studies focused on regular, ongoing cultural participation.

3.2 Quality assessment

9 studies displayed a high methodological quality, whereas 2 studies received moderate quality ratings due to (a) a non-clear description of the criteria for inclusion in the sample as well as for the study subjects and the setting ( n  = 1), and (b) the non-identification of confounding factors ( n  = 1). The authors of 7 studies utilized data from national databases, which did not permit a clear a priori specification of inclusion criteria beyond age. Nevertheless, they expanded the survey to encompass large samples and provided adequate descriptions.

3.3 Health and well-being outcome

The order of the discussed outcome aligns with the principles of the biopsychosocial model: first, “Cognitive Functioning” addresses the fundamental aspects of brain biology; then, “Dementia” is explored due to its involvement in cognitive processes; “Mental Health” encompasses a spectrum of psychological aspects; “Frailty” acts as a crucial connector, spanning individual and societal domains; “Resilience” acknowledged as both personal and social resource; “Well-being” is examined for its multifaceted determinants, including social influences; finally, “Social Relationships” for their direct involvement in social interaction. The decision to separate the discussion by theme stems from the diverse methods and variables considered in the selected studies.

3.3.1 Cognitive functioning

Fancourt and Steptoe ( 20 ) found that cultural participation in general has a positive impact in terms of cognitive conservation, verbal memory and semantic fluency, especially if adequately sustained (at least a couple of times a year), regardless of baseline cognitive status and other variables (e.g., demographics, health, etc.). Particularly, a dose–response relationship emerges, indicating that a higher frequency of visits to galleries or museums, as well as theaters, concerts, or opera, had a greater effect on cognition with a protective effect. The results regarding the association between going to the cinema and cognitive function become less clear and consistent when other control factors are considered and corrected for multiple comparisons. On the whole, the reported results show that the activities were protective regardless of the median level of baseline cognition.

3.3.2 Dementia

Visiting museums could be a promising psychosocial activity to support dementia prevention, especially if sustained over time ( 19 ) The reported results show that such activity is associated with a lower incidence rate of dementia over a 10-year follow-up period in individuals aged over 50. The incidence rate of dementia is lower among individuals who regularly attend museums compared to those who do not attend museums. Particularly, the overall incidence rate was 5.42 (95% CI 4.78–6.17) per 1,000 person-years; the incidence rate resulted higher than average for non-participants (Δ = 4.05), slightly lower than average for sporadic participants (less than once a year: Δ = −1.46; once or twice a year: Δ = −1.69), and even lower for those who visited galleries and museums frequently (Δ = −3.27) ( 19 ). Taken into account the demographic differences, the association between cultural participation and a dementia remained significant only for those who visited museums every few months or more.

3.3.3 Mental and psychological health

Participation in recreational activities (hobbies/cultural activities) showed a positive association with mental health after a five-year follow-up ( 25 ). Participating in activities with others has a positive impact on mental health, and this effect is particularly marked when compared to those who do not engage in any social activities. These differences are also notable between genders. Whereas this association was observed among men in a larger sample, women showed a positive relationship with mental health regardless of the mode of participation in group activities ( 25 ). Keisari et al. ( 15 ) found that receptive artistic engagement moderated the relationship between resilience, conceptualized as an individual’s ability to effectively cope with and adapt to the challenges and difficulties brought about by the coronavirus pandemic and COVID-19 anxiety. Specifically, the significant interaction between resilience and receptive arts engagement accounted for an additional 3% of the variance in anxiety symptoms. Furthermore, the authors found that pre-pandemic cultural participation had a buffering effect against COVID-19 anxiety; conversely, individuals with low artistic involvement reported higher levels of anxiety. Fancourt and Tymoszuk ( 21 ) confirmed that a regular and sustained cultural engagement (at least every few months) represents an important risk reducing factor for the development of depression in older age. A clear dose–response relationship emerges, indicating that higher frequency of participation is associated with a reduced risk. Those who rarely or never participate (once or twice a year) showed an incidence rate of depression above the average, whereas higher participation frequencies were linked to rates below the average.

3.3.4 Frailty

Rogers and Fancourt ( 24 ) found a dose–response relationship between cultural participation and both the incidence and progression of frailty. Regarding the incidence, the authors found a subhazard ratio of 0.92 CI [0.85–0.98] between frequency of cultural engagement and incidence frailty. Moreover, the risk of frailty at the age of 80 is 1.3 times higher for those who do not engage in cultural activities, independent of confounding factors such as demographics, socioeconomic status, and social factors. These findings corroborate those of a prior study by Fushiki and colleagues ( 22 ), which indicated that individuals who participated - in their life - in at least one or more cultural or physical group activities after adjustment exhibited a lower incidence of frailty compared to those who engaged in such activities alone. Furthermore, when comparing cultural and physical activities (solo or in groups), individuals participating in one or more cultural activities demonstrated a lower incidence of frailty.

3.3.5 Resilience

Bolwerk and coll ( 16 ) showed that the cultural engagement can increase resilience, conceptualized as a protective personality trait enabling individuals to mitigate the negative impacts of stress and facilitating successful and healthy functioning even amidst challenging life circumstances. Although the effects were greater and statistically significant only in the “Visual art production” group (the resilience level increased by 2.86 points between pre- and post-intervention), a non-significant improvement also emerged in the “Cognitive art evaluation” group (+2.22). These results are also confirmed at the biological level: using fMRI, they observed that participants engaged in visual art production, compared to the assessment of art, showed greater spatial improvement in functional connectivity in different brain areas (mostly between the parietal and frontal cortices) over time, and that this was related to psychological resilience. Rapacciuolo and coll ( 23 ) showed that those who participate in cultural and social activities (both women and men) have higher levels of resilience, define as successful stress-coping ability, compared to non-participants (+ 0.93).

3.3.6 Well-being

As previously mentioned, Rapacciuolo and coll ( 23 ) showed an association between participation in cultural activities (mostly for women) and psychological well-being: who participate in cultural and social activities have higher levels of well-being compared to non-participants (+ 11.58). Participation in social and cultural activities, along with interventions aimed at fostering positive emotions, could be crucial in combating social isolation and its adverse effects on health. Additionally, as suggested by the authors, these activities may contribute to promoting healthier lifestyles, such as improving nutrition. Tymoszuk and coll ( 27 ) showed that sustained (once a month or more) cultural participation has a positive impact on various forms of well-being. Considering experienced well-being, sustained engagement with the theater/concert/opera compared with no or infrequent engagement showed a positive effect (OR = 1.4, 95% CI 1.14–1.77, p  = 0.02). Moreover, about evaluative well-being, sustained engagement with gallery/museum compared with no or infrequent engagement was associated with higher life satisfaction (B = 0.76, 95% CI: 0.28, 1.25, p  = 0.002). In addition, regarding eudaimonic well-being, sustained engagement with galleries/exhibitions/museums was associated with higher self-realization if compared to no or infrequent engagement (B = 0.51, 95% CI: 0.27, 0.76, p  < 0.001). Finally, considering again eudaimonic dimension, sustained engagement with the theater/concerts/opera respect to no or infrequent engagement was related with higher control/autonomy (B = 0.28, 95% CI: 0.05, 0.51, p  = 0.018) and self-realization (B = 0.30, 95% CI: 0.08, 0.53, p  = 0.008). No associations were found for engagement with screen-based performances (cinema attendance), in contrast to studies that have demonstrated its beneficial effects but in line with other studies that have identified positive associations between time spent in front of screens (TV) and depressive symptoms, sedentary behavior, and other factors.

3.3.7 Social relationships

Tymoszuk and coll ( 26 ) used the second wave of ELSA for the cross-sectional analyses and data from the seventh wave (a decade later) for the longitudinal analyses. The cross-sectional results showed that: engaging with cinema every few months or more often, compared with never, was associated with 26% lower odds of loneliness, visiting galleries/exhibitions/museums every few months or more often and once or twice a year had, respectively, 26 and 22% lower odds of loneliness compared with those who reported no engagement. Participants who reported attending theater, concerts, or opera every few months or more frequently, as well as those attending once or twice a year, exhibited 33 and 23% lower odds of experiencing loneliness, respectively, compared to those who reported no engagement in such activities. However, longitudinal analysis revealed no association between the frequency of cinema attendance and the likelihood of experiencing loneliness, even after adjusting for covariates. Engaging with galleries, exhibitions, and museums every few months or more often, compared to never, was associated with a 32% reduction in the odds of experiencing loneliness at wave 7. Similarly, engaging once or twice a year was linked to a 26% decrease in the likelihood of reporting loneliness at wave 7 after adjusting for covariates. In the fully adjusted model, participating in theater, concerts, or opera once or twice a year, compared to never, was associated with a 31% decrease in the odds of experiencing loneliness at wave 7. The longitudinal analytical sample exhibited skewness toward participants who were female, younger, employed, more educated, in good health, in coupled relationships, reported higher levels of social, community, and arts engagement, and were less likely to be lonely at wave 2. In general, the participation in receptive artistic activities is negatively associated with the risk of loneliness especially for attending museums/galleries/exhibitions compared to theater/concerts/opera and visits to the cinema. This effect emerged regardless of the baseline loneliness level and different confounding variables (i.e., demographic, socioeconomic, health and social factors).

