discussion conclusion research paper

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• How to Write Discussions and Conclusions

The discussion section contains the results and outcomes of a study. An effective discussion informs readers what can be learned from your experiment and provides context for the results.

What makes an effective discussion?

When you’re ready to write your discussion, you’ve already introduced the purpose of your study and provided an in-depth description of the methodology. The discussion informs readers about the larger implications of your study based on the results. Highlighting these implications while not overstating the findings can be challenging, especially when you’re submitting to a journal that selects articles based on novelty or potential impact. Regardless of what journal you are submitting to, the discussion section always serves the same purpose: concluding what your study results actually mean.

A successful discussion section puts your findings in context. It should include:

• the results of your research,
• a discussion of related research, and
• a comparison between your results and initial hypothesis.

Tip: Not all journals share the same naming conventions.

You can apply the advice in this article to the conclusion, results or discussion sections of your manuscript.

Our Early Career Researcher community tells us that the conclusion is often considered the most difficult aspect of a manuscript to write. To help, this guide provides questions to ask yourself, a basic structure to model your discussion off of and examples from published manuscripts. 

Questions to ask yourself:

• Was my hypothesis correct?
• If my hypothesis is partially correct or entirely different, what can be learned from the results? 
• How do the conclusions reshape or add onto the existing knowledge in the field? What does previous research say about the topic? 
• Why are the results important or relevant to your audience? Do they add further evidence to a scientific consensus or disprove prior studies? 
• How can future research build on these observations? What are the key experiments that must be done? 
• What is the “take-home” message you want your reader to leave with?

How to structure a discussion

Trying to fit a complete discussion into a single paragraph can add unnecessary stress to the writing process. If possible, you’ll want to give yourself two or three paragraphs to give the reader a comprehensive understanding of your study as a whole. Here’s one way to structure an effective discussion:

Writing Tips

While the above sections can help you brainstorm and structure your discussion, there are many common mistakes that writers revert to when having difficulties with their paper. Writing a discussion can be a delicate balance between summarizing your results, providing proper context for your research and avoiding introducing new information. Remember that your paper should be both confident and honest about the results! 

• Read the journal’s guidelines on the discussion and conclusion sections. If possible, learn about the guidelines before writing the discussion to ensure you’re writing to meet their expectations. 
• Begin with a clear statement of the principal findings. This will reinforce the main take-away for the reader and set up the rest of the discussion. 
• Explain why the outcomes of your study are important to the reader. Discuss the implications of your findings realistically based on previous literature, highlighting both the strengths and limitations of the research. 
• State whether the results prove or disprove your hypothesis. If your hypothesis was disproved, what might be the reasons? 
• Introduce new or expanded ways to think about the research question. Indicate what next steps can be taken to further pursue any unresolved questions. 
• If dealing with a contemporary or ongoing problem, such as climate change, discuss possible consequences if the problem is avoided. 
• Be concise. Adding unnecessary detail can distract from the main findings. 

Don’t

• Rewrite your abstract. Statements with “we investigated” or “we studied” generally do not belong in the discussion. 
• Include new arguments or evidence not previously discussed. Necessary information and evidence should be introduced in the main body of the paper. 
• Apologize. Even if your research contains significant limitations, don’t undermine your authority by including statements that doubt your methodology or execution. 
• Shy away from speaking on limitations or negative results. Including limitations and negative results will give readers a complete understanding of the presented research. Potential limitations include sources of potential bias, threats to internal or external validity, barriers to implementing an intervention and other issues inherent to the study design. 
• Overstate the importance of your findings. Making grand statements about how a study will fully resolve large questions can lead readers to doubt the success of the research. 

Snippets of Effective Discussions:

Consumer-based actions to reduce plastic pollution in rivers: A multi-criteria decision analysis approach

Identifying reliable indicators of fitness in polar bears

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Discussion Vs. Conclusion: Know the Difference Before Drafting Manuscripts

The discussion section of your manuscript can be one of the hardest to write as it requires you to think about the meaning of the research you have done. An effective discussion section tells the reader what your study means and why it is important. In this article, we will cover some pointers for writing clear/well-organized discussion and conclusion sections and discuss what should NOT be a part of these sections.

What Should be in the Discussion Section?

Your discussion is, in short, the answer to the question “what do my results mean?” The discussion section of the manuscript should come after the methods and results section and before the conclusion. It should relate back directly to the questions posed in your introduction, and contextualize your results within the literature you have covered in your literature review . In order to make your discussion section engaging, you should include the following information:

• The major findings of your study
• The meaning of those findings
• How these findings relate to what others have done
• Limitations of your findings
• An explanation for any surprising, unexpected, or inconclusive results
• Suggestions for further research

Your discussion should NOT include any of the following information:

• New results or data not presented previously in the paper
• Unwarranted speculation
• Tangential issues
• Conclusions not supported by your data

Related: Avoid outright rejection with a well-structured manuscript. Check out these resources and improve your manuscript now!

How to Make the Discussion Section Effective?

There are several ways to make the discussion section of your manuscript effective, interesting, and relevant. Hear from one of our experts on how to structure your discussion section and distinguish it from the results section:

Now that we have listened to how to approach writing a discussion section, let’s delve deeper into some essential tips with a few examples:

• Most writing guides recommend listing the findings of your study in decreasing order of their importance. You would not want your reader to lose sight of the key results that you found. Therefore, put the most important finding front and center. Example: Imagine that you conduct a study aimed at evaluating the effectiveness of stent placement in patients with partially blocked arteries. You find that despite this being a common first-line treatment, stents are not effective for patients with partially blocked arteries. The study also discovers that patients treated with a stent tend to develop asthma at slightly higher rates than those who receive no such treatment.

Which sentence would you choose to begin your discussion? Our findings suggest that patients who had partially blocked arteries and were treated with a stent as the first line of intervention had no better outcomes than patients who were not given any surgical treatments.   Our findings noted that patients who received stents demonstrated slightly higher rates of asthma than those who did not. In addition, the placement of a stent did not impact their rates of cardiac events in a statistically significant way.

If you chose the first example, you are correct!

• If you are not sure which results are the most important, go back to your research question and start from there. The most important result is the one that answers your research question.
• It is also necessary to contextualize the meaning of your findings for the reader. What does previous literature say, and do your results agree? Do your results elaborate on previous findings, or differ significantly?
• In our stent example, if previous literature found that stents were an effective line of treatment for patients with partially blocked arteries, you should explore why your interpretation seems different in the discussion section. Did your methodology differ? Was your study broader in scope and larger in scale than the previous studies? Were there any limitations to previous studies that your study overcame? Alternatively, is it possible that your own study could be incorrect because of some difficulties you had in carrying it out? The discussion section should narrate a coherent story to the target audience.
• Finally, remember not to introduce new ideas/data, or speculate wildly on the possible future implications of your study in the discussion section. However, considering alternative explanations for your results is encouraged.

Avoiding Confusion in your Conclusion!

Many writers confuse the information they should include in their discussion with the information they should place in their conclusion. One easy way to avoid this confusion is to think of your conclusion as a summary of everything that you have said thus far. In the conclusion section, you remind the reader of what they have just read. Your conclusion should:

• Restate your hypothesis or research question
• Restate your major findings
• Tell the reader what contribution your study has made to the existing literature
• Highlight any limitations of your study
• State future directions for research/recommendations

Your conclusion should NOT:

• Introduce new arguments
• Introduce new data
• Fail to include your research question
• Fail to state your major results

An appropriate conclusion to our hypothetical stent study might read as follows:

In this study, we examined the effectiveness of stent placement. We compared the patients with partially blocked arteries to those with non-surgical interventions. After examining the five-year medical outcomes of 19,457 patients in the Greater Dallas area, our statistical analysis concluded that the placement of a stent resulted in outcomes that were no better than non-surgical interventions such as diet and exercise. Although previous findings indicated that stent placement improved patient outcomes, our study followed a greater number of patients than those in major studies conducted previously. It is possible that outcomes would vary if measured over a ten or fifteen year period. Future researchers should consider investigating the impact of stent placement in these patients over a longer period (five years or longer). Regardless, our results point to the need for medical practitioners to reconsider the placement of a stent as the first line of treatment as non-surgical interventions may have equally positive outcomes for patients.

Did you find the tips in this article relevant? What is the most challenging portion of a research paper for you to write? Let us know in the comments section below!

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Helped massively with writing a good conclusion!

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Discussion and Conclusions

Your Discussion and Conclusions sections should answer the question: What do your results mean?

In other words, the majority of the Discussion and Conclusions sections should be an interpretation of your results. You should:

• Discuss your conclusions in order of  most to least important.
• Compare  your results with those from other studies: Are they consistent? If not, discuss possible reasons for the difference.
• Mention any  inconclusive results  and explain them as best you can. You may suggest additional experiments needed to clarify your results.
• Briefly describe the  limitations  of your study to show reviewers and readers that you have considered your experiment’s weaknesses. Many researchers are hesitant to do this as they feel it highlights the weaknesses in their research to the editor and reviewer. However doing this actually makes a positive impression of your paper as it makes it clear that you have an in depth understanding of your topic and can think objectively of your research.
• Discuss  what your results may mean  for researchers in the same field as you, researchers in other fields, and the general public. How could your findings be applied?
• State how your results  extend the findings  of previous studies.
• If your findings are preliminary, suggest  future studies  that need to be carried out.
• At the end of your Discussion and Conclusions sections,  state your main conclusions once again .

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How to Write a Conclusion for Research Papers (with Examples)

The conclusion of a research paper is a crucial section that plays a significant role in the overall impact and effectiveness of your research paper. However, this is also the section that typically receives less attention compared to the introduction and the body of the paper. The conclusion serves to provide a concise summary of the key findings, their significance, their implications, and a sense of closure to the study. Discussing how can the findings be applied in real-world scenarios or inform policy, practice, or decision-making is especially valuable to practitioners and policymakers. The research paper conclusion also provides researchers with clear insights and valuable information for their own work, which they can then build on and contribute to the advancement of knowledge in the field.

The research paper conclusion should explain the significance of your findings within the broader context of your field. It restates how your results contribute to the existing body of knowledge and whether they confirm or challenge existing theories or hypotheses. Also, by identifying unanswered questions or areas requiring further investigation, your awareness of the broader research landscape can be demonstrated.

Remember to tailor the research paper conclusion to the specific needs and interests of your intended audience, which may include researchers, practitioners, policymakers, or a combination of these.

Table of Contents

What is a conclusion in a research paper, summarizing conclusion, editorial conclusion, externalizing conclusion, importance of a good research paper conclusion, how to write a conclusion for your research paper, research paper conclusion examples.

• How to write a research paper conclusion with Paperpal? 

Frequently Asked Questions

A conclusion in a research paper is the final section where you summarize and wrap up your research, presenting the key findings and insights derived from your study. The research paper conclusion is not the place to introduce new information or data that was not discussed in the main body of the paper. When working on how to conclude a research paper, remember to stick to summarizing and interpreting existing content. The research paper conclusion serves the following purposes: 1

• Warn readers of the possible consequences of not attending to the problem.
• Recommend specific course(s) of action.
• Restate key ideas to drive home the ultimate point of your research paper.
• Provide a “take-home” message that you want the readers to remember about your study.

Types of conclusions for research papers

In research papers, the conclusion provides closure to the reader. The type of research paper conclusion you choose depends on the nature of your study, your goals, and your target audience. I provide you with three common types of conclusions:

A summarizing conclusion is the most common type of conclusion in research papers. It involves summarizing the main points, reiterating the research question, and restating the significance of the findings. This common type of research paper conclusion is used across different disciplines.

An editorial conclusion is less common but can be used in research papers that are focused on proposing or advocating for a particular viewpoint or policy. It involves presenting a strong editorial or opinion based on the research findings and offering recommendations or calls to action.

An externalizing conclusion is a type of conclusion that extends the research beyond the scope of the paper by suggesting potential future research directions or discussing the broader implications of the findings. This type of conclusion is often used in more theoretical or exploratory research papers.

Align your conclusion’s tone with the rest of your research paper. Start Writing with Paperpal Now!  

The conclusion in a research paper serves several important purposes:

• Offers Implications and Recommendations : Your research paper conclusion is an excellent place to discuss the broader implications of your research and suggest potential areas for further study. It’s also an opportunity to offer practical recommendations based on your findings.
• Provides Closure : A good research paper conclusion provides a sense of closure to your paper. It should leave the reader with a feeling that they have reached the end of a well-structured and thought-provoking research project.
• Leaves a Lasting Impression : Writing a well-crafted research paper conclusion leaves a lasting impression on your readers. It’s your final opportunity to leave them with a new idea, a call to action, or a memorable quote.

