Questionnaire for Researchers; Final Version; February 2005
RESPONDENT’S DEMOGRAPHIC PROFILE
Country
Name
Age
Gender
Occupation
Highest Educational Attainment
Address
Phone Number
E-mail
Group/Institutional Affiliation
Years of service at present work
Please make sure that you have answered all the questions. In case you have any question, do not hesitate to contact us.
Number
1) Personal
1.1
1.2
1.3
Variable Label
Question
Variable Type
IDNUMB
AGE
SEX
How old are you (age at last birthday)?
What is your sex?
Number
Tick one
response only
1.4
COUNTRY
1.5
ADDRESS
1.6
PHONE
1.7
EMAIL
In which country have you spent the
majority of your professional time in the
past five years?
What is your current address (please
provide your full postal address)?
What is your daytime contact telephone
number with regional dialing code?
What is your email address?
Response Categories
Male
Female
Questionnaire for Researchers; Final Version; February 2005
1.8
DISCIPLINE
Which of these categories best describes
your professional position?
Tick all that
apply
Psychiatrist
Neurologist
Other Medical Practitioner
Psychologist
Social Scientist
Nurse
Public Health Professional
Other, please specify
1.9
INSTITUTION
Which of these categories best describe the
institution you work with?
Tick all that
apply
NGO
University Department
Research Organization/Institute
Hospital
Government Ministry
Private Sector (for profit)
Not applicable; do not work in an
institution
Other, please specify
1.10
NETWORKS
Are you affiliated to any research network?
Tick one
response only
No
National Network
Regional Network
International Network
Both regional and international
networks
1.10.1
NETWORK NAME
If yes to 1.10, which network/s are you a
member of?
Tick all that
apply
Epidemiology, Public Health
Qualitative research methods
Basic Sciences, e.g. neuroimaging,
genetics, statistics
Other, please specify
2) Research Experience
2.1
METHODS
In which of the following research methods
have you received formal training?
Questionnaire for Researchers; Final Version; February 2005
2.2
REVIEWER
How many mental health related articles or
grant applications have you reviewed in the
past five years?
Tick one
response only
2.3
EDITOR
How many editorial or advisory boards of
academic journals have you served on in
the past five years?
Tick one
response only
3.0
RECENT
RESEARCH
EXPERIENCE
Number of mental health related projects in
the past five years; for each project: status,
type of study, mental disorder, funding
source, collaborators, outcome
None
1 articles/grants
2 - 5 articles/grants
6 - 10 articles/grants
> 10 articles/grants
None
1
2
>2
Please complete this information in the
Table
Questionnaire for Researchers; Final Version; February 2005
LIST THE THREE MOST RECENT MENTAL HEALTH RELATED RESEARCH PROJECTS YOU HAVE BEEN INVOLVED WITH IN THE PAST 5 YEARS
TITLE OF PROJECT 1
1. The theme of the
research (Tick all
that apply)
Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify
2. The role you
played in this
research
(Tick one response
only)
3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)
Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify
Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify
4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)
None
National
International
with other
low and
middle
income
countries
International
with high
income
countries
5. The source of
funding for the
research (Tick all
that apply)
6. Which mental
health issue was the
focus? (Tick all that
apply)
7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)
8. The motivation
for pursuing this
research (Tick all
None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify
Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify
Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify
Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify
that apply)
Questionnaire for Researchers; Final Version; February 2005
TITLE OF PROJECT 2
1. The theme of the
research (Tick all
that apply)
Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify
2. The role you
played in this
research
(Tick one response
only)
3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)
Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify
Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify
4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)
None
National
International
with other
low and
middle
income
countries
International
with high
income
countries
5. The source of
funding for the
research (Tick all
that apply)
6. Which mental
health issue was the
focus? (Tick all that
apply)
7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)
8. The motivation
for pursuing this
research (Tick all
None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify
Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify
Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify
Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify
that apply)
Questionnaire for Researchers; Final Version; February 2005
TITLE OF PROJECT 3
1. The theme of the
research (Tick all
that apply)
Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify
2. The role you
played in this
research
(Tick one response
only)
3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)
Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify
Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify
4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)
None
National
International
with other
low and
middle
income
countries
International
with high
income
countries
5. The source of
funding for the
research (Tick all
that apply)
6. Which mental
health issue was the
focus? (Tick all that
apply)
7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)
8. The motivation
for pursuing this
research (Tick all
None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify
Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify
Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify
Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify
that apply)
Questionnaire for Researchers; Final Version; February 2005
4) Research Resources
4.1
TRAINING
Are you involved with teaching any of the
following training programs?
Tick all that
apply
None
Short courses in mental health research
Masters Programs in mental health research
PhD programs in mental health
4.2
INTERNET
Do you have access to the internet-based
databases of research literature?
Tick one
response only
No
Yes, but only free websites (e.g. PubMed)
Yes, to paid resources (e.g. PsycInfo)
4.3
LIBRARY
How many mental health related journals
does a library you can readily access
subscribe to?
Tick one
response only
None/do not access a library
1 journal
2-3 journals
4-10 journals
>10 journals
4.4
BIOSTATS
Do you have access to the technical support in Tick one
epidemiology and/or biostatistics?
response only
None
Yes, in my institution
Yes, from outside institution
Don’t need, am sufficiently qualified
4.5
NEUROSCI
Do you have access to the technical support in Tick one
neurosciences and/or basic sciences research? response only
None
Yes, in my institution
Yes, from outside institution
Don’t need, am sufficiently qualified
4.6
ETHICS
Do you have access to an ethical review
board?