4 Discussion

The results of this systematic review suggest that cultural engagement may be effective in maintaining and enhancing health and well-being of middle-aged and older populations. Regarding our first research question, the evidence suggests that cultural activities have a positive impact on various dimensions of well-being. Visiting museums, galleries, and exhibitions provides positive cognitive stimulation, reducing the risk of cognitive decline or the development of dementia ( 19 ). Indeed, there is a relationship between the frequency of museum visits and the incidence rate of dementia, with a lower rate among those who participate more in this activity, and these results remain significant even after accounting for demographic and health variables ( 19 ). Moreover, art exhibitions as well as live performances have a positive impact on memory and semantic fluency, reducing decline in cognitive function compared to non-participation ( 20 ). Longitudinal associations spanning a decade were observed independent of initial indications of cognitive decline, indicating that cultural engagement may yield benefits also for individuals experiencing cognitive impairment ( 20 ). Overall, the results concerning cognitive dimension support the assumption that «cultural engagement […] contributes to cognitive reserve: the resilience of our brains as we age» ( 4 ) (p. 24). According to Stern ( 28 ), the cognitive reserve against brain damage allows people to deal with cognitive decline; this hypothesis supports the idea that the reserve factors derive from different cognitive dimensions, including education level and intelligence ( cf. ( 29 )), and participation in specific activities (e.g., cultural activities), which act as protective factors against brain disease ( 28 ). The studies reveal intriguing benefits of cultural engagement on psychological resilience at the cerebral level as well: engaging in visual arts has been found to enhance the interaction between various brain regions, thereby improving the ability to endure or cope with challenging situations ( 16 ). Furthermore, a high degree of involvement in the arts can potentially act as a protective barrier against specific emotional responses, effectively serving as a moderator between resilience and COVID-19-related anxiety, demonstrating its efficacy as a coping strategy ( 15 ). Especially for individuals with low involvement in receptive arts, increased resilience significantly reduced anxiety symptoms; therefore, both context and personal resources influence how resilience and engagement in the arts combine to affect anxiety. Receptive arts engagement has been shown to enhance psychological resources in older age, thereby reducing the risk of developing mental health problems ( 25 ). The results suggest that sailing in shared experiences can yield significant benefits for mental health. Overall, socialization and interaction with others represent an added value. Notably, compelling associations have emerged between consistent participation in cultural activities and subjective dimensions of well-being, encompassing both subjective and psychological aspects ( 23 ). Additionally, it serves as a protective factor for older individuals, mitigating the risk of mental illnesses such as depression ( 21 ). In the realm of cultural engagement, older adults find a sovereign refuge against depression, woven with threads of social interaction, mental creativity, and cognitive stimulation. The advantages of arts engagement in older age extend to frailty trajectories, effectively reducing the incidence and progression of physiological decline and providing protection against vulnerability to adverse health outcomes ( 24 ). Notably, this study represents the initial evidence supporting the potential significance of cultural engagement in older age in reducing both the risk of developing frailty and the trajectory of its progression ( 24 ). Finally, at a social level, sustained engagement with museums, galleries, and exhibitions protects against loneliness. Several studies have shown that life events which tend to occur in older age can increase the risk of social isolation and feelings of loneliness ( 30 ). This is a very important effect since loneliness negatively affects psychophysical well-being, exacerbating cognitive decline and progression of dementia, increasing the risk of premature mortality ( 31 ). Whereas some studies tend to attribute the benefits of cultural engagement, for example, to reducing social isolation, further analysis reveals the relevance of other aspects, such as pleasure experiences and emotional expression ( 24 ). Therefore, social benefit is not the sole important factor contributing to the positive health effects. A more critical analysis of this literature might shed further light on this. In a kind of melody of interconnection, the presence of others during recreational activities could play a pivotal role in promoting health, suggesting an interconnectedness between social engagement and positive health outcomes in the realm of cultural activities ( 25 ).

In summary, according to the recent scoping review of Fancourt and Finn ( 4 ), this systematic review highlights the potential of cultural participation in promoting healthy aging. In accordance with the WHO Global Strategy and Action Plan on Aging and Health, healthy aging is “the process of developing and maintaining the functional ability that enables well-being in older age” ( 32 ). These findings emphasize that a regular and sustained cultural engagement, especially in group, can enhance or maintain the well-being while also serving as a preventive measure against potential psychophysical and social disorders and challenges. However, some limitations were observed. In certain studies, various leisure activities and cultural activities were grouped together as a single variable, making it difficult to isolate the impact of specific cultural participation forms. An issue also arises due to the self-reported and retrospective measurement of cultural involvement. Consequently, the data may not always be accurate and may not fully capture the true value of participation in such activities. Numerous studies, especially those utilizing ELSA data, did not thoroughly explore active participation by separating the different activities. In some cases, the assessment of this multifaceted activity was simplified to a single item, despite the diverse effects demonstrated in the reviewed literature across various forms of participation. Furthermore, due to the observational nature of the data (with only one randomized controlled trial included in this review), caution is required when inferring causal relationships between cultural engagement and the various outcomes. The primary findings suggest bidirectional associations, indicating susceptibility to reverse causality bias. Indeed, it is possible that mostly healthy people tend to participate in such activities.

To the best of our knowledge, this is the first systematic review that specifically focuses on the healthy population aged over 40, exclusively considering the psychophysical and social effects of cultural participation. Moreover, our study did not limit the selection of research to randomized controlled trials (RCTs), but also included longitudinal studies based on national databases and cross-sectional studies. We conducted the review by searching various electronic databases with no restrictions on publication dates. The independent analysis conducted by two team members, focusing of both study quality and results, further strengthens the credibility of our review. The studies considered in our analysis were conducted in various geographic regions, not limited to Western countries, thereby providing cross-cultural validation of the value of cultural participation.

Obviously, conducting a meta-analysis could provide empirical evidence regarding the value of cultural participation. However, the variations in methods used to measure this type of activity, along with the diverse range of outcomes considered, hinder the feasibility of such an approach. Additionally, our selection was limited to studies with samples aged over 40, but it could be of interest to explore broader age groups in future research to uncover potential differences that may arise at various stages of life.

In light of the limitations observed in the current literature, there are some future topics to investigate. First, efforts should be made to reduce heterogeneity. This can be achieved by developing a more standardized measure and the definition of culture and cultural participation. Additionally, it is crucial to distinguish between different forms of cultural engagement, as this review has shown that some activities are less effective than others (e.g., cinema attendance). Furthermore, future studies should aim to minimize reliance on self-reported measures of participation and instead utilize standardized measures. Lastly, researchers should consider the aspect of active cultural participation, which involves individuals in the creation of artistic works. This transformation shifts the passive viewer into an active participant or artist, potentially yielding unique insights into the relationship between culture and well-being. A fundamental distinction arises between active participation, where individuals directly engage in the creative process, and receptive engagement (i.e., attending arts events or listening to music). These distinctions result in significant variability that need for consideration in future studies aimed at advancing our understanding of the complex relationship between culture and health ( 11 , 12 ). To address the problem of revers causality, future studies should consider adopting experimental design, RCTs and consistently include a control group or condition.

5 Conclusion

Our results are encouraging. The primary finding from this systematic review suggests that sustained cultural participation appear to have a positive impact on various dimensions—biopsychosocial—of health and well-being, highlighting the importance of culture for middle-aged and older populations. Those who engage in cultural activities show an improvement in terms of well-being, or at the very least, a maintenance of their health status. Further research, particularly RCTs with control conditions, is needed to gain a deeper understanding of the mechanisms by which cultural participation influences health and well-being outcomes and to develop effective intervention strategies. These studies should employ robust multidimensional measures and also explore potential moderators and mediators, ultimately enhancing the development of future interventions. These findings present a valuable opportunity for multidisciplinary collaboration between healthcare, sociocultural sectors, and arts-related systems and policies.

Author contributions

EV: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, Writing – review & editing. MM: Data curation, Formal analysis, Investigation, Writing – original draft, Writing – review & editing. DC: Conceptualization, Data curation, Investigation, Writing – review & editing. MV: Conceptualization, Data curation, Investigation, Writing – review & editing. DA: Investigation, Writing – review & editing. FF: Conceptualization, Funding acquisition, Supervision, Writing – review & editing.

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The study was partially funded by a grant from Compagnia di Sanpaolo (three-year Cultural Wellbeing Lab project of Compagnia di Sanpaolo, date of resolution 14/12/2020, No. 2020.2218) and by the Aging Project of the Department of Translational Medicine of the University of Eastern Piedmont.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2024.1369066/full#supplementary-material

1. World Health Organization . Constitution of the World Health Organization . New York: United Nations (1948).

Google Scholar

2. Keyes, CLM . Social well-being. Soc Psychol Q . (1998) 61:121–40. doi: 10.2307/2787065

Crossref Full Text | Google Scholar

3. Huber, M, Knottnerus, JA, Green, L, Van Der Horst, H, Jadad, AR, Kromhout, D, et al. How should we define health? BMJ . (2011) 343:d4163. doi: 10.1136/bmj.d4163

4. Fancourt, D, and Finn, S. What is the evidence on the role of the arts in improving health and well-being? A scoping review. Health evidence network synthesis report 67 . WHO Europe: Copenhagen (2019).