Writing a strong conclusion for your research paper is essential to leave a lasting impression on your readers. Here’s a step-by-step process to help you create and know what to put in the conclusion of a research paper: 2

• Research Statement : Begin your research paper conclusion by restating your research statement. This reminds the reader of the main point you’ve been trying to prove throughout your paper. Keep it concise and clear.
• Key Points : Summarize the main arguments and key points you’ve made in your paper. Avoid introducing new information in the research paper conclusion. Instead, provide a concise overview of what you’ve discussed in the body of your paper.
• Address the Research Questions : If your research paper is based on specific research questions or hypotheses, briefly address whether you’ve answered them or achieved your research goals. Discuss the significance of your findings in this context.
• Significance : Highlight the importance of your research and its relevance in the broader context. Explain why your findings matter and how they contribute to the existing knowledge in your field.
• Implications : Explore the practical or theoretical implications of your research. How might your findings impact future research, policy, or real-world applications? Consider the “so what?” question.
• Future Research : Offer suggestions for future research in your area. What questions or aspects remain unanswered or warrant further investigation? This shows that your work opens the door for future exploration.
• Closing Thought : Conclude your research paper conclusion with a thought-provoking or memorable statement. This can leave a lasting impression on your readers and wrap up your paper effectively. Avoid introducing new information or arguments here.
• Proofread and Revise : Carefully proofread your conclusion for grammar, spelling, and clarity. Ensure that your ideas flow smoothly and that your conclusion is coherent and well-structured.

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Remember that a well-crafted research paper conclusion is a reflection of the strength of your research and your ability to communicate its significance effectively. It should leave a lasting impression on your readers and tie together all the threads of your paper. Now you know how to start the conclusion of a research paper and what elements to include to make it impactful, let’s look at a research paper conclusion sample.

How to write a research paper conclusion with Paperpal?

A research paper conclusion is not just a summary of your study, but a synthesis of the key findings that ties the research together and places it in a broader context. A research paper conclusion should be concise, typically around one paragraph in length. However, some complex topics may require a longer conclusion to ensure the reader is left with a clear understanding of the study’s significance. Paperpal, an AI writing assistant trusted by over 800,000 academics globally, can help you write a well-structured conclusion for your research paper. 

• Sign Up or Log In: Create a new Paperpal account or login with your details.  
• Navigate to Features : Once logged in, head over to the features’ side navigation pane. Click on Templates and you’ll find a suite of generative AI features to help you write better, faster.  
• Generate an outline: Under Templates, select ‘Outlines’. Choose ‘Research article’ as your document type.  
• Select your section: Since you’re focusing on the conclusion, select this section when prompted.  
• Choose your field of study: Identifying your field of study allows Paperpal to provide more targeted suggestions, ensuring the relevance of your conclusion to your specific area of research. 
• Provide a brief description of your study: Enter details about your research topic and findings. This information helps Paperpal generate a tailored outline that aligns with your paper’s content. 
• Generate the conclusion outline: After entering all necessary details, click on ‘generate’. Paperpal will then create a structured outline for your conclusion, to help you start writing and build upon the outline.  
• Write your conclusion: Use the generated outline to build your conclusion. The outline serves as a guide, ensuring you cover all critical aspects of a strong conclusion, from summarizing key findings to highlighting the research’s implications. 
• Refine and enhance: Paperpal’s ‘Make Academic’ feature can be particularly useful in the final stages. Select any paragraph of your conclusion and use this feature to elevate the academic tone, ensuring your writing is aligned to the academic journal standards. 

By following these steps, Paperpal not only simplifies the process of writing a research paper conclusion but also ensures it is impactful, concise, and aligned with academic standards. Sign up with Paperpal today and write your research paper conclusion 2x faster .  

The research paper conclusion is a crucial part of your paper as it provides the final opportunity to leave a strong impression on your readers. In the research paper conclusion, summarize the main points of your research paper by restating your research statement, highlighting the most important findings, addressing the research questions or objectives, explaining the broader context of the study, discussing the significance of your findings, providing recommendations if applicable, and emphasizing the takeaway message. The main purpose of the conclusion is to remind the reader of the main point or argument of your paper and to provide a clear and concise summary of the key findings and their implications. All these elements should feature on your list of what to put in the conclusion of a research paper to create a strong final statement for your work.

A strong conclusion is a critical component of a research paper, as it provides an opportunity to wrap up your arguments, reiterate your main points, and leave a lasting impression on your readers. Here are the key elements of a strong research paper conclusion: 1. Conciseness : A research paper conclusion should be concise and to the point. It should not introduce new information or ideas that were not discussed in the body of the paper. 2. Summarization : The research paper conclusion should be comprehensive enough to give the reader a clear understanding of the research’s main contributions. 3 . Relevance : Ensure that the information included in the research paper conclusion is directly relevant to the research paper’s main topic and objectives; avoid unnecessary details. 4 . Connection to the Introduction : A well-structured research paper conclusion often revisits the key points made in the introduction and shows how the research has addressed the initial questions or objectives. 5. Emphasis : Highlight the significance and implications of your research. Why is your study important? What are the broader implications or applications of your findings? 6 . Call to Action : Include a call to action or a recommendation for future research or action based on your findings.

The length of a research paper conclusion can vary depending on several factors, including the overall length of the paper, the complexity of the research, and the specific journal requirements. While there is no strict rule for the length of a conclusion, but it’s generally advisable to keep it relatively short. A typical research paper conclusion might be around 5-10% of the paper’s total length. For example, if your paper is 10 pages long, the conclusion might be roughly half a page to one page in length.

In general, you do not need to include citations in the research paper conclusion. Citations are typically reserved for the body of the paper to support your arguments and provide evidence for your claims. However, there may be some exceptions to this rule: 1. If you are drawing a direct quote or paraphrasing a specific source in your research paper conclusion, you should include a citation to give proper credit to the original author. 2. If your conclusion refers to or discusses specific research, data, or sources that are crucial to the overall argument, citations can be included to reinforce your conclusion’s validity.

The conclusion of a research paper serves several important purposes: 1. Summarize the Key Points 2. Reinforce the Main Argument 3. Provide Closure 4. Offer Insights or Implications 5. Engage the Reader. 6. Reflect on Limitations

Remember that the primary purpose of the research paper conclusion is to leave a lasting impression on the reader, reinforcing the key points and providing closure to your research. It’s often the last part of the paper that the reader will see, so it should be strong and well-crafted.

• Makar, G., Foltz, C., Lendner, M., & Vaccaro, A. R. (2018). How to write effective discussion and conclusion sections. Clinical spine surgery, 31(8), 345-346.
• Bunton, D. (2005). The structure of PhD conclusion chapters.  Journal of English for academic purposes ,  4 (3), 207-224.

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How to Write the Discussion Section of a Research Paper

The discussion section of a research paper analyzes and interprets the findings, provides context, compares them with previous studies, identifies limitations, and suggests future research directions.

Updated on September 15, 2023

Structure your discussion section right, and you’ll be cited more often while doing a greater service to the scientific community. So, what actually goes into the discussion section? And how do you write it?

The discussion section of your research paper is where you let the reader know how your study is positioned in the literature, what to take away from your paper, and how your work helps them. It can also include your conclusions and suggestions for future studies.

First, we’ll define all the parts of your discussion paper, and then look into how to write a strong, effective discussion section for your paper or manuscript.

Discussion section: what is it, what it does

The discussion section comes later in your paper, following the introduction, methods, and results. The discussion sets up your study’s conclusions. Its main goals are to present, interpret, and provide a context for your results.

What is it?

The discussion section provides an analysis and interpretation of the findings, compares them with previous studies, identifies limitations, and suggests future directions for research.

This section combines information from the preceding parts of your paper into a coherent story. By this point, the reader already knows why you did your study (introduction), how you did it (methods), and what happened (results). In the discussion, you’ll help the reader connect the ideas from these sections.

Why is it necessary?

The discussion provides context and interpretations for the results. It also answers the questions posed in the introduction. While the results section describes your findings, the discussion explains what they say. This is also where you can describe the impact or implications of your research.

Adds context for your results

Most research studies aim to answer a question, replicate a finding, or address limitations in the literature. These goals are first described in the introduction. However, in the discussion section, the author can refer back to them to explain how the study's objective was achieved. 

Shows what your results actually mean and real-world implications

The discussion can also describe the effect of your findings on research or practice. How are your results significant for readers, other researchers, or policymakers?

What to include in your discussion (in the correct order)

A complete and effective discussion section should at least touch on the points described below.

Summary of key findings

The discussion should begin with a brief factual summary of the results. Concisely overview the main results you obtained.

Begin with key findings with supporting evidence

Your results section described a list of findings, but what message do they send when you look at them all together?

Your findings were detailed in the results section, so there’s no need to repeat them here, but do provide at least a few highlights. This will help refresh the reader’s memory and help them focus on the big picture.

Read the first paragraph of the discussion section in this article (PDF) for an example of how to start this part of your paper. Notice how the authors break down their results and follow each description sentence with an explanation of why each finding is relevant. 

State clearly and concisely

Following a clear and direct writing style is especially important in the discussion section. After all, this is where you will make some of the most impactful points in your paper. While the results section often contains technical vocabulary, such as statistical terms, the discussion section lets you describe your findings more clearly. 

Interpretation of results

Once you’ve given your reader an overview of your results, you need to interpret those results. In other words, what do your results mean? Discuss the findings’ implications and significance in relation to your research question or hypothesis.

Analyze and interpret your findings

Look into your findings and explore what’s behind them or what may have caused them. If your introduction cited theories or studies that could explain your findings, use these sources as a basis to discuss your results.

For example, look at the second paragraph in the discussion section of this article on waggling honey bees. Here, the authors explore their results based on information from the literature.

Unexpected or contradictory results

Sometimes, your findings are not what you expect. Here’s where you describe this and try to find a reason for it. Could it be because of the method you used? Does it have something to do with the variables analyzed? Comparing your methods with those of other similar studies can help with this task.

Context and comparison with previous work

Refer to related studies to place your research in a larger context and the literature. Compare and contrast your findings with existing literature, highlighting similarities, differences, and/or contradictions.

How your work compares or contrasts with previous work

Studies with similar findings to yours can be cited to show the strength of your findings. Information from these studies can also be used to help explain your results. Differences between your findings and others in the literature can also be discussed here. 

How to divide this section into subsections

If you have more than one objective in your study or many key findings, you can dedicate a separate section to each of these. Here’s an example of this approach. You can see that the discussion section is divided into topics and even has a separate heading for each of them. 

Limitations

Many journals require you to include the limitations of your study in the discussion. Even if they don’t, there are good reasons to mention these in your paper.

Why limitations don’t have a negative connotation

A study’s limitations are points to be improved upon in future research. While some of these may be flaws in your method, many may be due to factors you couldn’t predict.

Examples include time constraints or small sample sizes. Pointing this out will help future researchers avoid or address these issues. This part of the discussion can also include any attempts you have made to reduce the impact of these limitations, as in this study .

How limitations add to a researcher's credibility

Pointing out the limitations of your study demonstrates transparency. It also shows that you know your methods well and can conduct a critical assessment of them.  

Implications and significance

The final paragraph of the discussion section should contain the take-home messages for your study. It can also cite the “strong points” of your study, to contrast with the limitations section.

Restate your hypothesis

Remind the reader what your hypothesis was before you conducted the study. 

How was it proven or disproven?

Identify your main findings and describe how they relate to your hypothesis.

How your results contribute to the literature

Were you able to answer your research question? Or address a gap in the literature?

Future implications of your research

Describe the impact that your results may have on the topic of study. Your results may show, for instance, that there are still limitations in the literature for future studies to address. There may be a need for studies that extend your findings in a specific way. You also may need additional research to corroborate your findings. 

Sample discussion section

This fictitious example covers all the aspects discussed above. Your actual discussion section will probably be much longer, but you can read this to get an idea of everything your discussion should cover.

Our results showed that the presence of cats in a household is associated with higher levels of perceived happiness by its human occupants. These findings support our hypothesis and demonstrate the association between pet ownership and well-being. 

The present findings align with those of Bao and Schreer (2016) and Hardie et al. (2023), who observed greater life satisfaction in pet owners relative to non-owners. Although the present study did not directly evaluate life satisfaction, this factor may explain the association between happiness and cat ownership observed in our sample.

Our findings must be interpreted in light of some limitations, such as the focus on cat ownership only rather than pets as a whole. This may limit the generalizability of our results.

Nevertheless, this study had several strengths. These include its strict exclusion criteria and use of a standardized assessment instrument to investigate the relationships between pets and owners. These attributes bolster the accuracy of our results and reduce the influence of confounding factors, increasing the strength of our conclusions. Future studies may examine the factors that mediate the association between pet ownership and happiness to better comprehend this phenomenon.

This brief discussion begins with a quick summary of the results and hypothesis. The next paragraph cites previous research and compares its findings to those of this study. Information from previous studies is also used to help interpret the findings. After discussing the results of the study, some limitations are pointed out. The paper also explains why these limitations may influence the interpretation of results. Then, final conclusions are drawn based on the study, and directions for future research are suggested.

How to make your discussion flow naturally

If you find writing in scientific English challenging, the discussion and conclusions are often the hardest parts of the paper to write. That’s because you’re not just listing up studies, methods, and outcomes. You’re actually expressing your thoughts and interpretations in words.