None
Yes, in my institution
Yes, from outside institution
Tick one
response only
Questionnaire for Researchers; Final Version; February 2005
4.7
CONSUMER
4.8
POLICY
4.9
CONSULTANCY
4.10
FUNDING
5) RESEARCH IMPACT
5.1
PUBL_LOC
In the past five years, have consumers or
users of mental health services been
involved with your mental health research?
In the past five years, have policy makers
been involved with your mental health
research?
In the past five years, have you had access
to any mental health related research
fellowships or consultancies?
Tick one
response only
No
Yes
Tick one
response only
No
Yes
Tick all that
apply
No
Yes, from a charitable or public institution
Yes, from a private or corporate institution
(incl. pharmaceutical companies)
Approximately how much research funding
have you had access to in the past year?
(Please report the currency you are using to
describe this amount.)
Number
In the past five years, how many
publications have you had in local academic
journals, i.e. ones that mainly or exclusively
publish papers from your country?
Tick one
response only
5.2
PUBL_INT
In the past five years, how many
publications have you had in international
academic journals, i.e. predominately
publishing papers from different countries?
Tick one
response only
5.3
JNL_CHOICE
What is the primary reason for choosing a
particular journal for the last article you
published?
Tick one
response only
None
1 publication
2-5 publications
6-10 publications
>10 publications
None
1 publication
2-5 publications
6-10 publications
>10 publications
Impact factor
Readership
Personal preference for the journal
Better chance of the paper being accepted
No specific reason
Other, specify
Questionnaire for Researchers; Final Version; February 2005
5.4
PRES_LOC
In the past five years, how many
presentations of mental health research have
you made at national conferences, i.e. in
your country?
Tick one
response only
5.5
PRES_INT
In the past five years, how many
presentations of mental health research have
you made at international conferences, i.e.
outside your country?
Tick one
response only
5.6
PHD_STUD
In the past five years, how many students
have you supervised for higher research
degrees (e.g. PhD) having a significant
component related to mental health?
Tick one
response only
5.7
DISSEM
Have your research findings been
disseminated in any of the following ways
in the past five years?
Tick all that
apply
5.8
IMPACT
Tick one
response only
5.8.1
IMPACT_EG
Can you identify any policy, program,
advocacy or practice change that has
resulted from the evidence of your research
findings?
If yes, please give one specific example:
5.9
NOIMPACT
Tick one
response only
5.9.1
NOIMPACT_EG
Can you identify any established research
evidence you have generated that should
have influenced policy, program, advocacy
or practice, but that has not done so?
If yes, please give one specific example:
None
1 presentation
2-5 presentations
6-10 presentations
>10 presentations
None
1 presentation
2-5 presentations
6-10 presentations
>10 presentations
None
1 student
2-5 students
6-10 students
>10 students
TV
Radio
Local newspapers
International newspapers
Leaflets or other concise material
Materials for policy makers
Other, please specify
No
Yes
Don’t Know
No
Yes
Don’t Know
Questionnaire for Researchers; Final Version; February 2005
6) RESEARCH PRIORITIES
What in your opinion are the most important mental health research priorities in your country, over the next five years? Please rank up to 3
categories for each of the following themes relating to research priorities (1=First Priority ; 2= Second Priority ; 3= Third Priority) :
6.1
PRIOR_TYPE
Over the next five years, what in your
Ranking of 3
Epidemiological studies of burden and risk
opinion are the most important mental
choices
factors
health research priorities in your country?
(number
Clinical trials
according to
Social science research, e.g. illness beliefs,
priority)
measurement
Health systems research, e.g. services
evaluation, policy and economic studies
Basic sciences research, including genetics
and neuroimaging
Other, please specify
6.2
PRIOR_DISORD
Please rank the three most important mental
health issues for your research work:
Ranking of 3
choices
(number
according to
priority)
Psychoses
Depression/Anxiety
Substance Use Disorders
Child and Adolescent Disorders
Dementia
Epilepsy
Personality
Learning Disabilities
Eating Disorders
Suicide
Other, please specify
Questionnaire for Researchers; Final Version; February 2005
6.3
PRIOR_POP
Please rank the three most important
marginalized populations for your research:
Ranking of 3
choices
(number
according to
priority)
Women
Children and Adolescents
Poor
Refugees
Minorities
Elderly persons
Persons exposed to Violence/Trauma
Prisoners
Disabled Persons
Other, please specify
6.4
PRIOR_RSN
Please rank the three most important
reasons for the choices you made, in
response to the previous two questions
Ranking of 3
choices
(number
according to
priority)
Burden of disease in the population
Availability of funds
Personal interest
Policy maker request
Social justice/equity
Other, specify
6.5
PRIOR_CHAL
Please rank the three most important
challenges or obstacles you have faced in
implementing these research priorities.
Ranking of 3
choices
(number
according to
priority)
Lack of funds
Lack of trained researchers
Lack of support from peers
Lack of research culture in institution
Lack of collaborators
Lack of time
Personal conflicts
Other, specify
6.6
CONSENT
Tick one
response only
No
Yes
6.7
PARTICIPATE
Do you consent to having your name and
research experience included in databases of
Mental Health Researchers that may be used
in on-line or print databases?
Would you be interested in being part of a
mental health research network?
Tick one
response only
No
Yes
Questionnaire for Researchers; Final Version; February 2005
Please refer other researchers or stakeholders in your country who are also involve in mental health research and practice:
Name
Mailing Address
Phone/Fax/Mobile
Email
KINDLY ATTACH YOUR CV IF POSSIBLE.