5. Viola, E, Martorana, M, Airoldi, C, Meini, C, Ceriotti, D, De Vito, M, et al. The role of music in promoting health and well-being: a systematic review and meta-analysis. Eur J Pub Health . (2023) 33:738–45. doi: 10.1093/eurpub/ckad063

PubMed Abstract | Crossref Full Text | Google Scholar

6. Goulding, A . How can contemporary art contribute toward the development of social and cultural capital for people aged 64 and older. The Gerontologist . (2013) 53:1009–19. doi: 10.1093/geront/gns144

7. Grossi, E, Sacco, PL, Blessi, GT, and Cerutti, R. The impact of culture on the individual subjective well-being of the Italian population: an exploratory study. Appl Res Qual Life . (2011) 6:387–410. doi: 10.1007/s11482-010-9135-1

8. Grossi, E, Tavano Blessi, G, Sacco, PL, and Buscema, M. The interaction between culture, health and psychological well-being: data mining from the Italian culture and well-being project. J Happiness Stud . (2012) 13:129–48. doi: 10.1007/s10902-011-9254-x

9. Wheatley, D, and Bickerton, C. Subjective well-being and engagement in arts, culture and sport. J Cult Econ . (2017) 41:23–45. doi: 10.1007/s10824-016-9270-0

10. Bennington, R, Backos, A, Harrison, J, Reader, AE, and Carolan, R. Art therapy in art museums: promoting social connectedness and psychological well-being of older adults. Arts Psychother . (2016) 49:34–43. doi: 10.1016/j.aip.2016.05.013

11. Rena, M, Fancourt, D, Bu, F, Paul, E, Sonke, J, and Bone, J. Receptive and participatory arts engagement and healthy aging: longitudinal evidence from the health and retirement study. (2022). Available at: https://osf.io/preprints/psyarxiv/q4h6y [10/05/2024]

12. Rena, M, Fancourt, D, Bu, F, Paul, E, Sonke, JK, and Bone, JK. Receptive and participatory arts engagement and subsequent healthy aging: evidence from the health and retirement study. Soc Sci Med . (2023) 334:116198. doi: 10.1016/j.socscimed.2023.116198

13. Bone, JK, Fancourt, D, Sonke, JK, and Bu, F. Participatory and receptive arts engagement in older adults: associations with cognition over a seven-year period. Creat Res J . (2023):1–15. doi: 10.1080/10400419.2023.2247241

14. Pesata, V, Colverson, A, Sonke, J, Morgan-Daniel, J, Schaefer, N, Sams, K, et al. Engaging the arts for wellbeing in the United States of America: a scoping review. Front Psychol . (2022) 12:791773. doi: 10.3389/fpsyg.2021.791773

15. Keisari, S, Hoffman, Y, Ring, L, and Palgi, Y. The moderating effect of older adults’ receptive arts engagement on the association between resilience and anxiety symptoms during coronavirus breakout. J Nerv Ment Dis . (2021) 209:443–8. doi: 10.1097/NMD.0000000000001326

16. Bolwerk, A, Mack-Andrick, J, Lang, FR, Dörfler, A, and Maihöfner, C. How art changes your brain: differential effects of visual art production and cognitive art evaluation on functional brain connectivity. PLoS One . (2014) 9:e101035. doi: 10.1371/journal.pone.0101035

17. Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg . (2021) 88:105906. doi: 10.1016/j.ijsu.2021.105906

18. Moola, S, Munn, Z, Tufanaru, C, Aromataris, E, Sears, K, Sfetcu, R, et al. Systematic reviews of etiology and risk In: E Aromataris and Z Munn, editors. JBI manual for evidence synthesis (2020)

19. Fancourt, D, Steptoe, A, and Cadar, D. Cultural engagement and cognitive reserve: museum attendance and dementia incidence over a 10-year period. Br J Psychiatry . (2018) 213:661–3. doi: 10.1192/bjp.2018.129

20. Fancourt, D, and Steptoe, A. Cultural engagement predicts changes in cognitive function in older adults over a 10 year period: findings from the English longitudinal study of ageing. Sci Rep . (2018) 8:10226–8. doi: 10.1038/s41598-018-28591-8

21. Fancourt, D, and Tymoszuk, U. Cultural engagement and incident depression in older adults: evidence from the English longitudinal study of ageing. Br J Psychiatry . (2019) 214:225–9. doi: 10.1192/bjp.2018.267

22. Fushiki, Y, Ohnishi, H, Sakauchi, F, Oura, A, and Mori, M. Relationship of hobby activities with mortality and frailty among community-dwelling elderly adults: results of a follow-up study in Japan. J Epidemiol . (2012) 22:340–7. doi: 10.2188/jea.JE20110057

23. Rapacciuolo, A, Perrone Filardi, P, Cuomo, R, Mauriello, V, Quarto, M, Kisslinger, A, et al. The impact of social and cultural engagement and dieting on well-being and resilience in a group of residents in the metropolitan area of Naples. J Aging Res . (2016) 2016:1–11. doi: 10.1155/2016/4768420

24. Rogers, NT, and Fancourt, D. Cultural engagement is a risk-reducing factor for frailty incidence and progression. J Gerontol: Series B . (2020) 75:571–6. doi: 10.1093/geronb/gbz004

25. Takeda, F, Noguchi, H, Monma, T, and Tamiya, N. How possibly do leisure and social activities impact mental health of middle-aged adults in Japan?: an evidence from a national longitudinal survey. PLoS One . (2015) 10:e0139777. doi: 10.1371/journal.pone.0139777

26. Tymoszuk, U, Perkins, R, Fancourt, D, and Williamon, A. Cross-sectional and longitudinal associations between receptive arts engagement and loneliness among older adults. Soc Psychiatry Psychiatr Epidemiol . (2020) 55:891–900. doi: 10.1007/s00127-019-01764-0

27. Tymoszuk, U, Perkins, R, Spiro, N, Williamon, A, and Fancourt, D. Longitudinal associations between short-term, repeated, and sustained arts engagement and well-being outcomes in older adults. J Gerontol: Series B . (2020) 75:1609–19. doi: 10.1093/geronb/gbz085

28. Stern, Y . What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc . (2002) 8:448–60. doi: 10.1017/S1355617702813248

29. Buckner, RL . Memory and executive function in aging and AD: multiple factors that cause decline and reserve factors that compensate. Neuron . (2004) 44:195–208. doi: 10.1016/j.neuron.2004.09.006

30. Somes, J . The loneliness of aging. J Emerg Nurs . (2021) 47:469–75. doi: 10.1016/j.jen.2020.12.009

31. Rokach, A . The effect of gender and culture on loneliness: a Mini review. Emerg Sci Jl . (2018) 2:59–64. doi: 10.28991/esj-2018-01128

32. World Health Organization (WHO) . Decade of healthy ageing 2021–2030. (2021). Available at: https://www.who.int/initiatives/decade-of-healthy-ageing .

Keywords: cultural engagement, leisure activities, health, well - being, quality of life

Citation: Viola E, Martorana M, Ceriotti D, De Vito M, De Ambrosi D and Faggiano F (2024) The effects of cultural engagement on health and well-being: a systematic review. Front. Public Health . 12:1369066. doi: 10.3389/fpubh.2024.1369066

Received: 11 January 2024; Accepted: 28 June 2024; Published: 10 July 2024.

Reviewed by:

Copyright © 2024 Viola, Martorana, Ceriotti, De Vito, De Ambrosi and Faggiano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Erica Viola, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

• News Releases

National Institutes of Health grant could mean progress toward improved outcomes for stroke patients

University of Tennessee Health Science Center

Ansley Stanfill, PhD, RN, FAAN

Credit: University of Tennessee Health Science Center

The Associate Dean of Research at the University of Tennessee Health Science Center’s College of Nursing has received a two-year, $421,188 grant from the National Institutes of Health (NIH) to improve cognitive screening in people who suffer from a devastating type of stroke called aneurysmal subarachnoid hemorrhage (aSAH).

Professor Ansley Stanfill, PhD, RN, FAAN, has devoted her program of research to improving outcomes for people who survive strokes. Her latest grant aims to determine if an existing screening tool can be used in a new way to assess patients following aSAH and trigger a referral to an in-depth neuropsychological assessment, which could lead to earlier effective interventions.

 “Over the last 20 years we have done a much better job of saving people. But there is always the question, ‘What are we saving them to?’” Dr. Stanfill said. “My goal is to return them to a good quality of life and to ameliorate their symptoms.”

The aSAH type of stroke strikes relatively young people, carrying a mortality rate of almost 40 percent. About 30 percent of those who do survive will experience severe long-term disability, and many survivors experience cognitive symptoms.  A higher incidence of cognitive issues following such a stroke is seen in rural or African-American patients, Dr. Stanfill said. It is hoped that the study could make a significant impact on improving equity by informing new practice guidelines that provide an earlier and more accurate assessment of cognitive issues.

In the study’s pilot data, cognitive problems went undetected in about 67% of patients because they were not picked up by typical outpatient clinical neurological exams, Dr. Stanfill said. Patients who survive aSAH can be affected at the level of executive function in cognition, which includes some of the everyday skills needed to make plans or solve problems. Dr. Stanfill gave the example of an accountant who could still do his job but was frustrated that he could not add numbers in his head anymore.

The study will enroll 60 aSAH patients over 18 months as they seek outpatient follow-up care at Semmes Murphey Clinic. The researchers will also be collecting information from someone who lives with or is close to the patient to determine if they report different cognitive issues than the patient does.

Dr. Stanfill will serve as Principal Investigator on this grant and will be supported by Co-Investigators Assistant Professor Brandon Baughman, PhD, in the Department of Neurosurgery, and Associate Professor Xueyuan Cao, PhD,  and Research Manager Drew Prescott, MHIM, both in the College of Nursing.