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The conclusion is intended to help the reader understand why your research should matter to them after they have finished reading the paper. A conclusion is not merely a summary of the main topics covered or a re-statement of your research problem, but a synthesis of key points derived from the findings of your study and, if applicable, where you recommend new areas for future research. For most college-level research papers, two or three well-developed paragraphs is sufficient for a conclusion, although in some cases, more paragraphs may be required in describing the key findings and their significance.

Conclusions. The Writing Center. University of North Carolina; Conclusions. The Writing Lab and The OWL. Purdue University.

Importance of a Good Conclusion

A well-written conclusion provides you with important opportunities to demonstrate to the reader your understanding of the research problem. These include:

• Presenting the last word on the issues you raised in your paper . Just as the introduction gives a first impression to your reader, the conclusion offers a chance to leave a lasting impression. Do this, for example, by highlighting key findings in your analysis that advance new understanding about the research problem, that are unusual or unexpected, or that have important implications applied to practice.
• Summarizing your thoughts and conveying the larger significance of your study . The conclusion is an opportunity to succinctly re-emphasize  your answer to the "So What?" question by placing the study within the context of how your research advances past research about the topic.
• Identifying how a gap in the literature has been addressed . The conclusion can be where you describe how a previously identified gap in the literature [first identified in your literature review section] has been addressed by your research and why this contribution is significant.
• Demonstrating the importance of your ideas . Don't be shy. The conclusion offers an opportunity to elaborate on the impact and significance of your findings. This is particularly important if your study approached examining the research problem from an unusual or innovative perspective.
• Introducing possible new or expanded ways of thinking about the research problem . This does not refer to introducing new information [which should be avoided], but to offer new insight and creative approaches for framing or contextualizing the research problem based on the results of your study.

Bunton, David. “The Structure of PhD Conclusion Chapters.” Journal of English for Academic Purposes 4 (July 2005): 207–224; Conclusions. The Writing Center. University of North Carolina; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion. San Francisco Edit, 2003-2008; Conclusions. The Writing Lab and The OWL. Purdue University; Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8.

Structure and Writing Style

I.  General Rules

The general function of your paper's conclusion is to restate the main argument . It reminds the reader of the strengths of your main argument(s) and reiterates the most important evidence supporting those argument(s). Do this by clearly summarizing the context, background, and necessity of pursuing the research problem you investigated in relation to an issue, controversy, or a gap found in the literature. However, make sure that your conclusion is not simply a repetitive summary of the findings. This reduces the impact of the argument(s) you have developed in your paper.

When writing the conclusion to your paper, follow these general rules:

• Present your conclusions in clear, concise language. Re-state the purpose of your study, then describe how your findings differ or support those of other studies and why [i.e., what were the unique, new, or crucial contributions your study made to the overall research about your topic?].
• Do not simply reiterate your findings or the discussion of your results. Provide a synthesis of arguments presented in the paper to show how these converge to address the research problem and the overall objectives of your study.
• Indicate opportunities for future research if you haven't already done so in the discussion section of your paper. Highlighting the need for further research provides the reader with evidence that you have an in-depth awareness of the research problem but that further investigations should take place beyond the scope of your investigation.

Consider the following points to help ensure your conclusion is presented well:

• If the argument or purpose of your paper is complex, you may need to summarize the argument for your reader.
• If, prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the end of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration that returns the topic to the context provided by the introduction or within a new context that emerges from the data [this is opposite of the introduction, which begins with general discussion of the context and ends with a detailed description of the research problem]. 

The conclusion also provides a place for you to persuasively and succinctly restate the research problem, given that the reader has now been presented with all the information about the topic . Depending on the discipline you are writing in, the concluding paragraph may contain your reflections on the evidence presented. However, the nature of being introspective about the research you have conducted will depend on the topic and whether your professor wants you to express your observations in this way. If asked to think introspectively about the topics, do not delve into idle speculation. Being introspective means looking within yourself as an author to try and understand an issue more deeply, not to guess at possible outcomes or make up scenarios not supported by the evidence.

II.  Developing a Compelling Conclusion

Although an effective conclusion needs to be clear and succinct, it does not need to be written passively or lack a compelling narrative. Strategies to help you move beyond merely summarizing the key points of your research paper may include any of the following:

• If your essay deals with a critical, contemporary problem, warn readers of the possible consequences of not attending to the problem proactively.
• Recommend a specific course or courses of action that, if adopted, could address a specific problem in practice or in the development of new knowledge leading to positive change.
• Cite a relevant quotation or expert opinion already noted in your paper in order to lend authority and support to the conclusion(s) you have reached [a good source would be from your literature review].
• Explain the consequences of your research in a way that elicits action or demonstrates urgency in seeking change.
• Restate a key statistic, fact, or visual image to emphasize the most important finding of your paper.
• If your discipline encourages personal reflection, illustrate your concluding point by drawing from your own life experiences.
• Return to an anecdote, an example, or a quotation that you presented in your introduction, but add further insight derived from the findings of your study; use your interpretation of results from your study to recast it in new or important ways.
• Provide a "take-home" message in the form of a succinct, declarative statement that you want the reader to remember about your study.

III. Problems to Avoid

Failure to be concise Your conclusion section should be concise and to the point. Conclusions that are too lengthy often have unnecessary information in them. The conclusion is not the place for details about your methodology or results. Although you should give a summary of what was learned from your research, this summary should be relatively brief, since the emphasis in the conclusion is on the implications, evaluations, insights, and other forms of analysis that you make. Strategies for writing concisely can be found here .

Failure to comment on larger, more significant issues In the introduction, your task was to move from the general [the field of study] to the specific [the research problem]. However, in the conclusion, your task is to move from a specific discussion [your research problem] back to a general discussion framed around the implications and significance of your findings [i.e., how your research contributes new understanding or fills an important gap in the literature]. In short, the conclusion is where you should place your research within a larger context [visualize your paper as an hourglass--start with a broad introduction and review of the literature, move to the specific analysis and discussion, conclude with a broad summary of the study's implications and significance].

Failure to reveal problems and negative results Negative aspects of the research process should never be ignored. These are problems, deficiencies, or challenges encountered during your study. They should be summarized as a way of qualifying your overall conclusions. If you encountered negative or unintended results [i.e., findings that are validated outside the research context in which they were generated], you must report them in the results section and discuss their implications in the discussion section of your paper. In the conclusion, use negative results as an opportunity to explain their possible significance and/or how they may form the basis for future research.

Failure to provide a clear summary of what was learned In order to be able to discuss how your research fits within your field of study [and possibly the world at large], you need to summarize briefly and succinctly how it contributes to new knowledge or a new understanding about the research problem. This element of your conclusion may be only a few sentences long.

Failure to match the objectives of your research Often research objectives in the social and behavioral sciences change while the research is being carried out. This is not a problem unless you forget to go back and refine the original objectives in your introduction. As these changes emerge they must be documented so that they accurately reflect what you were trying to accomplish in your research [not what you thought you might accomplish when you began].

Resist the urge to apologize If you've immersed yourself in studying the research problem, you presumably should know a good deal about it [perhaps even more than your professor!]. Nevertheless, by the time you have finished writing, you may be having some doubts about what you have produced. Repress those doubts! Don't undermine your authority as a researcher by saying something like, "This is just one approach to examining this problem; there may be other, much better approaches that...." The overall tone of your conclusion should convey confidence to the reader about the study's validity and realiability.

Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8; Concluding Paragraphs. College Writing Center at Meramec. St. Louis Community College; Conclusions. The Writing Center. University of North Carolina; Conclusions. The Writing Lab and The OWL. Purdue University; Freedman, Leora  and Jerry Plotnick. Introductions and Conclusions. The Lab Report. University College Writing Centre. University of Toronto; Leibensperger, Summer. Draft Your Conclusion. Academic Center, the University of Houston-Victoria, 2003; Make Your Last Words Count. The Writer’s Handbook. Writing Center. University of Wisconsin Madison; Miquel, Fuster-Marquez and Carmen Gregori-Signes. “Chapter Six: ‘Last but Not Least:’ Writing the Conclusion of Your Paper.” In Writing an Applied Linguistics Thesis or Dissertation: A Guide to Presenting Empirical Research . John Bitchener, editor. (Basingstoke,UK: Palgrave Macmillan, 2010), pp. 93-105; Tips for Writing a Good Conclusion. Writing@CSU. Colorado State University; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion. San Francisco Edit, 2003-2008; Writing Conclusions. Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Writing: Considering Structure and Organization. Institute for Writing Rhetoric. Dartmouth College.

Writing Tip

Don't Belabor the Obvious!

Avoid phrases like "in conclusion...," "in summary...," or "in closing...." These phrases can be useful, even welcome, in oral presentations. But readers can see by the tell-tale section heading and number of pages remaining that they are reaching the end of your paper. You'll irritate your readers if you belabor the obvious.

Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8.

Another Writing Tip

New Insight, Not New Information!

Don't surprise the reader with new information in your conclusion that was never referenced anywhere else in the paper. This why the conclusion rarely has citations to sources. If you have new information to present, add it to the discussion or other appropriate section of the paper. Note that, although no new information is introduced, the conclusion, along with the discussion section, is where you offer your most "original" contributions in the paper; the conclusion is where you describe the value of your research, demonstrate that you understand the material that you’ve presented, and position your findings within the larger context of scholarship on the topic, including describing how your research contributes new insights to that scholarship.

Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8; Conclusions. The Writing Center. University of North Carolina.

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Research Paper Conclusion – Writing Guide and Examples

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Research Paper Conclusion

Definition:

A research paper conclusion is the final section of a research paper that summarizes the key findings, significance, and implications of the research. It is the writer’s opportunity to synthesize the information presented in the paper, draw conclusions, and make recommendations for future research or actions.

The conclusion should provide a clear and concise summary of the research paper, reiterating the research question or problem, the main results, and the significance of the findings. It should also discuss the limitations of the study and suggest areas for further research.

Parts of Research Paper Conclusion

The parts of a research paper conclusion typically include:

Restatement of the Thesis

The conclusion should begin by restating the thesis statement from the introduction in a different way. This helps to remind the reader of the main argument or purpose of the research.

Summary of Key Findings

The conclusion should summarize the main findings of the research, highlighting the most important results and conclusions. This section should be brief and to the point.

Implications and Significance

In this section, the researcher should explain the implications and significance of the research findings. This may include discussing the potential impact on the field or industry, highlighting new insights or knowledge gained, or pointing out areas for future research.

Limitations and Recommendations

It is important to acknowledge any limitations or weaknesses of the research and to make recommendations for how these could be addressed in future studies. This shows that the researcher is aware of the potential limitations of their work and is committed to improving the quality of research in their field.

Concluding Statement

The conclusion should end with a strong concluding statement that leaves a lasting impression on the reader. This could be a call to action, a recommendation for further research, or a final thought on the topic.

How to Write Research Paper Conclusion

Here are some steps you can follow to write an effective research paper conclusion:

• Restate the research problem or question: Begin by restating the research problem or question that you aimed to answer in your research. This will remind the reader of the purpose of your study.
• Summarize the main points: Summarize the key findings and results of your research. This can be done by highlighting the most important aspects of your research and the evidence that supports them.
• Discuss the implications: Discuss the implications of your findings for the research area and any potential applications of your research. You should also mention any limitations of your research that may affect the interpretation of your findings.
• Provide a conclusion : Provide a concise conclusion that summarizes the main points of your paper and emphasizes the significance of your research. This should be a strong and clear statement that leaves a lasting impression on the reader.
• Offer suggestions for future research: Lastly, offer suggestions for future research that could build on your findings and contribute to further advancements in the field.

Remember that the conclusion should be brief and to the point, while still effectively summarizing the key findings and implications of your research.

Example of Research Paper Conclusion

Here’s an example of a research paper conclusion:

Conclusion :

In conclusion, our study aimed to investigate the relationship between social media use and mental health among college students. Our findings suggest that there is a significant association between social media use and increased levels of anxiety and depression among college students. This highlights the need for increased awareness and education about the potential negative effects of social media use on mental health, particularly among college students.

Despite the limitations of our study, such as the small sample size and self-reported data, our findings have important implications for future research and practice. Future studies should aim to replicate our findings in larger, more diverse samples, and investigate the potential mechanisms underlying the association between social media use and mental health. In addition, interventions should be developed to promote healthy social media use among college students, such as mindfulness-based approaches and social media detox programs.

Overall, our study contributes to the growing body of research on the impact of social media on mental health, and highlights the importance of addressing this issue in the context of higher education. By raising awareness and promoting healthy social media use among college students, we can help to reduce the negative impact of social media on mental health and improve the well-being of young adults.

Purpose of Research Paper Conclusion

The purpose of a research paper conclusion is to provide a summary and synthesis of the key findings, significance, and implications of the research presented in the paper. The conclusion serves as the final opportunity for the writer to convey their message and leave a lasting impression on the reader.

The conclusion should restate the research problem or question, summarize the main results of the research, and explain their significance. It should also acknowledge the limitations of the study and suggest areas for future research or action.