“I have been wanting to do this project for a long time,” Dr. Stanfill said. “This is all building toward my goal of improving physical, affective, and cognitive outcomes for people who suffer a stroke.” In 2018, she received a $1.1 million NIH grant to study how social, clinical, and genetic factors affect a person’s risk for developing severe disability after subarachnoid hemorrhage, aiming to also give insight into the disparities for this outcome seen between Caucasian and African-American patients.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Original Source

• Open access
• Published: 12 July 2024

Evaluating the perceived impact and legacy of master’s degree level research in the allied health professions: a UK-wide cross-sectional survey

• Terry Cordrey 1 , 2 ,
• Amanda Thomas 3 ,
• Elizabeth King 1 , 2 &
• Owen Gustafson 1 , 2  

BMC Medical Education volume  24 , Article number:  750 ( 2024 ) Cite this article

136 Accesses

3 Altmetric

Metrics details

Post graduate master’s degree qualifications are increasingly required to advance allied health profession careers in education, clinical practice, leadership, and research. Successful awards are dependent on completion of a research dissertation project. Despite the high volume of experience gained and research undertaken at this level, the benefits and impact are not well understood. Our study aimed to evaluate the perceived impact and legacy of master’s degree training and research on allied health profession practice and research activity.

A cross-sectional online survey design was used to collect data from allied health professionals working in the United Kingdom who had completed a postgraduate master’s degree. Participants were recruited voluntarily using social media and clinical interest group advertisement. Data was collected between October and December 2022 and was analysed using descriptive statistics and narrative content analysis. Informed consent was gained, and the study was approved by the university research ethics committee.

Eighty-four responses were received from nine allied health professions with paramedics and physiotherapists forming the majority (57%) of respondents. Primary motivation for completion of the master’s degree was for clinical career progression ( n  = 44, 52.4%) and formation of the research dissertation question was predominantly sourced from individual ideas ( n  = 58, 69%). Formal research output was low with 27.4% ( n  = 23) of projects published in peer reviewed journal and a third of projects reporting no output or dissemination at all. Perceived impact was rated highest in individual learning outcomes, such as improving confidence and capability in clinical practice and research skills. Ongoing research engagement and activity was high with over two thirds ( n  = 57, 67.9%) involved in formal research projects.

The focus of master's degree level research was largely self-generated with the highest perceived impact on individual outcomes rather than broader clinical service and organisation influence. Formal output from master’s research was low, but ongoing research engagement and activity was high suggesting master’s degree training is an under-recognised source for AHP research capacity building. Future research should investigate the potential benefits of better coordinated and prioritised research at master’s degree level on professional and organisational impact.

Peer Review reports

Higher levels of research engagement by healthcare organisations and clinicians are associated with improved organisational performance and clinical outcomes [ 1 , 2 , 3 ]. The Allied Health Professions (AHPs) comprise one third of the health and social care workforce in the United Kingdom and when engaged in research, offer substantial benefit to population health and organisational performance [ 4 ]. The strategic focus on AHP research has grown substantially in recent years. This includes the first ever national research and innovation strategy for AHPs in England, as well as clear strategic intention through AHP clinical research networks hosted by the National Institute for Health Research [ 5 , 6 ]. These strategies reinforce the need for capacity building, engagement, and cultural improvements for advancing AHP research. Realising these ambitions has, to date, been limited by insufficient funding, career infrastructure, and organisational support [ 7 ].

Alongside the strategic ambitions for AHP research, is the increasing requirement for post-graduate master’s degree qualifications for career progression in academic, leadership and clinically advanced AHP roles. For example, 69% of Advanced Clinical Practitioners (ACP’s) state the requirement for master’s degree qualification for their current ACP role [ 8 ].

With few exceptions, a master’s degree award is dependent on the successful completion of a supervised research dissertation project. This is usually accompanied by taught research methodology to support the development of research knowledge and skills. Master’s degree research ideas are conceived in a variety of ways, either as stand-alone projects, supplied by a university academic as one part of a larger programme of work, or developed in collaboration with a health service [ 9 ]. AHP research projects developed collaboratively between health and academic centres are more likely to be widely disseminated, impactful on clinical practice, and lead to further research compared to projects undertaken exclusively within a university setting [ 10 ].

Despite the high cumulation of training and research at this level over the years, the broader impact on clinical services, employing organisations, and the wider research community is currently unknown [ 11 ]. Beyond the fulfilment of individual learning objectives, it is difficult to determine what real-world impact AHP master’s research offers in terms of original knowledge contribution. Similarly, the rate of conversion of AHP master’s degree research to peer reviewed publications or conference proceedings remains unexplored [ 12 ]. This situation risks a low return on investment in terms of the generation and translation of knowledge to address the challenges faced by AHPs in healthcare practice [ 13 ]. Responsible practice in AHP post graduate training and research should, in part, be concerned with reducing waste that arises from decisions about what research to prioritise, as well as educational benefit to the individuals [ 14 ]. Aligning and coordinating more AHP master's degree research activity through collaboration may prevent AHP dissertations entering the “relevance waste quadrant” [ 15 ]. Models of portfolio research, which are coordinated efforts to address the highest priority knowledge gaps through research collaborations, represent an alternative approach to the current system [ 16 ].

The primary aim of our study is to evaluate the perceived impact and sustained effect of master’s degree research dissertation projects on AHP research capacity, capability, and clinical practice. In doing this, we have set out five supporting objectives:

To understand how master’s degree research dissertation questions were determined.

To establish the rate of conversion of master’s degree research to traditional measures of research output and dissemination.

To establish whether successful completion of master’s degree research promotes the maturation of ongoing research active clinicians.

To determine the perceived impact of research skills developed through master’s degree completion on AHP research capacity building within individuals and organisations.

To determine the perceived impact of master’s degree research on clinical practice and services.

An online cross-sectional survey design was chosen as the method to conduct this study, and it is being reported according to the consensus-based checklist for reporting of survey studies [ 17 ]. A bespoke survey was constructed using Microsoft Forms software and was hosted online via Microsoft Office 365. The survey comprised 27 questions arranged into sections to collect data on participant demographics, and the experience, outcomes, and perceived impact of master’s degree training and completion of a research dissertation project (see additional file 2 in supplementary information). To develop the survey, a pilot survey was undertaken using four qualified AHP volunteers to appraise the structure, content, and readability of the questions. Feedback from the pilot was used to revise and finalise the survey.

The target population were AHPs, which is an umbrella term for fourteen different professions usually employed in a variety of roles across health, care, academic, and voluntary sectors ( https://www.england.nhs.uk/ahp/role/ ). Participants were eligible to take part if they were 1) qualified AHPs currently working in the United Kingdom (UK), 2) held a post graduate master’s degree award, and 3) were able to provide informed consent. Participants were ineligible if their master’s degree was obtained as a pre-registration qualification, and they did not meet the other inclusion criteria. A target sample size of 139 was calculated by estimating the proportion of all registered AHPs in the UK holding a master’s degree qualification. This estimation was determined by profiling the qualifications of AHP staff in two large National Health Service (NHS) teaching hospitals. To account for a sampling calculation error, a confidence interval (95%) and margin of error (5%) threshold were applied accordingly (see additional file 3 in supplementary information).

Participant recruitment was achieved through advertising on social media platforms, and via newsletters and bulletins circulated by AHP professional and clinical interest groups. Participant information was provided outlining the study details, anonymity of survey responses, and the requirement to provide informed consent and eligibility at the start of the online survey. Those taking part were asked to reflect on their experiences of completing a post graduate master’s degree and research dissertation project in relation to its impact and legacy. The ‘one response per participant’ feature was enabled to prevented multiple completion of the survey by the same participant. The survey was live for data collection for three months running from October to the end of December 2022. During data collection, several efforts were made to promote the survey through social media to increase participation.

The survey data was analysed in two ways. First, descriptive statistics were used to analyse numerical, multiple choice, and ordinal scale data. Second, free text responses providing reflective accounts and experiences underwent coding and content analysis using NVivo software (version 12).

This study was approved by the university research ethics committee (registration number: 221613) and was conducted in accordance with the principles of good clinical practice.

The survey received 84 responses from nine of the fourteen allied health professions, which represents 60% of the target sample of 139. The majority of responses were from physiotherapists ( n  = 40, 47.6%) and respondents had been qualified for a median (IQR) of 18 years (12–23). Respondents worked in a variety of clinical specialties, with emergency/pre-hospital medicine ( n  = 18, 21.4%), neurology ( n  = 12, 14.3%) and critical care ( n  = 11, 13.1%) the most common. Most respondents had completed their master’s degree after 2010 ( n  = 68, 81%) and were employed at band 6 grade when starting ( n  = 39, 46.4%). Most respondents worked in the NHS ( n  = 78, 92.3%) and had undertaken a Master of Science (MSc) award ( n  = 70, 83.3%). Most participants were employed in a higher paid position after completing their master's degree ( n  = 62, 73.8%). The full characteristics of the respondents are detailed in Table  1 .

Respondents predominantly formed their dissertation research questions from their own area of interest (Table  2 ). Less than 10% of the dissertation questions were based on published research priorities or set by the Higher Education Institute (HEI), regional or local healthcare organisation/collaborative ( n  = 7, 8.3%). A variety of methodologies were used to conduct the master’s research dissertation with evidence synthesis being the most common ( n  = 30, 35.7%).

Formal research output from the dissertations was low (Table  2 ). Half the dissertations were presented at a local research symposium ( n  = 44, 52.4%), 27.4% ( n  = 23) were published in a peer reviewed journal, and over a third of dissertations had no output at all ( n  = 30, 35.7%). Master’s degree programmes contributing to the peer reviewed publications as a proportion of students were Master by Research (MRes) ( n  = 5, 45.5%), and MSc ( n  = 18, 25.7%).

Of the dissertations formed through the individual's own ideas, 27.6% ( n  = 16) were published in a peer reviewed journal, compared to 57.1% ( n  = 4) of those set through research priorities, or the HEI/healthcare organisation. The most common methodologies published in a peer review journal were evidence synthesis ( n  = 7, 30.4%), qualitative interviews/focus groups ( n  = 6, 26.1%) and quantitative experimental studies ( n  = 6, 26.1%). The methodology of dissertation projects with the highest proportion of peer reviewed journal publication was qualitative interviews/focus groups ( n  = 7, 36.8%).

The respondents reported their master's degree dissertation as having a positive impact on their professional development (Fig.  1 ). Qualitative content analysis of the free text responses demonstrated that respondents felt the dissertation increased their research capability and confidence at multiple stages of the research process while providing opportunities for networking and collaborations.

Perceived impact of master’s degree research on professional and clinical service development

Most participants continued to engage in research activities after their dissertation ( n  = 65, 77.4%) through supporting others ( n  = 63, 75%), taking part in formal research projects ( n  = 57, 67.9%) and publishing research papers ( n  = 41, 48.8%) (Table  3 ). Less than ten percent (9.5%, n  = 8) reported being deterred from undertaking further research (Fig.  1 ).

The wider perceived impact of the dissertation on services in which the respondents worked was more varied (Fig.  1 ). Improved service user outcome/experience and team practice was reported by 60.7% ( n  = 51) and 53.6% ( n  = 45) respectively. Analysis of free text responses demonstrated wide ranging perceived impact on services from no local impact to improved team education, service delivery and application of evidence-based practice.

Our study evaluated the perceived impact of master's degree level research on AHP professional development, research capacity, and clinical practice. Our findings indicate a relatively low level of dissemination and formal output arising from master’s degree research, but a high perception of impact on individual AHPs and the clinical services in which they work. The level of ongoing engagement in research activity following master’s degree completion was high indicating a positive legacy in this respect. The degree to which this meaningfully contributes to AHP research capacity building requires further investigation.

The majority (69%) of master’s degree research questions were developed from the respondent’s own ideas rather than drawing on published research priorities or collaborations between health and academic organisations. The limited use of research priorities may be explained by a potential lack of awareness. A qualitative study of 95 AHPs working in Australia found that in the absence of a recognised framework to guide research prioritisation, individual clinicians conducted research in areas important to them [ 18 ]. Pursuing individual preferences in this way stemmed from evaluations of their personal work, departmental policies or procedures, models of care innovation, and a clear preference for research which “tested solutions”. Similarly, Amalkumaran et al. (2016) explored critical care research priorities and found that research topics suggested by professional sub-groups tended to be related to their daily practice rather than broader research priorities [ 19 ].

It is also possible that the choice of research question is influenced by the career motivation of the individual AHP. A UK wide cross-sectional survey of AHPs working in health and social care reported primary motivators for research participation were to develop skills (80%) and increase job satisfaction (63%), rather than contribute to the prioritised evidential knowledge base [ 20 ]. Davis et al. (2019) also recognise this self-actualising motivation for research participation in their AHP cohort [ 18 ]. It is possible that the debut, non-commissioned research activity introduced by master’s level academic programmes emphasises process over content , decreasing the alignment of research activity with known research priorities.

We found a low conversion rate from master’s dissertation completion to formal research output. This is well illustrated in that just one in four (27.4%) master’s theses resulted in a peer-reviewed publication. Similar publication rates have been reported in master’s students of other healthcare disciplines; these are also considered low by way of expected research output [ 21 ]. Understanding this further is challenging due to the limited research in this subject area, which suggests a lack of interest and/or perceived importance. However, there are two key issues that arguably counter this view. First, master’s degree research projects are typically approved by a university research ethics committee, and thus are guided by the principle that the value in their conduct and knowledge contribution should outweigh the burden or risks to participants [ 22 ]. Fidelity to this principle can only be meaningfully appraised if the results are published for wider critical evaluation. Second, AHP skill and success level in research activities, such as writing for peer-reviewed publication is widely and consistently reported as low [ 23 , 24 , 25 ]. This clearly represents an area for improvement for AHPs and failing to challenge the development of this skill in those undertaking post graduate level research seems counter intuitive. Higher rates of master’s degree research publication could offer a meaningful contribution to AHP research capacity building, since our findings suggest there is continued engagement in research activity from this group beyond completion of their studies.

Respondents to our survey indicated a good level of research engagement after master’s degree training. Over three quarters reported continued involvement in research beyond the completion of their programme. This finding supports the idea that research education is a key lever and greatly needed to successfully build AHP research capacity [ 26 , 27 ]. However, the degree to which master’s degree training translates to growth in the research capacity of individuals has not been subject to causal investigation. Proxy indicators of individual research capacity from our cohort can be found in the self-reported high levels of research confidence and capability derived from master’s degree training (Fig.  1 ) and ongoing research activity. This activity included 60% taking part in formal research projects, around half had published research papers, and over a third had embarked on a higher research degree. The lack of previous research in this area makes it challenging to fully contextualise our findings, but in conducting our study, we have set out a benchmark for the perceived impact of masters degree training on individual AHP research capacity for future investigation.

We explored higher level outcomes of master’s degree training on research capacity building, such as those that might influence policy, career pathways, and organisational practice. Using the Kirkpatrick-Barr model of educational outcomes, we found the activity and outcomes from our cohort aligned best to an individual learner level [ 28 ]. This finding is typical of outcomes from education at this level, which centre largely on the individuals through self-reported satisfaction and perceptions of learning [ 29 ]. Understanding the impact of research education and training in relation to higher Kirkpatrick-Barr outcomes requires objective and longitudinal evaluation of research metrics and impact at organisational and system level [ 30 ]. This is likely to include contributions to larger programmes of work requiring large grant awards, significant publications, and translation of those research findings to health organisation and system level innovation [ 31 , 32 ]. Research capacity building at this level is known to be challenging due to the inherent complexities involving political, financial, structural, and cultural factors [ 33 ]. To overcome this, the use of theoretical frameworks has been suggested to help conceptualise and integrate a culture and proliferation of AHP research at various health system structural levels [ 34 ]. The positioning of AHP master’s degree training and research activity as part of this may foster greater academic-health system collaboration for professional, service user, and population benefit [ 35 ].

The perceived impact of master’s degree research included improvements to service user outcomes, clinical pathways, and organisational policies and/or guidelines. Research impact, defined as the demonstrable benefit of research to individuals and society, is complex and requires wide stakeholder engagement to determine whether research has addressed known priorities through effective translation of knowledge from its findings [ 36 ]. The self-generated research questions and low level of dissemination and output reported by our cohort suggests a degree of dissonance between the level of perceived impact versus what is measurably impactful to clinical services and end users. This difference may be explained by the challenges in defining and quantifying research impact for novice researchers, which is described as an ambiguous and subjective concept [ 37 ]. It is therefore not surprising to see the highest levels of reported impact from our cohort was on their own professional development in terms of improved confidence, leadership and research capability, and clinical practice development. Without a more objective assessment of the wider impact from the research undertaken at this level, it is difficult to reconcile its actual impact. The emergence of assessment frameworks, such as the visible impact of research tool, make it accessible for relatively inexperienced researchers to understand how their research has led to visible changes and impact on services and other research consumers [ 38 ].

Strengths and limitations

A key strength of our study lies in its novelty; we believe it to be the first to evaluate the perceived impact of research undertaken by AHPs at master’s degree level. This represents an important first step in highlighting the conduct and contribution of research undertaken at this level, as well providing opportunities to improve future practice and impact. There are several limitations to our study. We only managed to recruit 60% of our target sample via a non-probability sampling technique, which included a lack of representation from five of the 14 professions. This means our findings are vulnerable to sampling bias by potentially excluding AHPs who do not use social media or subscribe to clinical interest groups, which were the two main platforms for our recruitment. Our recruitment practice and the method of a self-reporting survey means our findings are not generalisable to the wider AHP population and they should be interpreted with these limitations in mind. A further limitation is the disproportionate representation of two of the fourteen allied health professions. Responses from paramedics and physiotherapists constituted 57% of our data with very few responses from seven other professions and no responses from five of the professions.

The perceived impact of AHP master’s degree training and research was highest on individual development rather than service and organisation outcomes. This is likely to derive from the individual motivation in undertaking post-graduate study and self-determined research dissertation focus. Whilst the formal research output arising from the master’s research was relatively low, the legacy in terms of ongoing research engagement and activity was positive indicating that master’s degree completion maybe an under-recognised source of AHP research capacity building. Our study provides novel insights into the perceived impact of AHP master’s degree level research. Future research should explore the feasibility and benefits of coordinating AHP master’s degree research with local or national priorities to understand the impact beyond that realised at an individual level.

Availability of data and materials

All data generated or analysed during this study are included in this published article [and its supplementary information files].

Abbreviations

Allied Health Professions

Advanced Clinical Practitioner

United Kingdom

National Health Service

Qualitative data analysis software

Interquartile Range

Master of Science

Higher Education Institute

Masters by Research

Master of Art

Doctor of Philosophy

Boaz A, Hanney S, Jones T, et al. Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open. 2015;5:e009415. https://doi.org/10.1136/bmjopen-2015-009415 .