Overall, the purpose of the conclusion is to provide a sense of closure to the research paper and to emphasize the importance of the research and its potential impact. It should leave the reader with a clear understanding of the main findings and why they matter. The conclusion serves as the writer’s opportunity to showcase their contribution to the field and to inspire further research and action.

When to Write Research Paper Conclusion

The conclusion of a research paper should be written after the body of the paper has been completed. It should not be written until the writer has thoroughly analyzed and interpreted their findings and has written a complete and cohesive discussion of the research.

Before writing the conclusion, the writer should review their research paper and consider the key points that they want to convey to the reader. They should also review the research question, hypotheses, and methodology to ensure that they have addressed all of the necessary components of the research.

Once the writer has a clear understanding of the main findings and their significance, they can begin writing the conclusion. The conclusion should be written in a clear and concise manner, and should reiterate the main points of the research while also providing insights and recommendations for future research or action.

Characteristics of Research Paper Conclusion

The characteristics of a research paper conclusion include:

• Clear and concise: The conclusion should be written in a clear and concise manner, summarizing the key findings and their significance.
• Comprehensive: The conclusion should address all of the main points of the research paper, including the research question or problem, the methodology, the main results, and their implications.
• Future-oriented : The conclusion should provide insights and recommendations for future research or action, based on the findings of the research.
• Impressive : The conclusion should leave a lasting impression on the reader, emphasizing the importance of the research and its potential impact.
• Objective : The conclusion should be based on the evidence presented in the research paper, and should avoid personal biases or opinions.
• Unique : The conclusion should be unique to the research paper and should not simply repeat information from the introduction or body of the paper.

Advantages of Research Paper Conclusion

The advantages of a research paper conclusion include:

• Summarizing the key findings : The conclusion provides a summary of the main findings of the research, making it easier for the reader to understand the key points of the study.
• Emphasizing the significance of the research: The conclusion emphasizes the importance of the research and its potential impact, making it more likely that readers will take the research seriously and consider its implications.
• Providing recommendations for future research or action : The conclusion suggests practical recommendations for future research or action, based on the findings of the study.
• Providing closure to the research paper : The conclusion provides a sense of closure to the research paper, tying together the different sections of the paper and leaving a lasting impression on the reader.
• Demonstrating the writer’s contribution to the field : The conclusion provides the writer with an opportunity to showcase their contribution to the field and to inspire further research and action.

Limitations of Research Paper Conclusion

While the conclusion of a research paper has many advantages, it also has some limitations that should be considered, including:

• I nability to address all aspects of the research: Due to the limited space available in the conclusion, it may not be possible to address all aspects of the research in detail.
• Subjectivity : While the conclusion should be objective, it may be influenced by the writer’s personal biases or opinions.
• Lack of new information: The conclusion should not introduce new information that has not been discussed in the body of the research paper.
• Lack of generalizability: The conclusions drawn from the research may not be applicable to other contexts or populations, limiting the generalizability of the study.
• Misinterpretation by the reader: The reader may misinterpret the conclusions drawn from the research, leading to a misunderstanding of the findings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Writing a scientific paper.

• Writing a lab report
• INTRODUCTION

Writing a "good" discussion section

"discussion and conclusions checklist" from: how to write a good scientific paper. chris a. mack. spie. 2018., peer review.

• LITERATURE CITED
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This is is usually the hardest section to write. You are trying to bring out the true meaning of your data without being too long. Do not use words to conceal your facts or reasoning. Also do not repeat your results, this is a discussion.

• Present principles, relationships and generalizations shown by the results
• Point out exceptions or lack of correlations. Define why you think this is so.
• Show how your results agree or disagree with previously published works
• Discuss the theoretical implications of your work as well as practical applications
• State your conclusions clearly. Summarize your evidence for each conclusion.
• Discuss the significance of the results
•  Evidence does not explain itself; the results must be presented and then explained.
• Typical stages in the discussion: summarizing the results, discussing whether results are expected or unexpected, comparing these results to previous work, interpreting and explaining the results (often by comparison to a theory or model), and hypothesizing about their generality.
• Discuss any problems or shortcomings encountered during the course of the work.
• Discuss possible alternate explanations for the results.
• Avoid: presenting results that are never discussed; presenting discussion that does not relate to any of the results; presenting results and discussion in chronological order rather than logical order; ignoring results that do not support the conclusions; drawing conclusions from results without logical arguments to back them up. 

CONCLUSIONS

• Provide a very brief summary of the Results and Discussion.
• Emphasize the implications of the findings, explaining how the work is significant and providing the key message(s) the author wishes to convey.
• Provide the most general claims that can be supported by the evidence.
• Provide a future perspective on the work.
• Avoid: repeating the abstract; repeating background information from the Introduction; introducing new evidence or new arguments not found in the Results and Discussion; repeating the arguments made in the Results and Discussion; failing to address all of the research questions set out in the Introduction. 

WHAT HAPPENS AFTER I COMPLETE MY PAPER?

 The peer review process is the quality control step in the publication of ideas.  Papers that are submitted to a journal for publication are sent out to several scientists (peers) who look carefully at the paper to see if it is "good science".  These reviewers then recommend to the editor of a journal whether or not a paper should be published. Most journals have publication guidelines. Ask for them and follow them exactly.    Peer reviewers examine the soundness of the materials and methods section.  Are the materials and methods used written clearly enough for another scientist to reproduce the experiment?  Other areas they look at are: originality of research, significance of research question studied, soundness of the discussion and interpretation, correct spelling and use of technical terms, and length of the article.

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Writing a discussion section: how to integrate substantive and statistical expertise

Michael höfler.

1 Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

5 Chair of Clinical Psychology and Behavioural Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

2 Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany

Sebastian Trautmann

Robert miller.

3 Faculty of Psychology, Technische Universität Dresden, Dresden, Germany

4 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden

Associated Data

Not applicable.

When discussing results medical research articles often tear substantive and statistical (methodical) contributions apart, just as if both were independent. Consequently, reasoning on bias tends to be vague, unclear and superficial. This can lead to over-generalized, too narrow and misleading conclusions, especially for causal research questions.

To get the best possible conclusion, substantive and statistical expertise have to be integrated on the basis of reasonable assumptions. While statistics should raise questions on the mechanisms that have presumably created the data, substantive knowledge should answer them. Building on the related principle of Bayesian thinking, we make seven specific and four general proposals on writing a discussion section.

Misinterpretation could be reduced if authors explicitly discussed what can be concluded under which assumptions. Informed on the resulting conditional conclusions other researchers may, according to their knowledge and beliefs, follow a particular conclusion or, based on other conditions, arrive at another one. This could foster both an improved debate and a better understanding of the mechanisms behind the data and should therefore enable researchers to better address bias in future studies.

After a research article has presented the substantive background, the methods and the results, the discussion section assesses the validity of results and draws conclusions by interpreting them. The discussion puts the results into a broader context and reflects their implications for theoretical (e.g. etiological) and practical (e.g. interventional) purposes. As such, the discussion contains an article’s last words the reader is left with.

Common recommendations for the discussion section include general proposals for writing [ 1 ] and structuring (e.g. with a paragraph on a study’s strengths and weaknesses) [ 2 ], to avoid common statistical pitfalls (like misinterpreting non-significant findings as true null results) [ 3 ] and to “go beyond the data” when interpreting results [ 4 ]. Note that the latter includes much more than comparing an article’s results with the literature. If results and literature are consistent, this might be due to shared bias only. If they are not consistent, the question arises why inconsistency occurs – maybe because of bias acting differently across studies [ 5 – 7 ]. Recommendations like the CONSORT checklist do well in demanding all quantitative information on design, participation, compliance etc. to be reported in the methods and results section and “addressing sources of potential bias”, “limitations” and “considering other relevant evidence” in the discussion [ 8 , 9 ]. Similarly, the STROBE checklist for epidemiological research demands “a cautious overall interpretation of results” and "discussing the generalizability (external validity)" [ 10 , 11 ]. However, these guidelines do not clarify how to deal with the complex bias issue, and how to get to and report conclusions.

Consequently, suggestions on writing a discussion often remain vague by hardly addressing the role of the assumptions that have (often implicitly) been made when designing a study, analyzing the data and interpreting the results. Such assumptions involve mechanisms that have created the data and are related to sampling, measurement and treatment assignment (in observational studies common causes of factor and outcome) and, as a consequence, the bias this may produce [ 5 , 6 ]. They determine whether a result allows only an associational or a causal conclusion. Causal conclusions, if true, are of much higher relevance for etiology, prevention and intervention. However, they require much stronger assumptions. These have to be fully explicit and, therewith, essential part of the debate since they always involve subjectivity. Subjectivity is unavoidable because the mechanisms behind the data can never be fully estimated from the data themselves [ 12 ].

In this article, we argue that the conjunction of substantive and statistical (methodical) knowledge in the verbal integration of results and beliefs on mechanisms can be greatly improved in (medical) research papers. We illustrate this through the personal roles that a statistician (i.e. methods expert) and a substantive researcher should take. Doing so, we neither claim that usually just two people write a discussion, nor that one person lacks the knowledge of the other, nor that there were truly no researchers that have both kinds of expertise. As a metaphor, the division of these two roles into two persons describes the necessary integration of knowledge via the mode of a dialogue. Verbally, it addresses the finding of increased specialization of different study contributors in biomedical research. This has teared apart the two processes of statistical compilation of results and their verbal integration [ 13 ]. When this happens a statistician alone is limited to a study’s conditions (sampled population, experimental settings etc.), because he or she is unaware of the conditions’ generalizability. On the other hand, a A substantive expert alone is prone to over-generalize because he or she is not aware of the (mathematical) prerequisites for an interpretation.

The article addresses both (medical) researchers educated in basic statistics and research methods and statisticians who cooperate with them. Throughout the paper we exemplify our arguments with the finding of an association in a cross-tabulation between a binary X (factor) and a binary Y (outcome): those who are exposed to or treated with X have a statistically significantly elevated risk for Y as compared to the non-exposed or not (or otherwise) treated (for instance via the chi-squared independence test or logistic regression). Findings like this are frequent and raise the question which more profound conclusion is valid under what assumptions. Until some decades ago, statistics has largely avoided the related topic of causality and instead limited itself on describing observed distributions (here a two-by-two table between D = depression and LC = lung cancer) with well-fitting models.

We illustrate our arguments with the concrete example of the association found between the factor depression (D) and the outcome lung cancer (LC) [ 14 ]. Yet very different mechanisms could have produced such an association [ 7 ], and assumptions on these lead to the following fundamentally different conclusions (Fig. ​ (Fig.1 1 ):

• D causes LC (e.g. because smoking might constitute “self-medication” of depression symptoms)
• LC causes D (e.g. because LC patients are demoralized by their diagnosis)
• D and LC cause each other (e.g. because the arguments in both a. and b. apply)
• D and LC are the causal consequence of the same factor(s) (e.g. poor health behaviors - HB)
• D and LC only share measurement error (e.g. because a fraction of individuals that has either depression or lung cancer denies both in self-report measures).

Different conclusions about an association between D and LC. a D causes LC, b LC causes B, c D and LC cause each other, d D and LC are associated because of a shared factor (HB), e D and LC are associated because they have correlated errors

Note that we use the example purely for illustrative purposes. We do not make substantive claims on what of a. through e. is true but show how one should reflect on mechanisms in order to find the right answer. Besides, we do not consider research on the D-LC relation apart from the finding of association [ 14 ].

Assessing which of a. through e. truly applies requires substantive assumptions on mechanisms: the temporal order of D and LC (a causal effect requires that the cause occurs before the effect), shared factors, selection processes and measurement error. Questions on related mechanisms have to be brought up by statistical consideration, while substantive reasoning has to address them. Together this yields provisional assumptions for inferring that are subject to readers’ substantive consideration and refinement. In general, the integration of prior beliefs (anything beyond the data a conclusion depends on) and the results from the data themselves is formalized by Bayesian statistics [ 15 , 16 ]. This is beyond the scope of this article, still we argue that Bayesian thinking should govern the process of drawing conclusions.

Building on this idea, we provide seven specific and four general recommendations for the cooperative process of writing a discussion. The recommendations are intended to be suggestions rather than rules. They should be subject to further refinement and adjustment to specific requirements in different fields of medical and other research. Note that the order of the points is not meant to structure a discussion’s writing (besides 1.).

Recommendations for writing a discussion section

Specific recommendations.

Consider the example on the association between D and LC. Rather than starting with an in-depth (causal) interpretation a finding should firstly be taken as what it allows inferring without doubt: Under the usual assumptions that a statistical model makes (e.g. random sampling, independence or certain correlation structure between observations [ 17 ]), the association indicates that D (strictly speaking: measuring D) predicts an elevated LC risk (strictly speaking: measuring LC) in the population that one has managed to sample (source population). Assume that the sample has been randomly drawn from primary care settings. In this case the association is useful to recommend medical doctors to better look at an individual’s LC risk in case of D. If the association has been adjusted for age and gender (conveniently through a regression model), the conclusion modifies to: If the doctor knows a patient’s age and gender (what should always be the case) D has additional value in predicting an elevated LC risk.