Article   Google Scholar  

Hanney S, Boaz A, Jones T, Soper B. Engagement in research: an innovative three-stage review of the benefits for health-care performance. Southampton: NIHR Journals Library; 2013.

Google Scholar  

Harding K, Lynch L, Porter J, Taylor NF. Organisational benefits of a strong research culture in a health service: a systematic review. Aust Health Rev. 2017;41(1):45–53. https://doi.org/10.1071/AH15180 .

Harris J, Grafton K, Cooke J. Developing a consolidated research framework for clinical allied health professionals practising in the UK. BMC Health Serv Res. 2020;20:852. https://doi.org/10.1186/s12913-020-05650-3 .

Health Education England. Allied health professions research and innovation strategy. NHS England; 2022.  https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/allied-health-professions%E2%80%99-research-innovation-strategy-england . Accessed 21 Jan 2023.

National Institute of Health Research. NIHR Clinical Research Network (CRN) allied health professionals strategy 2018–2020. 2018. https://www.nihr.ac.uk/documents/nihr-crn-allied-health-professionals-strategy-2018-2020/11530 . Accessed 4 Jan 2023.

Pager S, Holden L, Golenko X. Motivators, enablers, and barriers to building allied health research capacity. J Multidiscip Healthc. 2012;5:53–9. https://doi.org/10.2147/JMDH.S27638 .

Stewart-Lord A, Beanlands C, Khine R, Shamah S, Sinclair N, Woods S, Woznitza N, Baillie L. The role and development of advanced clinical practice within allied health professions: a mixed method study. J Multidiscip Healthc. 2020;25(13):1705–15. https://doi.org/10.2147/JMDH.S267083 .

Angus RL, Hattingh HL, Weir KA. Experiences of hospital allied health professionals in collaborative student research projects: a qualitative study. BMC Health Serv Res. 2022;22:729. https://doi.org/10.1186/s12913-022-08119-7 .

Whelan K, Thomas JE, Madden AM. Student research projects: the experiences of student dietitians, university faculty members, and collaborators. J Am Diet Assoc. 2007;107(9):1567–74. https://doi.org/10.1016/j.jada.2007.06.009 .

Zwanikken PA, Dieleman M, Samaranayake D, et al. A systematic review of outcome and impact of Master’s in health and health care. BMC Med Educ. 2013;13:18. https://doi.org/10.1186/1472-6920-13-18 .

Murray C, Judd D, Snyder P. Evaluation of a post-professional master’s program in allied health. J Allied Health. 2001;30(4):223–8.

Salbach NM, O’Brien K, Evans C, Yoshida K. Dissemination of student research in a Canadian master of science in physical therapy programme. Physiother Can. 2013;65(2):154–7. https://doi.org/10.3138/ptc.2012-18 .

Choi T, Palermo C, Sarkar M, Whitton J, Rees C, Clemans A. Priority setting in higher education research using a mixed methods approach. Higher Ed Res Dev. 2022;42(4):816–30. https://doi.org/10.1080/07294360.2022.2082389 .

Chalmers I, Bracken MB, Djulbegovic B, Garattini S, Grant J, Gülmezoglu AM, Howells DW, Ioannidis JP, Oliver S. How to increase value and reduce waste when research priorities are set. Lancet. 2014;383(9912):156–65. https://doi.org/10.1016/S0140-6736(13)62229-1 .

Nyström ME, Karltun J, Keller C, et al. Collaborative and partnership research for improvement of health and social services: researcher’s experiences from 20 projects. Health Res Policy Sys. 2018;16:46. https://doi.org/10.1186/s12961-018-0322-0 .

Sharma A, Minh Duc N, Luu Lam Thang T, et al. A consensus-based checklist for reporting of survey studies (CROSS). J Gen Intern Med. 2021;36:3179–87. https://doi.org/10.1007/s11606-021-06737-1 .

Davis A, Lee D, Wenzel L, Haines T. Setting research priorities within allied health: what do clinicians think? Int J Allied Health Sci Pract. 2019;17(1):Article 6.

Arulkumaran N, Reay H, Brett SJ, JLA Intensive Care Research Priority Setting Partnership. Research priorities by professional background - a detailed analysis of the James Lind Alliance Priority Setting Partnership. J Intensive Care Soc. 2016;17(2):111–6. https://doi.org/10.1177/1751143715609954 .

Comer C, Collings R, McCracken A, Payne C, Moore A. Allied health professionals’ perceptions of research in the United Kingdom national health service: a survey of research capacity and culture. BMC Health Serv Res. 2022;22(1):1094. https://doi.org/10.1186/s12913-022-08465-6 .

Resta RG, McCarthy Veach P, Charles S, Vogel K, Blase T, Palmer CG. Publishing a master’s thesis: a guide for novice authors. J Genet Couns. 2010;19(3):217–27. https://doi.org/10.1007/s10897-009-9276-2 .

United Kingdom Research and Innovation. Framework for research ethics. 2021. https://www.ukri.org/councils/esrc/guidance-for-applicants/research-ethics-guidance/framework-for-research-ethics/our-core-principles/ . Accessed 23 Jan 2023.

Cordrey T, King E, Pilkington E, et al. Exploring research capacity and culture of allied health professionals: a mixed methods evaluation. BMC Health Serv Res. 2022;22:85. https://doi.org/10.1186/s12913-022-07480-x .

Frakking T, Craswell A, Clayton A, Waugh J. Evaluation of research capacity and culture of health professionals working with women, children and families at an Australian Public Hospital: a cross sectional observational study. J Multidiscip Healthc. 2021;14:2755–66. https://doi.org/10.2147/JMDH.S330647 . Published 2021 Oct 1.

Matus J, Wenke R, Hughes I, Mickan S. Evaluation of the research capacity and culture of allied health professionals in a large regional public health service. J Multidiscip Healthc. 2019;12(83):96. https://doi.org/10.2147/JMDH.S178696 .

King O, West E, Lee S, Glenister K, Quilliam C, Wong Shee A, Beks H. Research education and training for nurses and allied health professionals: a systematic scoping review. BMC Med Educ. 2022;22(1):385. https://doi.org/10.1186/s12909-022-03406-7 .

King E, Cordrey T, Gustafson O. Exploring individual character traits and behaviours of clinical academic allied health professionals: a qualitative study. BMC Health Serv Res. 2023;23:1025. https://doi.org/10.1186/s12913-023-10044-2 .

Barr H, Koppel I, Reeves S, Hammick M, Freeth DS. Effective interprofessional education: argument, assumption and evidence (promoting partnership for health). Chichester: John Wiley & Sons, Incorporated; 2005.

Book   Google Scholar  

Famure O, Batoy B, Minkovich M, Liyanage I, Kim SJ. Evaluation of a professional development course on research methods for healthcare professionals. Healthc Manage Forum. 2021;34(3):186–92.

Madi M, Hamzeh H, Griffiths M, et al. Exploring taught masters education for healthcare practitioners: a systematic review of literature. BMC Med Educ. 2019;19:340. https://doi.org/10.1186/s12909-019-1768-7 .

Duncanson K, Webster EL, Schmidt DD. Impact of a remotely delivered, writing for publication program on publication outcomes of novice researchers. Rural Remote Health. 2018;18(2):4468.

Schmidt D, Duncanson K, Webster E, Saurman E, Lyle D. Critical realist exploration of long-term outcomes, impacts and skill development from an Australian rural research capacity building programme: a qualitative study. BMJ Open. 2022;12(12):e065972.

Whitehouse CL, Copping J, Morris P, Guledew D, Chilson B, Gray R, et al. An organisational approach to building research capacity among nurses, midwives and allied health professionals (NMAHPs) in clinical practice. Int Pract Dev J. 2022;12(2):1.

Slade SC, Philip K, Morris ME. Frameworks for embedding a research culture in allied health practice: a rapid review. Health Res Policy Sys. 2018;16:29. https://doi.org/10.1186/s12961-018-0304-2 .

Matus J, Walker A, Mickan S. Research capacity building frameworks for allied health professionals - a systematic review. BMC Health Serv Res. 2018;18(1):716. https://doi.org/10.1186/s12913-018-3518-7 .

Reed MS, Ferré M, Martin-Ortega J, Blanche R, Lawford-Rolfe R, Dallimer M, Holden J. Evaluating impact from research: a methodological framework. Res Policy. 2021;50(4):104147. https://doi.org/10.1016/j.respol.2020.104147

Belcher B, Halliwell J. Conceptualizing the elements of research impact: towards semantic standards. Humanit Soc Sci Commun. 2021;8:183. https://doi.org/10.1057/s41599-021-00854-2 .

Jones NL, Cooke J, Holliday J. Making occupational therapy research visible: amplifying and elevating the contribution and impacts. Br J Occup Ther. 2021;84(4):197–9. https://doi.org/10.1177/0308022620988473 .

Download references

Acknowledgements

The authors would like to thank all the allied health professionals who gave their time to participate in this survey.

Dr Owen Gustafson, Clinical Doctoral Research Fellow (NIHR301569), is funded by Health Education England (HEE)/National Institute for Health Research (NIHR). The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.

Author information

Authors and affiliations.

Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK

Terry Cordrey, Elizabeth King & Owen Gustafson

Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK

Barts Health NHS Trust, Royal London Hospital, London, E1 1BB, UK

Amanda Thomas

You can also search for this author in PubMed   Google Scholar

Contributions

All authors conceived and designed the study. All authors designed the survey content and structure. TC prepared the online survey. All authors promoted recruitment to the survey. EK and OG undertook data analysis and interpretation. TC prepared Fig.  1 . OG prepared Tables 1 ,  2 and  3 . AT wrote the background and part of the discussion. TC wrote the abstract, methods, part of the discussion, and conclusion. EK and OG wrote the results. All authors reviewed the manuscript and consented to publication.

Corresponding author

Correspondence to Terry Cordrey .

Ethics declarations

Ethics approval and consent to participate.

The study was approved by Oxford Brookes University research ethics committee and assigned registration number: 221613. This study was conducted according to the relevant guidelines and regulations of the Declaration of Helsinki. Survey respondents were required to read the participant information sheet and provide informed consent prior to taking part.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

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

Supplementary Information

Supplementary material 1., supplementary material 2., supplementary material 3., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Cordrey, T., Thomas, A., King, E. et al. Evaluating the perceived impact and legacy of master’s degree level research in the allied health professions: a UK-wide cross-sectional survey. BMC Med Educ 24 , 750 (2024). https://doi.org/10.1186/s12909-024-05582-0

Download citation

Received : 20 March 2023

Accepted : 21 May 2024

Published : 12 July 2024

DOI : https://doi.org/10.1186/s12909-024-05582-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Master’s degree
• Research training
• Allied health professions
• Research capacity
• Research impact

BMC Medical Education

ISSN: 1472-6920

• Submission enquiries: [email protected]
• General enquiries: [email protected]

• Biochemistry and Molecular Biology
• Biostatistics
• Environmental Health and Engineering
• Epidemiology
• Health Policy and Management
• Health, Behavior and Society
• International Health
• Mental Health
• Molecular Microbiology and Immunology
• Population, Family and Reproductive Health
• Program Finder
• Admissions Services
• Course Directory
• Academic Calendar
• Hybrid Campus
• Lecture Series
• Convocation
• Strategy and Development
• Implementation and Impact
• Integrity and Oversight
• In the School
• In the Field
• In Baltimore
• Resources for Practitioners
• Articles & News Releases
• In The News
• Statements & Announcements
• At a Glance
• Student Life
• Strategic Priorities
• Inclusion, Diversity, Anti-Racism, and Equity (IDARE)
• What is Public Health?

Concentration in Health Economics and Policy

Offered By: Department of Health Policy and Management

Onsite | Full-Time | 4 - 5 years

• MAS Application Fee Waiver Requirements
• Master of Arts (MA) in Geography and Environmental Engineering
• Master of Arts and Master of Science in Public Health (MA/MSPH)
• Master of Arts in Public Health Biology (MAPHB)
• Master of Bioethics (MBE)
• Mission, Vision, and Values
• Student Experience
• Program Outcomes
• For Hopkins Undergraduate Students
• Master of Health Science (MHS) - Department of Biochemistry and Molecular Biology
• Master of Health Science (MHS) - Department of Epidemiology
• Alumni Update
• MHS Combined with a Certificate Program
• Master of Health Science (MHS) - Department of Molecular Microbiology and Immunology
• Alumni Highlights
• Post-Baccalaureate Program in Environmental Health for Pre-Medicine Students
• Bachelor's/MHS in Health Economics and Outcomes Research
• MHS HEOR Careers
• Frequently Asked Questions
• Master of Health Science (MHS)
• Concurrent School-Wide Master of Health Science Program in Biostatistics
• Master of Health Science - Department of Population, Family and Reproductive Health
• Master of Health Science Online (MHS) - Department of Population, Family and Reproductive Health
• Careers in Health Economics
• Core Competencies
• Meet the Director
• What is Health Economics
• MPH Capstone Schedule
• Concentrations
• Online/Part-Time Format
• Requirements

Tuition and Funding

• Executive Board Faculty
• Master of Science (MS) in Geography and Environmental Engineering
• Independent Professional Project and Final Essay 
• Program Objectives and Outcomes
• Internships
• Master of Science (ScM) - Department of Biochemistry and Molecular Biology
• Master of Science (ScM) - Department of Biostatistics
• Master of Science (ScM) - Department of Epidemiology
• Master of Science (ScM) - Department of Molecular Microbiology and Immunology
• ScM Faculty Advisers
• Master of Science in Engineering (MSE) in Geography and Environmental Engineering
• Bachelor's/MSPH in Health Policy
• FAQ for MSPH in Health Policy
• Field Placement Experience
• MSPH Capstone
• MSPH Practicum
• Required and Elective Courses
• Student Timeline
• Career Opportunities
• 38-Week Dietetics Practicum
• Completion Requirements
• MSPH/RD Program FAQ
• Program Goals
• Master's Essay Titles
• Application Fee Waiver Requirements
• Doctor of Philosophy (PhD) - Department of Biostatistics
• Doctor of Philosophy (PhD) - Department of Epidemiology
• Program Goals and Expectations
• Doctor of Philosophy (PhD) - Department of Molecular Microbiology and Immunology
• Doctor of Philosophy (PhD) - Department of Population, Family and Reproductive Health
• Doctor of Philosophy (PhD) in Clinical Investigation
• Track in Environmental Sustainability, Resilience, and Health
• Track in Exposure Sciences and Environmental Epidemiology
• Track in Health Security
• Track in Toxicology, Physiology and Molecular Mechanisms
• PhD in Geography and Environmental Engineering Faculty Advisers
• Recent Graduates and Dissertation Titles
• PhD Funding
• PhD TA Requirement
• Recent Dissertation Titles
• JHU-Tsinghua Doctor of Public Health
• Core Course Requirements
• Concentration in Women’s and Reproductive Health
• Custom Track
• Concentration in Environmental Health
• Concentration in Global Health: Policy and Evaluation
• Concentration in Health Equity and Social Justice
• Concentration in Health Policy and Management
• Concentration in Implementation Science
• Meet Current Students
• Combined Bachelor's / Master's Programs
• Concurrent MHS Option for BSPH Doctoral Students
• Concurrent MSPH Option for JHSPH Doctoral students
• Doctor of Medicine and Doctor of Philosophy (MD/PhD)
• Adolescent Health Certificate Program
• Bioethics Certificate Program
• Climate and Health Certificate Program
• Clinical Trials Certificate Program
• Community- Based Public Health Certificate Program
• Demographic Methods Certificate Program
• Environmental and Occupational Health Certificate Program
• Epidemiology for Public Health Professionals Certificate Program
• Evaluation: International Health Programs Certificate Program
• Food Systems, the Environment and Public Health Certificate Program
• Frequently Asked Questions for Certificate Programs
• Gender and Health Certificate Program
• Gerontology Certificate Program
• Global Digital Health Certificate Program
• Global Health Certificate Program
• Global Health Practice Certificate Program
• Health Communication Certificate Program
• Health Disparities and Health Inequality Certificate Program
• Health Education Certificate Program
• Health Finance and Management Certificate Program
• Health and Human Rights Certificate Program
• Healthcare Epidemiology and Infection Prevention and Control Certificate Program
• Humane Sciences and Toxicology Policy Certificate Program
• Humanitarian Health Certificate Program
• Implementation Science and Research Practice Certificate Program
• Injury and Violence Prevention Certificate Program
• International Healthcare Management and Leadership Certificate Program
• Leadership for Public Health and Healthcare Certificate Program
• Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Public Health Certificate Program
• Maternal and Child Health Certificate Program
• Mental Health Policy, Economics and Services Certificate Program
• Non-Degree Students General Admissions Info
• Pharmacoepidemiology and Drug Safety Certificate Program
• Population Health Management Certificate Program
• Population and Health Certificate Program
• Product Stewardship for Sustainability Certificate Program
• Public Health Advocacy Certificate Program
• Public Health Economics Certificate Program
• Public Health Informatics Certificate Program
• Public Health Practice Certificate Program
• Declaration of Intent - Public Health Preparedness
• Public Health Training Certificate for American Indian Health Professionals
• Public Mental Health Research Certificate Program
• Quality, Patient Safety and Outcomes Research Certificate Program
• Quantitative Methods in Public Health Certificate Program
• Requirements for Successful Completion of a Certificate Program
• Rigor, Reproducibility, and Responsibility in Scientific Practice Certificate Program
• Risk Sciences and Public Policy Certificate Program
• Spatial Analysis for Public Health Certificate Program
• Training Certificate in Public Health
• Tropical Medicine Certificate Program
• Tuition for Certificate Programs
• Vaccine Science and Policy Certificate Program
• Online Student Experience
• Online Programs for Applied Learning
• Barcelona Information
• Registration, Tuition, and Fees
• Agency Scholarship Application
• General Scholarship Application
• UPF Scholarship Application
• Course Evaluations
• Online Courses
• Registration
• General Institute Tuition Information
• International Students
• Directions to the Bloomberg School
• All Courses
• Important Guidance for ONSITE Students
• D.C. Courses
• Registration and Fees
• Cancellation and Closure Policies
• Application Procedures
• Career Search
• Current Activities
• Current Trainees
• Related Links
• Process for Appointing Postdoctoral Fellows
• Message from the Director
• Program Details
• Admissions FAQ
• Current Residents
• Elective Opportunities for Visiting Trainees
• What is Occupational and Environmental Medicine?
• Admissions Info
• Graduates by Year
• Compensation and Benefits
• How to Apply
• Academic Committee
• Course Details and Registration
• Tuition and Fees
• ONLINE SOCI PROGRAM
• Principal Faculty
• General Application
• JHHS Application
• Areas of Study
• Important Dates
• Our Faculty
• Welcome Letter
• Descripción los Cursos
• Programa en Epidemiología para Gestores de Salud, Basado en Internet
• Consultants
• Britt Dahlberg, PhD
• Joke Bradt, PhD, MT-BC
• Mark R. Luborsky, PhD
• Marsha Wittink, PhD
• Rebekka Lee, ScD
• Su Yeon Lee-Tauler, PhD
• Theresa Hoeft, PhD
• Vicki L. Plano Clark, PhD
• Program Retreat
• Mixed Methods Applications: Illustrations
• Announcements
• 2023 Call for Applications
• Jennifer I Manuel, PhD, MSW
• Joke Bradt, PhD
• Josiemer Mattei, PhD, MPH
• Justin Sanders, MD, MSc
• Linda Charmaran, PhD
• Nao Hagiwara, PhD
• Nynikka R. A. Palmer, DrPH, MPH
• Olayinka O. Shiyanbola, BPharm, PhD
• Sarah Ronis, MD, MPH
• Susan D. Brown, PhD
• Tara Lagu, MD, MPH
• Theresa Hoft, PhD
• Wynne E. Norton, PhD
• Yvonne Mensa-Wilmot, PhD, MPH
• A. Susana Ramírez, PhD, MPH
• Animesh Sabnis, MD, MSHS
• Autumn Kieber-Emmons, MD, MPH
• Benjamin Han, MD, MPH
• Brooke A. Levandowski, PhD, MPA
• Camille R. Quinn, PhD, AM, LCSW
• Justine Wu, MD, MPH
• Kelly Aschbrenner, PhD
• Kim N. Danforth, ScD, MPH
• Loreto Leiva, PhD
• Marie Brault, PhD
• Mary E. Cooley, PhD, RN, FAAN
• Meganne K. Masko, PhD, MT-BC/L
• PhuongThao D. Le, PhD, MPH
• Rebecca Lobb, ScD, MPH
• Allegra R. Gordon, ScD MPH
• Anita Misra-Hebert, MD MPH FACP
• Arden M. Morris, MD, MPH
• Caroline Silva, PhD
• Danielle Davidov, PhD
• Hans Oh, PhD
• J. Nicholas Dionne-Odom, PhD RN ACHPN
• Jacqueline Mogle, PhD
• Jammie Hopkins, DrPH, MS
• Joe Glass, PhD MSW
• Karen Whiteman, PhD MSW
• Katie Schultz, PhD MSW
• Rose Molina, MD
• Uriyoán Colón-Ramos, ScD MPA
• Andrew Riley, PhD
• Byron J. Powell, PhD, LCSW
• Carrie Nieman MD, MPH
• Charles R. Rogers, PhD, MPH, MS, CHES®
• Emily E. Haroz, PhD
• Jennifer Tsui, Ph.D., M.P.H.
• Jessica Magidson, PhD
• Katherine Sanchez, PhD, LCSW
• Kelly Doran, MD, MHS
• Kiara Alvarez, PhD
• LaPrincess C. Brewer, MD, MPH
• Melissa Radey, PhD, MA, MSSW
• Sophia L. Johnson, PharmD, MPH, PhD
• Supriya Gupta Mohile, MD, MS
• Virginia McKay, PhD
• Andrew Cohen, MD, PhD
• Angela Chen, PhD, PMHNP-BC, RN
• Christopher Salas-Wright, PhD, MSW
• Eliza Park MD, MS
• Jaime M. Hughes, PhD, MPH, MSW
• Johanne Eliacin, PhD, HSPP
• Lingrui Liu ScD MS
• Meaghan Kennedy, MD
• Nicole Stadnick, PhD, MPH
• Paula Aristizabal, MD
• Radhika Sundararajan, MD
• Sara Mamo, AuD, PhD
• Tullika Garg, MD MPH FACS
• Allison Magnuson, DO
• Ariel Williamson PhD, DBSM
• Benita Bamgbade, PharmD, PhD
• Christopher Woodrell MD
• Hung-Jui (Ray) Tan, MD, MSHPM
• Jasmine Abrams, PhD
• Jose Alejandro Rauh-Hain, MD
• Karen Flórez, DrPH, MPH
• Lavanya Vasudevan, PhD, MPH, CPH
• Maria Garcia, MD, MPH
• Robert Brady, PhD
• Saria Hassan, MD
• Scherezade Mama, DrPH
• Yuan Lu, ScD
• 2021 Scholars
• Sign Up for Our Email List
• Workforce Training
• Cells-to-Society Courses
• Course/Section Numbers Explained
• Pathway Program with Goucher College
• The George G. Graham Lecture