In the above example, a substantive researcher might want to conclude that D and LC are associated in a general population instead of just inferring to patients in primary care settings (a.). Another researcher might even take the finding as evidence for D being a causal factor in the etiology of LC, meaning that prevention of D could reduce the incidence rate of LC (in whatever target population) (b.). In both cases, the substantive researcher should insist on assessing the desired interpretation that goes beyond the data [ 4 ], but the statistician immediately needs to bring up the next point.

The explanation of all the assumptions that lead from a data result to a conclusion enables a reader to assess whether he or she agrees with the authors’ inference or not. These conditions, however, often remain incomplete or unclear, in which case the reader can hardly assess whether he or she follows a path of argumentation and, thus, shares the conclusion this path leads to.

Consider conclusion a. and suppose that, instead of representative sampling in a general population (e.g. all U.S. citizens aged 18 or above), the investigators were only able to sample in primary care settings. Extrapolating the results to another population than the source population requires what is called “external validity”, “transportability” or the absence of “selection bias” [ 18 , 19 ]. No such bias occurs if the parameter of interest is equal in the source and the target population. Note that this is a weaker condition than the common belief that the sample must represent the target population in everything . If the parameter of interest is the difference in risk for LC between cases and non-cases of D, the condition translates into: the risk difference must be equal in target and source population.

For the causal conclusion b., however, sufficient assumptions are very strict. In an RCT, the conclusion is valid under random sampling from the target population, random allocation of X, perfect compliance in X, complete participation and no measurement error in outcome (for details see [ 20 ]). In practice, on the other hand, the derivations from such conditions might sometimes be modest what may produce little bias only. For instance, non-compliance in a specific drug intake (treatment) might occur only in a few individuals to little extent through a random process (e.g. sickness of a nurse being responsible for drug dispense) and yield just small (downward) bias [ 5 ]. The conclusion of downward bias might also be justified if non-compliance does not cause anything that has a larger effect on a Y than the drug itself. Another researcher, however, could believe that non-compliance leads to taking a more effective, alternative treatment. He or she could infer upward bias instead if well-informed on the line of argument.

In practice, researchers frequently use causal language yet without mentioning any assumptions. This does not imply that they truly have a causal effect in mind, often causal and associational wordings are carelessly used in synonymous way. For example, concluding “depression increases the risk of lung cancer” constitutes already causal wording because it implies that a change in the depression status would change the cancer risk. Associational language like “lung cancer risk is elevated if depression occurs”, however, would allow for an elevated lung cancer risk in depression cases just because LC and D share some causes (“inducing” or “removing” depression would not change the cancer risk here).

Often, it is unclear where the path of argumentation from assumptions to a conclusion leads when alternative assumptions are made. Consider again bias due to selection. A different effect in target and source population occurs if effect-modifying variables distribute differently in both populations. Accordingly, the statistician should ask which variables influence the effect of interest, and whether these can be assumed to distribute equally in the source population and the target population. The substantive researcher might answer that the causal risk difference between D and LC likely increases with age. Given that this is true, and if elder individuals have been oversampled (e.g. because elderly are over-represented in primary care settings), both together would conclude that sampling has led to over-estimation (despite other factors, Fig. ​ Fig.2 2 ).

If higher age is related to a larger effect (risk difference) of D on LC, a larger effect estimate is expected in an elder sample

However, the statistician might add, if effect modification is weak, or the difference in the age distributions is modest (e.g. mean 54 vs. 52 years), selection is unlikely to have produced large (here: upward) bias. In turn, another substantive researcher, who reads the resulting discussion, might instead assume a decrease of effect with increasing age and thus infer downward bias.

In practice, researchers should be extremely sensitive for bias due to selection if a sample has been drawn conditionally on a common consequence of factor and outcome or a variable associated with such a consequence [19 and references therein]. For instance, hospitalization might be influenced by both D and LC, and thus sampling from hospitals might introduce a false association or change an association’s sign; particularly D and LC may appear to be negatively associated although the association is positive in the general population (Fig. ​ (Fig.3 3 ).

If hospitalization (H) is a common cause of D and LC, sampling conditionally on H can introduce a spurious association between D and LC ("conditioning on a collider")

Usually, only some kinds of bias are discussed, while the consequences of others are ignored [ 5 ]. Besides selection the main sources of bias are often measurement and confounding. If one is only interested in association, confounding is irrelevant. For causal conclusions, however, assumptions on all three kinds of bias are necessary.

Measurement error means that the measurement of a factor and/or outcome deviates from the true value, at least in some individuals. Bias due to measurement is known under many other terms that describe the reasons why such error occurs (e.g. “recall bias” and “reporting bias”). In contrast to conventional wisdom, measurement error does not always bias association and effect estimates downwards [ 5 , 6 ]. It does, for instance, if only the factor (e.g. depression) is measured with error and the errors occur independently from the outcome (e.g. lung cancer), or vice versa (“non-differential misclassification”) [22 and references therein]. However, many lung cancer cases might falsely report depression symptoms (e.g. to express need for care). Such false positives (non-cases of depression classified as cases) may also occur in non-cases of lung cancer but to a lesser extent (a special case of “differential misclassification”). Here, bias might be upward as well. Importantly, false positives cause larger bias than false negatives (non-cases of depression falsely classified as depression cases) as long as the relative frequency of a factor is lower than 50% [ 21 ]. Therefore, they should receive more attention in discussion. If measurement error occurs in depression and lung cancer, the direction of bias also depends on the correlation between both errors [ 21 ].

Note that what is in line with common standards of “good” measurement (e.g. a Kappa value measuring validity or reliability of 0.7) might anyway produce large bias. This applies to estimates of prevalence, association and effect. The reason is that while indices of measurement are one-dimensional, bias depends on two parameters (sensitivity and specificity) [ 21 , 22 ]. Moreover, estimates of such indices are often extrapolated to different kinds of populations (typically from a clinical to general population), what may be inadequate. Note that the different kinds of bias often interact, e.g. bias due to measurement might depend on selection (e.g. measurement error might differ between a clinical and a general population) [ 5 , 6 ].

Assessment of bias due to confounding variables (roughly speaking: common causes of factor and outcome) requires assumptions on the entire system of variables that affect both factor and outcome. For example, D and LC might share several causes such as stressful life events or socioeconomic status. If these influence D and LC with the same effect direction, this leads to overestimation, otherwise (different effect directions) the causal effect is underestimated. In the medical field, many unfavorable conditions may be positively related. If this holds true for all common factors of D and LC, upward bias can be assumed. However, not all confounders have to be taken into account. Within the framework of “causal graphs”, the “backdoor criterion” [ 7 ] provides a graphical rule for sets of confounders to be sufficient when adjusted for. Practically, such a causal graph must include all factors that directly or indirectly affect both D and LC. Then, adjustment for a set of confounders that meets the “backdoor criterion” in the graph completely removes bias due to confounding. In the example of Fig. ​ Fig.4 4 it is sufficient to adjust for Z 1 and Z 2 because this “blocks” all paths that otherwise lead backwards from D to LC. Note that fully eliminating bias due to confounding also requires that the confounders have been collected without measurement error [ 5 , 6 , 23 ]. Therefore, the advice is always to concede at least some “residual” bias and reflect on the direction this might have (could be downward if such error is not stronger related to D and LC than a confounder itself).

Causal graph for the effect of D on LC and confounders Z 1 , Z 2 and Z 3

Whereas the statistician should pinpoint to the mathematical insight of the backdoor criterion, its application requires profound substantive input and literature review. Of course, there are numerous relevant factors in the medical field. Hence, one should practically focus on those with the highest prevalence (a very seldom factor can hardly cause large bias) and large assumed effects on both X and Y.

If knowledge on any of the three kinds of bias is poor or very uncertain, researchers should admit that this adds uncertainty in a conclusion: systematic error on top of random error. In the Bayesian framework, quantitative bias analysis formalizes this through the result of larger variance in an estimate. Technically, this additional variance is introduced via the variances of distributions assigned to “bias parameters”; for instance a misclassification probability (e.g. classifying a true depression case as non-case) or the prevalence of a binary confounder and its effects on X and Y. Of course, bias analysis also changes point estimates (hopefully reducing bias considerably). Note that conventional frequentist analysis, as regarded from the Bayesian perspective, assumes that all bias parameters were zero with a probability of one [ 5 , 6 , 23 ]. The only exceptions (bias addressed in conventional analyses) are adjustment on variables to hopefully reduce bias due to confounding and weighting the individuals (according to variables related to participation) to take into account bias due to selection.

If the substantive investigator understands the processes of selection, measurement and confounding only poorly, such strict analysis numerically reveals that little to nothing is known on the effect of X on Y, no matter how large an observed association and a sample (providing small random error) may be [ 5 , 6 , 23 ]). This insight has to be brought up by the statistician. Although such an analysis is complicated, itself very sensitive to how it is conducted [ 5 , 6 ] and rarely done, the Bayesian thinking behind it forces researchers to better understand the processes behind the data. Otherwise, he or she cannot make any assumptions and, in turn, no conclusion on causality.

Usually articles end with statements that only go little further than the always true but never informative statement “more research is needed”. Moreover, larger samples and better measurements are frequently proposed. If an association has been found, a RCT or other interventional study is usually proposed to investigate causality. In our example, this recommendation disregards that: (1) onset of D might have a different effect on LC risk than an intervention against D (the effect of onset cannot be investigated in any interventional study), (2) the effects of onset and intervention concern different populations (those without vs. those with depression), (3) an intervention effect depends on the mode of intervention [ 24 ], and (4) (applying the backdoor criterion) a well-designed observational study may approximatively yield the same result as a randomized study would [ 25 – 27 ]. If the effect of “removing” depression is actually of interest, one could propose an RCT that investigates the effect of treating depression in a strictly defined way and in a strictly defined population (desirably in all who meet the criteria of depression). Ideally, this population is sampled randomly, and non-participants and dropouts are investigated with respect to assumed effect-modifiers (differences in their distributions between participants and non-participants can then be addressed e.g. by weighting [ 27 ]). In a non-randomized study, one should collect variables supposed to meet the backdoor-criterion with the best instruments possible.

General recommendations

Yet when considering 1) through 7); i.e. carefully reflecting on the mechanisms that have created the data, discussions on statistical results can be very misleading, because the basic statistical methods are mis-interpreted or inadequately worded.

A common pitfall is to consider the lack of evidence for the alternative hypothesis (e.g. association between D and LC) as evidence for the null hypothesis (no association). In fact, such inference requires an a-priori calculated sample-size to ensure that the type-two error probability does not exceed a pre-specified limit (typically 20% or 10%, given the other necessary assumptions, e.g. on the true magnitude of association). Otherwise, the type-two error is unknown and in practice often large. This may put a “false negative result” into the scientific public that turns out to be “unreplicable” – what would be falsely interpreted as part of the “replication crisis”. Such results are neither positive nor negative but uninformative . In this case, the wording “there is no evidence for an association” is adequate because it does not claim that there is no association.

Frequently, it remains unclear which hypotheses have been a-priori specified and which have been brought up only after some data analysis. This, of course, is scientific malpractice because it does not enable the readership to assess the random error emerging from explorative data analysis. Accordingly, the variance of results across statistical methods is often misused to filter out the analysis that yields a significant result (“ p -hacking”, [ 28 ]). Pre-planned tests (via writing a grant) leave at least less room for p-hacking because they specify a-priori which analysis is to be conducted.

On the other hand, post-hoc analyses can be extremely useful for identifying unexpected phenomena and creating new hypotheses. Verbalization in the discussion section should therefore sharply separate between conclusions from hypothesis testing and new hypotheses created from data exploration. The distinction is profound, since a newly proposed hypothesis just makes a new claim. Suggesting new hypotheses cannot be wrong, this can only be inefficient if many hypotheses turn out to be wrong. Therefore, we suggest proposing only a limited number of new hypotheses that appear promising to stimulate further research and scientific progress. They are to be confirmed or falsified with future studies. A present discussion, however, should yet explicate the testable predictions a new hypothesis entails, and how a future study should be designed to keep bias in related analyses as small as possible.

Confidence intervals address the problem of reducing results to the dichotomy of significant and non-significant through providing a range of values that are compatible with the data at the given confidence level, usually 95% [ 29 ].

This is also addressed by Bayesian statistics that allows calculating what frequentist p -values are often misinterpreted to be: the probability that the alternative (or null) hypothesis is true [ 17 ]. Moreover, one can calculate how likely it is that the parameter lies within any specified range (e.g. the risk difference being greater than .05, a lower boundary for practical significance) [ 15 , 16 ]. To gain these benefits, one needs to specify how the parameter of interest (e.g. causal risk difference between D and LC) is distributed before inspecting the data. In Bayesian statistics (unlike frequentist statistics) a parameter is a random number that expresses prior beliefs via a “prior distribution”. Such a “prior” is combined with the data result to a “posterior distribution”. This integrates both sources of information.