About the Concentration in Health Economics and Policy

The concentration in Health Economics and Policy prepares doctoral students to address the most pressing challenges in health and health care through innovative, rigorous and interdisciplinary research in the field of health economics. This program integrates traditional training in economics with practical training in health policy and health services research to train the next generation of health economists.

The curriculum offers a broad exposure to the health economics literature and public health disciplines, and stresses the policy implications of these fields of research. The curriculum stresses a foundation in applied modern microeconomic theory, economic evaluation, quantitative methods and econometrics, including PhD-level courses from the Department of Economics in the Krieger School of Arts and Sciences.

Doctoral students are paired with a faculty adviser from the Health Economics concentration with similar research interests. Faculty in the Health Economics concentration are working in a variety of research areas including understanding health insurance design, the economic implications of health and health care disparities, market forces and health care prices, pharmaceutical economics, and payment design and access. Doctoral students will also have the opportunity to work with other faculty within the Department, as well as faculty from other Departments including International Health, Population, Family, and Reproductive Health, Biostatistics, the School of Medicine, School of Nursing, the Carey Business School, and the Department of Economics. Students also often work with various centers and initiatives across the University, including the Hopkins Business of Health Initiative.

What Can You Do With a Graduate Degree In Health Economics And Policy?

The program prepares students for successful research careers as health economists. Former students have gone onto careers in academia, government, research-oriented non-profits, and the private sector. Visit the  Graduate Employment Outcomes Dashboard to learn about Bloomberg School graduates' employment status, sector, and salaries.

View a list of selected recent graduates and dissertation titles for the PhD Concentration in Health Economics and Policy.

Curriculum for the Concentration in Health Economics and Policy

Browse an overview of the requirements for this PhD program in the JHU  Academic Catalogue  and explore all course offerings in the Bloomberg School  Course Directory .

Admissions Requirements

For general admissions requirements, please visit the How to Apply page.

Standardized Test Scores

Standardized test scores are  not required and not reviewed  for this program. If you have taken a standardized test such as the GRE, GMAT, or MCAT and want to submit your scores, please note that they will not be used as a metric during the application review.  Applications will be reviewed holistically based on all required application components.

Matthew Eisenberg, PhD, MPhil,

uses applied health economics methods to study how consumers make decisions about their healthcare.

Per the Collective Bargaining Agreement (CBA) with the JHU PhD Union, the minimum guaranteed 2025-2026 academic year stipend is $50,000 for all PhD students with a 4% increase the following year. Tuition, fees, and medical benefits are provided, including health insurance premiums for PhD student’s children and spouses of international students, depending on visa type. The minimum stipend and tuition coverage is guaranteed for at least the first four years of a BSPH PhD program; specific amounts and the number of years supported, as well as work expectations related to that stipend will vary across departments and funding source. Please refer to the CBA to review specific benefits, compensation, and other terms.

Need-Based Relocation Grants Students who  are admitted to PhD programs at JHU starting in Fall 2023 or beyond can apply to receive a need-based grant to offset the costs of relocating to be able to attend JHU.   These grants provide funding to a portion of incoming students who, without this money, may otherwise not be able to afford to relocate to JHU for their PhD program. This is not a merit-based grant. Applications will be evaluated solely based on financial need.  View more information about the need-based relocation grants for PhD students .

Questions about the program? We're happy to help. [email protected]

Health Care Access & Coverage

Comment: Health Care Market Consolidation and Private Equity Funds

Submitted to u.s. department of justice, department of health and human services, and  federal trade commission .

• Share this page on Twitter
• Share this page on Facebook
• Share this page on LinkedIn

On May 6th, 2024, University of Pennsylvania Leonard Davis Institute of Health Economics (LDI) Executive Director Rachel M. Werner , MD, PhD submitted a public comment in response to a Request for Information (RFI) on consolidation in health care and the effects of transactions conducted by private equity funds or other alternative asset managers, health systems, or private payers. Werner provides an overview of the evidence on the impacts of health care consolidation of hospitals, with a specific focus on health equity, including low-income Medicaid beneficiaries.

More on Policy at LDI

Opioid Epidemic

Briefing: Addressing U.S. Opioid Epidemic Through Increasing Access to Methadone

Presented to Staff of U.S. House of Representative

Presented to Staff of U.S. Senate Committee on Health, Education, Labor, and Pensions

Comment: Insurance Coverage for Over-the-Counter Preventive Services Without a Prescription

Submitted to U.S. Departments of the Treasury, Labor, and Health and Human Services

Comment: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid

Submitted to Centers for Medicare and Medicaid Services

Testimony: Impact of Hospital Consolidation on Outcomes, Quality, and Access

Delivered to Pennsylvania House of Representatives Subcommittee on Health Facilities

Testimony: Market-Level Changes and New Hospital Payment Models in Health Care