Note that confidence intervals also can be interpreted from the Bayesian perspective (then called “credibility interval”). This assumes that all parameter values were equally likely (uniformly distributed, strictly speaking) before analyzing the data [ 5 , 6 , 20 ].

Testing just for a non-zero association can only yield evidence for an association deviating from zero. A better indicator for the true impact of an effect/association for clinical, economic, political, or research purposes is its magnitude. If an association between D and LC after adjusting for age and gender has been discovered, then the knowledge of D has additional value in predicting an elevated LC probability beyond age and gender. However, there may be many other factors that stronger predict LC and thus should receive higher priority in a doctor’s assessment. Besides, if an association is small, it may yet be explained by modest (upward) bias. Especially large samples often yield significant results with little practical value. The p -value does not measure strength of association [ 17 ]. For instance, in a large sample, a Pearson correlation between two dimensional variables could equal 0.1 only but with a p -value <.001. A further problem arises if the significance threshold of .05 is weakened post-hoc to allow for “statistical trends” ( p between .05 and .10) because a result has “failed to reach significance” (this wording claims that there is truly an association. If this was known, no research would be necessary).

It is usually the statistician’s job to insist not only on removing the attention from pure statistical significance to confidence intervals or even Bayesian interpretation, but also to point out the necessity of a meaningful cutoff for practical significance. The substantive researcher then has to provide this cutoff.

Researchers should not draw conclusions that have not been explicitly tested for. For example, one may have found a positive association between D and LC (e.g. p  = .049), but this association is not significant (e.g. p  = .051), when adjusting for “health behavior”. This does not imply that “health behavior” “explains” the association (yet fully). The difference in magnitude of association in both analyses compared here (without and with adjustment on HB) may be very small and the difference in p -values (“borderline significance” after adjustment) likely to emerge from random error. This often applies to larger differences in p as well.

Investigators, however, might find patterns in their results that they consider worth mentioning for creating hypotheses. In the example above, adding the words “in the sample”, would clarify that they refer just to the difference of two point estimates . By default, “association” in hypotheses testing should mean “statistically significant association” (explorative analyses should instead refer to “suggestive associations”).

Conclusions

Some issues of discussing results not mentioned yet appear to require only substantive reasoning. For instance, Bradford Hill’s consideration on “plausibility” claims that a causal effect is more likely, if it is in line with biological (substantive) knowledge, or if a dose-response relation has been found [ 30 ]. However, the application of these considerations itself depends on the trueness of assumptions. For instance, bias might act differently across the dose of exposure (e.g. larger measurement error in outcome among those with higher dosage). As a consequence, a pattern observed across dose may mask a true or pretend a wrong dose-response relation [ 30 ]. This again has to be brought up by statistical expertise.

There are, however, some practical issues that hinder the cooperation we suggest. First, substantive researchers often feel discomfort when urged to make assumptions on the mechanisms behind the data, presumably because they fear to be wrong. Here, the statistician needs to insist: “If you are unable to make any assumptions, you cannot conclude anything!” And: “As a scientist you have to understand the processes that create your data.” See [ 31 ] for practical advice on how to arrive at meaningful assumptions.

Second, statisticians have long been skeptical against causal inference. Still, most of them focus solely on describing observed data with distributional models, probably because estimating causal effects has long been regarded as unfeasible with scientific methods. Training in causality remains rather new, since strict mathematical methods have been developed only in the last decades [ 7 ].

The cooperation could be improved if education in both fields focused on the insight that one cannot succeed without the other. Academic education should demonstrate that in-depth conclusions from data unavoidably involve prior beliefs. Such education should say: Data do not “speak for themselves”, because they “speak” only ambiguously and little, since they have been filtered through various biases [ 32 ]. The subjectivity introduced by addressing bias, however, unsettles many researchers. On the other hand, conventional frequentist statistics just pretends to be objective. Instead of accepting the variety of possible assumptions, it makes the absurd assumption of “no bias with probability of one”. Or it avoids causal conclusions at all if no randomized study is possible. This limits science to investigating just associations for all factors that can never be randomized (e.g. onset of depression). However, the alternative of Bayesian statistics and thinking are themselves prone to fundamental cognitive biases which should as well be subject of interdisciplinary teaching [ 33 ].

Readers may take this article as an invitation to read further papers’ discussions differently while evaluating our claims. Rather than sharing a provided conclusion (or not) they could ask themselves whether a discussion enables them to clearly specify why they share it (or not). If the result is uncertainty, this might motivate them to write their next discussion differently. The proposals made in this article could help shifting scientific debates to where they belong. Rather than arguing on misunderstandings caused by ambiguity in a conclusion’s assumptions one should argue on the assumptions themselves.

Acknowledgements

We acknowledge support by the German Research Foundation and the Open Access Publication Funds of the TU Dresden. We wish to thank Pia Grabbe and Helen Steiner for language editing and the cited authors for their outstanding work that our proposals build on.

John Venz is funded by the German Federal Ministry of Education and Research (BMBF) project no. 01ER1303 and 01ER1703. He has contributed to this manuscript outside of time funded by these projects.

Availability of data and materials

Abbreviations, authors’ contributions.

MH and RM had the initial idea on the article. MH has taken the lead in writing. JV has contributed to the statistical parts, especially the Bayesian aspects. RM has refined the paragraphs on statistical inference. ST joined later and has added many clarifications related to the perspective of the substantive researcher. All authors have contributed to the final wording of all sections and the article’s revision. All authors read and approved the final manuscript.

Ethics approval and consent to participate

Consent for publication, competing interests.

The authors declare that they have no competing interests.

Publisher’s Note

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

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General Research Paper Guidelines: Discussion

Discussion section.

The overall purpose of a research paper’s discussion section is to evaluate and interpret results, while explaining both the implications and limitations of your findings. Per APA (2020) guidelines, this section requires you to “examine, interpret, and qualify the results and draw inferences and conclusions from them” (p. 89). Discussion sections also require you to detail any new insights, think through areas for future research, highlight the work that still needs to be done to further your topic, and provide a clear conclusion to your research paper. In a good discussion section, you should do the following:

• Clearly connect the discussion of your results to your introduction, including your central argument, thesis, or problem statement.
• Provide readers with a critical thinking through of your results, answering the “so what?” question about each of your findings. In other words, why is this finding important?
• Detail how your research findings might address critical gaps or problems in your field
• Compare your results to similar studies’ findings
• Provide the possibility of alternative interpretations, as your goal as a researcher is to “discover” and “examine” and not to “prove” or “disprove.” Instead of trying to fit your results into your hypothesis, critically engage with alternative interpretations to your results.

For more specific details on your Discussion section, be sure to review Sections 3.8 (pp. 89-90) and 3.16 (pp. 103-104) of your 7 th edition APA manual

*Box content adapted from:

University of Southern California (n.d.). Organizing your social sciences research paper: 8 the discussion . https://libguides.usc.edu/writingguide/discussion

Limitations

Limitations of generalizability or utility of findings, often over which the researcher has no control, should be detailed in your Discussion section. Including limitations for your reader allows you to demonstrate you have thought critically about your given topic, understood relevant literature addressing your topic, and chosen the methodology most appropriate for your research. It also allows you an opportunity to suggest avenues for future research on your topic. An effective limitations section will include the following:

• Detail (a) sources of potential bias, (b) possible imprecision of measures, (c) other limitations or weaknesses of the study, including any methodological or researcher limitations.
• Sample size: In quantitative research, if a sample size is too small, it is more difficult to generalize results.
• Lack of available/reliable data : In some cases, data might not be available or reliable, which will ultimately affect the overall scope of your research. Use this as an opportunity to explain areas for future study.
• Lack of prior research on your study topic: In some cases, you might find that there is very little or no similar research on your study topic, which hinders the credibility and scope of your own research. If this is the case, use this limitation as an opportunity to call for future research. However, make sure you have done a thorough search of the available literature before making this claim.
• Flaws in measurement of data: Hindsight is 20/20, and you might realize after you have completed your research that the data tool you used actually limited the scope or results of your study in some way. Again, acknowledge the weakness and use it as an opportunity to highlight areas for future study.
• Limits of self-reported data: In your research, you are assuming that any participants will be honest and forthcoming with responses or information they provide to you. Simply acknowledging this assumption as a possible limitation is important in your research.
• Access: Most research requires that you have access to people, documents, organizations, etc.. However, for various reasons, access is sometimes limited or denied altogether. If this is the case, you will want to acknowledge access as a limitation to your research.
• Time: Choosing a research focus that is narrow enough in scope to finish in a given time period is important. If such limitations of time prevent you from certain forms of research, access, or study designs, acknowledging this time restraint is important. Acknowledging such limitations is important, as they can point other researchers to areas that require future study.
• Potential Bias: All researchers have some biases, so when reading and revising your draft, pay special attention to the possibilities for bias in your own work. Such bias could be in the form you organized people, places, participants, or events. They might also exist in the method you selected or the interpretation of your results. Acknowledging such bias is an important part of the research process.
• Language Fluency: On occasion, researchers or research participants might have language fluency issues, which could potentially hinder results or how effectively you interpret results. If this is an issue in your research, make sure to acknowledge it in your limitations section.

University of Southern California (n.d.). Organizing your social sciences research paper: Limitations of the study . https://libguides.usc.edu/writingguide/limitations

In many research papers, the conclusion, like the limitations section, is folded into the larger discussion section. If you are unsure whether to include the conclusion as part of your discussion or as a separate section, be sure to defer to the assignment instructions or ask your instructor.

The conclusion is important, as it is specifically designed to highlight your research’s larger importance outside of the specific results of your study. Your conclusion section allows you to reiterate the main findings of your study, highlight their importance, and point out areas for future research. Based on the scope of your paper, your conclusion could be anywhere from one to three paragraphs long. An effective conclusion section should include the following:

• Describe the possibilities for continued research on your topic, including what might be improved, adapted, or added to ensure useful and informed future research.
• Provide a detailed account of the importance of your findings
• Reiterate why your problem is important, detail how your interpretation of results impacts the subfield of study, and what larger issues both within and outside of your field might be affected from such results

University of Southern California (n.d.). Organizing your social sciences research paper: 9. the conclusion . https://libguides.usc.edu/writingguide/conclusion

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• How to Write a Discussion Section | Tips & Examples

How to Write a Discussion Section | Tips & Examples

Published on 21 August 2022 by Shona McCombes . Revised on 25 October 2022.

The discussion section is where you delve into the meaning, importance, and relevance of your results .

It should focus on explaining and evaluating what you found, showing how it relates to your literature review , and making an argument in support of your overall conclusion . It should not be a second results section .

There are different ways to write this section, but you can focus your writing around these key elements:

• Summary: A brief recap of your key results
• Interpretations: What do your results mean?
• Implications: Why do your results matter?
• Limitations: What can’t your results tell us?
• Recommendations: Avenues for further studies or analyses

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What not to include in your discussion section, step 1: summarise your key findings, step 2: give your interpretations, step 3: discuss the implications, step 4: acknowledge the limitations, step 5: share your recommendations, discussion section example.

There are a few common mistakes to avoid when writing the discussion section of your paper.

• Don’t introduce new results: You should only discuss the data that you have already reported in your results section .
• Don’t make inflated claims: Avoid overinterpretation and speculation that isn’t directly supported by your data.
• Don’t undermine your research: The discussion of limitations should aim to strengthen your credibility, not emphasise weaknesses or failures.

Prevent plagiarism, run a free check.

Start this section by reiterating your research problem  and concisely summarising your major findings. Don’t just repeat all the data you have already reported – aim for a clear statement of the overall result that directly answers your main  research question . This should be no more than one paragraph.

Many students struggle with the differences between a discussion section and a results section . The crux of the matter is that your results sections should present your results, and your discussion section should subjectively evaluate them. Try not to blend elements of these two sections, in order to keep your paper sharp.

• The results indicate that …
• The study demonstrates a correlation between …
• This analysis supports the theory that …
• The data suggest  that …

The meaning of your results may seem obvious to you, but it’s important to spell out their significance for your reader, showing exactly how they answer your research question.

The form of your interpretations will depend on the type of research, but some typical approaches to interpreting the data include:

• Identifying correlations , patterns, and relationships among the data
• Discussing whether the results met your expectations or supported your hypotheses
• Contextualising your findings within previous research and theory
• Explaining unexpected results and evaluating their significance
• Considering possible alternative explanations and making an argument for your position

You can organise your discussion around key themes, hypotheses, or research questions, following the same structure as your results section. Alternatively, you can also begin by highlighting the most significant or unexpected results.

• In line with the hypothesis …
• Contrary to the hypothesised association …
• The results contradict the claims of Smith (2007) that …
• The results might suggest that x . However, based on the findings of similar studies, a more plausible explanation is x .

As well as giving your own interpretations, make sure to relate your results back to the scholarly work that you surveyed in the literature review . The discussion should show how your findings fit with existing knowledge, what new insights they contribute, and what consequences they have for theory or practice.

Ask yourself these questions:

• Do your results support or challenge existing theories? If they support existing theories, what new information do they contribute? If they challenge existing theories, why do you think that is?
• Are there any practical implications?

Your overall aim is to show the reader exactly what your research has contributed, and why they should care.

• These results build on existing evidence of …
• The results do not fit with the theory that …
• The experiment provides a new insight into the relationship between …
• These results should be taken into account when considering how to …
• The data contribute a clearer understanding of …
• While previous research has focused on  x , these results demonstrate that y .

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Even the best research has its limitations. Acknowledging these is important to demonstrate your credibility. Limitations aren’t about listing your errors, but about providing an accurate picture of what can and cannot be concluded from your study.

Limitations might be due to your overall research design, specific methodological choices , or unanticipated obstacles that emerged during your research process.

Here are a few common possibilities:

• If your sample size was small or limited to a specific group of people, explain how generalisability is limited.
• If you encountered problems when gathering or analysing data, explain how these influenced the results.
• If there are potential confounding variables that you were unable to control, acknowledge the effect these may have had.

After noting the limitations, you can reiterate why the results are nonetheless valid for the purpose of answering your research question.

• The generalisability of the results is limited by …
• The reliability of these data is impacted by …
• Due to the lack of data on x , the results cannot confirm …
• The methodological choices were constrained by …
• It is beyond the scope of this study to …

Based on the discussion of your results, you can make recommendations for practical implementation or further research. Sometimes, the recommendations are saved for the conclusion .

Suggestions for further research can lead directly from the limitations. Don’t just state that more studies should be done – give concrete ideas for how future work can build on areas that your own research was unable to address.

• Further research is needed to establish …
• Future studies should take into account …
• Avenues for future research include …

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6 Writing the Discussion and Conclusion Sections

6.1 Discussion

This section discusses your results, presenting the “so what,” or “why should the reader care” about your research. This is where you explain what you think the results show. Tell the reader the significance of your document by discussing how the results fit with what is already known as you discussed in your introduction, how the results compare with what is expected, or why are there unexpected results. Here are some words to get you thinking about this section: evaluate, interpret, examine, qualify, etc.

Start by either summarizing the the information in this section or by stating the validity of the hypothesis. This allows readers to see upfront your interpretation of the data. End the discussion by summarizing why the results matter.

Writing tips:

• Summarize the most important findings at the beginning (1-3 sentences)
• Describe patterns and relationships shown in your results
• Explain how results relate to expectations and literature cited in Introduction
• Explain contradictions and exceptions
• Describe need for future research (if no Conclusion section)
• Overgeneralize, use specific supported statements
• Ignore unexpected results or deviations from your data
• Speculate conclusions that cannot be tested in the foreseeable future.

6.2 Conclusion

The Discussion usually serves as the conclusion. If there is a separate conclusion section then it should be brief, only one or two paragraphs. In the conclusion typically authors offer either recommendations or future perspectives for the research. Figs. 2.9 and 2.10 show the Discussion and Conclusion sections from the sample paper.

Technical Writing @ SLCC Copyright © 2020 by Department of English, Linguistics, and Writing Studies at SLCC is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Organizing Academic Research Papers: 9. The Conclusion

• Purpose of Guide
• Design Flaws to Avoid
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• How to Manage Group Projects
• Multiple Book Review Essay
• Reviewing Collected Essays
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Acknowledgements

The conclusion is intended to help the reader understand why your research should matter to them after they have finished reading the paper. A conclusion is not merely a summary of your points or a re-statement of your research problem but a synthesis of key points. For most essays, one well-developed paragraph is sufficient for a conclusion, although in some cases, a two-or-three paragraph conclusion may be required.

Importance of a Good Conclusion

A well-written conclusion provides you with several important opportunities to demonstrate your overall understanding of the research problem to the reader. These include:

• Presenting the last word on the issues you raised in your paper . Just as the introduction gives a first impression to your reader, the conclusion offers a chance to leave a lasting impression. Do this, for example, by highlighting key points in your analysis or findings.
• Summarizing your thoughts and conveying the larger implications of your study . The conclusion is an opportunity to succinctly answer the "so what?" question by placing the study within the context of past research about the topic you've investigated.
• Demonstrating the importance of your ideas . Don't be shy. The conclusion offers you a chance to elaborate on the significance of your findings.
• Introducing possible new or expanded ways of thinking about the research problem . This does not refer to introducing new information [which should be avoided], but to offer new insight and creative approaches for framing/contextualizing the research problem based on the results of your study.

Conclusions . The Writing Center. University of North Carolina; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion . San Francisco Edit, 2003-2008.

Structure and Writing Style

https://writing.wisc.edu/wp-content/uploads/sites/535/2018/07/conclusions_uwmadison_writingcenter_aug2012.pdf I.  General Rules

When writing the conclusion to your paper, follow these general rules:

• State your conclusions in clear, simple language.
• Do not simply reiterate your results or the discussion.
• Indicate opportunities for future research, as long as you haven't already done so in the discussion section of your paper.

The function of your paper's conclusion is to restate the main argument . It reminds the reader of the strengths of your main argument(s) and reiterates the most important evidence supporting those argument(s). Make sure, however, that your conclusion is not simply a repetitive summary of the findings because this reduces the impact of the argument(s) you have developed in your essay.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or point of your paper is complex, you may need to summarize the argument for your reader.
• If, prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the end of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration that returns the topic to the context provided by the introduction or within a new context that emerges from the data.

The conclusion also provides a place for you to persuasively and succinctly restate your research problem, given that the reader has now been presented with all the information about the topic . Depending on the discipline you are writing in, the concluding paragraph may contain your reflections on the evidence presented, or on the essay's central research problem. However, the nature of being introspective about the research you have done will depend on the topic and whether your professor wants you to express your observations in this way.

NOTE : Don't delve into idle speculation. Being introspective means looking within yourself as an author to try and understand an issue more deeply not to guess at possible outcomes.

II.  Developing a Compelling Conclusion

Strategies to help you move beyond merely summarizing the key points of your research paper may include any of the following.

• If your essay deals with a contemporary problem, warn readers of the possible consequences of not attending to the problem.
• Recommend a specific course or courses of action.
• Cite a relevant quotation or expert opinion to lend authority to the conclusion you have reached [a good place to look is research from your literature review].
• Restate a key statistic, fact, or visual image to drive home the ultimate point of your paper.
• If your discipline encourages personal reflection, illustrate your concluding point with a relevant narrative drawn from your own life experiences.
• Return to an anecdote, an example, or a quotation that you introduced in your introduction, but add further insight that is derived from the findings of your study; use your interpretation of results to reframe it in new ways.
• Provide a "take-home" message in the form of a strong, succient statement that you want the reader to remember about your study.

III. Problems to Avoid Failure to be concise The conclusion section should be concise and to the point. Conclusions that are too long often have unnecessary detail. The conclusion section is not the place for details about your methodology or results. Although you should give a summary of what was learned from your research, this summary should be relatively brief, since the emphasis in the conclusion is on the implications, evaluations, insights, etc. that you make. Failure to comment on larger, more significant issues In the introduction, your task was to move from general [the field of study] to specific [your research problem]. However, in the conclusion, your task is to move from specific [your research problem] back to general [your field, i.e., how your research contributes new understanding or fills an important gap in the literature]. In other words, the conclusion is where you place your research within a larger context. Failure to reveal problems and negative results Negative aspects of the research process should never be ignored. Problems, drawbacks, and challenges encountered during your study should be included as a way of qualifying your overall conclusions. If you encountered negative results [findings that are validated outside the research context in which they were generated], you must report them in the results section of your paper. In the conclusion, use the negative results as an opportunity to explain how they provide information on which future research can be based. Failure to provide a clear summary of what was learned In order to be able to discuss how your research fits back into your field of study [and possibly the world at large], you need to summarize it briefly and directly. Often this element of your conclusion is only a few sentences long. Failure to match the objectives of your research Often research objectives change while the research is being carried out. This is not a problem unless you forget to go back and refine your original objectives in your introduction, as these changes emerge they must be documented so that they accurately reflect what you were trying to accomplish in your research [not what you thought you might accomplish when you began].

Resist the urge to apologize If you've immersed yourself in studying the research problem, you now know a good deal about it, perhaps even more than your professor! Nevertheless, by the time you have finished writing, you may be having some doubts about what you have produced. Repress those doubts!  Don't undermine your authority by saying something like, "This is just one approach to examining this problem; there may be other, much better approaches...."

Concluding Paragraphs. College Writing Center at Meramec. St. Louis Community College; Conclusions . The Writing Center. University of North Carolina; Conclusions . The Writing Lab and The OWL. Purdue University; Freedman, Leora  and Jerry Plotnick. Introductions and Conclusions . The Lab Report. University College Writing Centre. University of Toronto; Leibensperger, Summer. Draft Your Conclusion. Academic Center, the University of Houston-Victoria, 2003; Make Your Last Words Count . The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Tips for Writing a Good Conclusion . Writing@CSU. Colorado State University; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion . San Francisco Edit, 2003-2008; Writing Conclusions . Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Writing: Considering Structure and Organization . Institute for Writing Rhetoric. Dartmouth College.

Writing Tip

Don't Belabor the Obvious!

Avoid phrases like "in conclusion...," "in summary...," or "in closing...." These phrases can be useful, even welcome, in oral presentations. But readers can see by the tell-tale section heading and number of pages remaining to read, when an essay is about to end. You'll irritate your readers if you belabor the obvious.

Another Writing Tip

New Insight, Not New Information!

Don't surprise the reader with new information in your Conclusion that was never referenced anywhere else in the paper. If you have new information to present, add it to the Discussion or other appropriate section of the paper.  Note that, although no actual new information is introduced, the conclusion is where you offer your most "original" contributions in the paper; it's where you describe the value of your research, demonstrate your understanding of the material that you’ve presented, and locate your findings within the larger context of scholarship on the topic.

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Characterizing Community Forests in the United States

Current affiliation: University of North Carolina Wilmington, Environmental Science, Wilmington, NC, USA

Current affiliation: US Department of the Interior, Office of Collaborative Action and Dispute Resolution Washington, DC, USA

• Article contents
• Figures & tables
• Supplementary Data

Reem Hajjar, Kathleen McGinley, Susan Charnley, Gregory E Frey, Meredith Hovis, Frederick W Cubbage, John Schelhas, Kailey Kornhauser, Characterizing Community Forests in the United States, Journal of Forestry , Volume 122, Issue 3, May 2024, Pages 273–284, https://doi.org/10.1093/jofore/fvad054

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Research on community forests (CFs), primarily governed and managed by local forest users in the United States, is limited, despite their growth in numbers over the past decade. We conducted a survey to inventory CFs in the United States and better understand their ownership and governance structures, management objectives, benefits, and financing. The ninety-eight CFs in our inventory are on private, public, and tribal lands. They had various ways of soliciting input from, or sharing decision-making authority with, local groups, organizations, and citizens. Recreation and environmental services were the most important management goals, but timber production occurred on more than two-thirds of CFs, contributing to income on many CFs, along with a diversity of other income sources to fund operations. We discuss the difficulties in creating a comprehensive CF inventory and typology given the diversity of models that exist, reflecting local social and environmental conditions and the bottom-up nature of community forestry in the United States.

Study Implications: Despite their small footprint in the United States, community forests are a rapidly developing model of forest ownership, governance, and management that helps protect forestlands and open space and demonstrates how market and nonmarket forest goods and services can be produced for broad and enduring community benefits. This study inventories and characterizes community forests in the United States to increase understanding of this model, its prevalence, and its potential. It provides a baseline of information that serves as a foundation for further exploration and research on the impacts and contributions of community forests.

Over the past few decades, many countries have increasingly promoted community forests (CFs) as a way to conserve forests, enhance rural livelihoods, and recognize the traditional and customary rights of local forest users to access, use, and manage forests ( Hajjar et al. 2021 ; Lund et al. 2018 ). CFs are delineated forest areas where community members have access to natural resources, are engaged in their governance, and receive indirect and direct benefits from their management ( Charnley and Poe 2007 ; McDermott and Schreckenberg 2009 ). Although CFs have existed in many forms across the globe for centuries, these more recent efforts are typically formal, government-sanctioned, and often government-sponsored. A total 14% of the world’s forests, and 28% of forests in low- and middle-income countries, are currently owned or managed by Indigenous peoples and local communities ( Rights and Resources Initiative 2018 ). Internationally, CF initiatives span a broad range of tenure regimes, institutional arrangements, relationships between communities and higher levels of government, activities, and outcomes that have evolved in line with local contexts, conditions, needs, and goals ( Charnley and Poe 2007 ; Hajjar and Molnar 2016 ).

In the United States, CFs have also existed in diverse forms for centuries ( Baker and Kusel 2003 ; McCullough 1995 ), although as elsewhere, formally designated community forests have been increasing in number since the 1990s. This relatively recent trend is likely driven by several factors. First, vertically integrated forest products companies nationwide have been divesting of their industrial timberlands since the late 1980s for economic reasons ( Zhang 2021 ), causing a large-scale shift in timberland ownership from industrial to institutional investors ( Zhang 2021 ). To prevent residential development, maintain access to local forests, conserve forest resources, and keep working forests working to provide economic opportunities for local residents, initiatives to acquire industrial timberland and manage it as CFs have proliferated ( Belsky 2008 ). Second, private family forest owners are aging; the average age of the primary decision-maker over family forestlands is 65 and, for about 20% of these ownerships, 75 or older ( Butler et al. 2021 ). Keeping their family forestland intact for future generations is a top concern for family forest owners ( Butler et al. 2021 ). If their descendants are uninterested or unable to keep this land in the family, community groups or municipalities may wish to acquire it as a CF to prevent its subdivision and fragmentation and provide community benefits.

Third, Indigenous peoples in the United States have regained greater control over ancestral lands, including forestlands, both on and off tribal trust lands over the past several decades ( McGinley et al. 2022 ). Some tribes have acquired forestland through fee simple purchase, including with funding designated for CF creation, and established CFs on those lands ( McGinley et al. 2022 ). Fourth, the 1990s saw a dramatic increase in citizen participation in decision-making about the management of public forestlands ( Baker and Kusel 2003 ; Charnley and Poe 2007 ). This trend has persisted, with community-based organizations, community members, forest collaborative groups, and other stakeholders playing a greater role in management decision-making and collaborative forest stewardship on federal lands ( Davis et al. 2020 ). In some cases, these arrangements may exhibit the characteristics of a CF.

Simultaneously, several programs providing funding for land acquisition to create CFs have arisen in the past two decades ( McGinley et al. 2022 ). Access to funding along with the emergence of supportive policies, organizations providing technical assistance, and practitioner networks have fostered a more favorable environment for CF creation since the 2000s ( Frey et al. forthcoming ). These trends have played out somewhat differently in different locations, but together they have contributed to a nationwide rise in CFs in the United States.

Unlike many other countries around the world with communal property systems, CFs in the United States do not exist as a distinct land tenure or ownership class. CFs have been established on a variety of public, private, and tribal lands and have diverse land tenure arrangements ( McGinley et al. 2022 ). Furthermore, there is no universally accepted definition of a CF in the United States ( Frey et al. forthcoming ). These two facts make studying CFs in the United States, as a distinct form of forest tenure, management, and governance, challenging. Literature on US CFs, most of it published since the 1990s, has primarily been descriptive in nature, relying on limited numbers of case studies to elaborate on the various motivations for creating CFs and the institutional and political context that pushed them forward ( Belsky 2015 ; McCarthy 2006 ); development of mechanisms and institutional arrangements for governance ( Abrams 2023 ; Abrams et al. 2015 ; Belsky and Barton 2018 ); and their potential benefits ( Christoffersen et al. 2008 ; Lyman et al. 2014 ). Belsky (2008) proposed a typology of CFs defined by who owns the CF—Indigenous groups, towns or municipalities, or community-based conservation organizations. A key message of the scientific literature is that a vast diversity of CFs exists in the United States, reflecting the diverse social, economic, and ecological contexts in which they occur.

To our knowledge, no prior research has attempted to document or characterize the full suite of CFs in the United States. Thus, the goals of this paper are to (1) identify, inventory, and characterize CFs in the United States; (2) enhance understanding of their ownership and governance structures, management objectives, and sources of income; (3) extend the discussion of the variability in forms of CFs and build on previous work to refine a CF typology; and (4) problematize how we recognize CFs in the United States (i.e., what is included, what is not, and why).

Defining CFs 1

A common but broad premise of CFs internationally is that place-based communities have some role in determining how local forests are to be managed for community benefit ( Hajjar et al. 2021 ). In the United States, communities associated with CFs are frequently not only place-based but also communities of interest and practice or some combination of these ( McGinley et al. 2022 ), complicating the notion of “community” and “local” (see Brosius et al. [2005 ] for a discussion). For purposes of deciding what to include in this study, we considered the following attributes of CFs, which are prevalent in the literature on US CFs (see Frey et al. forthcoming ): (1) ownership or tenure by a local governmental or nongovernmental organization (NGO) on behalf of the community; (2) communities are substantively involved in forest management and governance; (3) communities have secure rights to access and benefit from the forest; (4) social and economic benefits for local communities are a management priority; and (5) forest conservation values are permanently protected.

Creating a CF Inventory

To catalogue and characterize CFs in the United States, we first undertook an inventory of existing CFs, aiming to be as comprehensive as possible. Given the lack of a consistent definition or model of CFs, we used a hybrid approach to identify them ( Frey et al. forthcoming ). This meant first searching for entities that self-identify their property or initiative as a CF and for those that have participated in programs or policies related to CFs. Then we overlaid a series of inclusion criteria based on the attributes of CFs outlined above. Therefore, to be included in our study, local communities had to have rights of access and use and some form of management responsibility or decision-making authority (beyond consultation) over local forests. Additionally, these forests were managed to promote ecological sustainability and contribute to conservation while creating tangible local community benefits as a management priority.

We began by compiling a list of CFs and related information from a US Endowment for Forestry and Communities study ( Christoffersen et al. 2008 ) and a previous exploratory project ( Hovis et al. 2022 ). We then added to this list, drawing from CF lists provided by organizations that work with and support them, such as the Ford Foundation, the Northwest Community Forest Coalition, the Northern Forest Center, the Trust for Public Lands, the Open Space Institute, and the USDA Forest Service (Forest Service) Community Forest and Open Space Conservation Program. We also used Google Search Engine to identify any additional CFs not already included in our list. Search terms included: state name AND community forest OR community managed forest OR community-based forest OR town forest. We further consulted with various professionals in our networks involved with CFs (e.g., via the Northwest Community Forest Coalition annual meeting) to ensure the comprehensiveness of our list. Finally, we consulted with two project advisory committees that we set up at the start of the funded project under which this research was undertaken: one, a research advisory committee consisting of CF professionals across select government agencies, CF coalitions, and networks; the other, a tribal forestry advisory committee consisting of representatives of tribes with CFs and tribal natural resources networks.

We also used Google Search Engine to record any information on the identified CFs, usually landing on the websites of CF owners or their supporters. This information typically included the group name, forest location, acreage, landowner, governance, management objectives, history, URL, and contact information. Searches and consultations took place between 2019 and 2023, with more CFs identified and added continually as we heard of cases that were missed in our searches or that were being newly created. We examine the limitations of this approach in the Discussion section.

We initially located 136 possible CFs in the United States using these methods. Of these, thirty-two clearly did not meet our criteria, and we were unable to find additional information or contacts for eleven. To the remaining ninety-three CFs that met our inclusion criteria and for which we had contact information, we sent an internet-based survey using Qualtrics. We requested that a CF manager or other person familiar with the CF fill out the survey. The survey included questions about the CF, such as size, forest type, ownership, decision-making, who is involved in day-to-day management, management priorities, rules of access and use, and financing. Although most survey questions were designed to capture objective characteristics of the CF (i.e., size, ownership, etc.), we acknowledge that answers to a question asking about “management priorities” may not reflect the diversity of priorities a community may have for its forests. Rather, we expected that a CF manager responding to the survey would choose priorities that were being explicitly managed for, consistent with their management plan or mission statement.

To increase response rates ( Dillman et al. 2014 ), we followed up by sending reminder emails after 2 and 4 weeks and then through phone calls where phone numbers were available. Following this, for all nonresponses or cases where contact information could not be located, we filled out the survey ourselves to the extent possible using CF websites and other available resources. Not all survey questions had responses readily available from website sources, and so these surveys were not as complete. This resulted in some topic areas having smaller sample sizes, as displayed in the Results section. We also followed this protocol for newly identified CFs throughout the time period of the research (either newly created CFs or CFs discovered through our networks that met our criteria), for a combined total of ninety-eight CFs recorded up to April 2023. Survey responses were tabulated in SPSS, where descriptive statistics (frequencies and crosstabs) were used to show patterns across various CF characteristics.

We refer to three regions in discussing our results based on the Forest Service Resources Planning Act Assessment (RPA) regions: the West, combining the Pacific Coast and Rocky Mountain RPA regions, including CFs in Montana, Idaho, Washington, Oregon, California, and Arizona; the North, which includes CFs found in Maine, Vermont, New Hampshire, Massachusetts, New York, Connecticut, Michigan, and Wisconsin; and the South, which includes CFs in Georgia, North and South Carolina, Virginia, and Puerto Rico.

We collected data on ninety-eight CFs across the United States, constituting the sample used for this study ( SI Table 1 ). The survey response rate was 87% (eighty-five of ninety-eight); for the remaining thirteen survey nonresponses, we gathered information from internet sources. We expect the number of CFs to continue to grow in the coming years: after closing the survey in April 2023, we learned of at least four additional initiatives that were close to acquiring CF lands and nine that were seeking funds to purchase CF land. We believe that ninety-eight is close to the current total number of self-identifying CFs in the United States but acknowledge that it is likely an undercount of actual CFs that meet our inclusion criteria. We discuss the difficulties in accurately capturing all US CFs in the Discussion section. Rather than thinking of our sample as a complete inventory of all US CFs, we consider it sufficient for characterizing different types of CFs in the United States.

Location, Year Established, and Size

The greatest number of CFs per state were found in West Coast states ( figure 1 ; Washington, fourteen CFs; Oregon, twelve; California, nine); northeastern states (Maine, twelve CFs; Vermont, nine; New Hampshire, eight); and the upper midwestern states of Michigan and Wisconsin (five each). Fewer were located in southern states, with a handful spread across Georgia, North and South Carolina, and Virginia. The earliest recorded CFs in our sample were created in the 1930s and 1940s ( figure 2 ), mostly city and county forests in the northwestern United States (Montesano Community Forest, Hood River County Forest, Ashland Forestlands, Arcata Community Forest), and two town forests that self-describe as CFs in the Northeast (Gorham Town Forest, Mendon Town Forest). Most CFs in our sample were created after 2010 when there was a sharp increase in the number of CFs in all regions. This time period corresponded with new legislative support for CFs in some states (e.g., Washington State’s 2011 Community Forest Trust legislation) and at the federal level (e.g., the Forest Service's 2011 Community Forest Program), which have helped tribes, local governments, and nonprofit organizations acquire land at risk of development to establish CFs.

Location of CFs in our database. In this article, we refer to three regions in discussing our results: the West, which includes CFs found in Montana, Idaho, Washington, Oregon, California, and Arizona; the North, which includes Maine, Vermont, New Hampshire, Massachusetts, New York, Connecticut, Michigan, and Wisconsin; and the South, which includes Georgia, North and South Carolina, Virginia, and Puerto Rico.

Number of CFs in the United States since 1930.

The total area covered by CFs in our inventory is 436,411 acres (ac). Of this total, 87% of CFs were smaller than 5,000 ac ( figure 3 ), and 63% were less than 1,000 ac. By region, median sizes of CFs were: 1,360 ac in the West, 375 ac in the North, and 334 ac in the South. Nine CFs in the West were 5,000 ac or larger, compared to four in the North and none in the South. The majority of CFs less than 1,000 ac (thirty-nine of sixty-one CFs) were located in the North, with over half of those being between 100 and 500 ac (twenty-five of thirty-nine CFs). A total of 76% of reporting CFs said their forests were located on one contiguous parcel and 24% were on multiple unconnected parcels (varying from two to seventeen parcels).

Acreage of CFs across regions.

Ownership, Decision-Making Authority, and Management

As indicated in figure 4 , CFs in our sample were primarily owned by either a local government body (town, city, or county government) or by an NGO (e.g., a community-based organization, land trust, or other nonprofit). In the West, CFs were mostly purchased from private corporate owners (industrial timber companies, timber investment management organizations [TIMOs], or real estate investment trusts). In the North, CF lands were mostly acquired from private family forest owners. Ownership types included CFs of various sizes, although CFs larger than 1,000 ac tended to be held by a government body, whereas the majority of NGO-held CFs were smaller than 1,000 ac ( SI Table 2 ).

Ownership of CFs: (a) current landowner of forestlands designated as CFs and (b) previous landowners from whom the current landowner acquired the CF land. “Joint ownership” in (a) were parcels jointly owned by a local government body and a land trust ( n  = 3), a private utilities firm ( n  = 1), or a university ( n  = 1); a tribe and a conservancy ( n  = 1); and a land trust and private equity firm ( n  = 1). “Other” in (b) were parcels that were pieced together from multiple ownerships.

Land ownership largely corresponded with the entity with ultimate decision-making authority over management, access, and use of the CF ( SI Figure 1 ). Government agencies largely had authority over government-owned CFs, tribes over tribally owned CFs, and NGOs over the land they owned. These entities had various ways of soliciting input from, or sharing decision-making authority with, local groups, organizations, and citizens. In some cases, this was institutionalized through formal joint decision-making processes. For example, there were eleven cases of local government ownership (town, city, or county-owned forests) where decision-making authority was jointly held by both that government body and formal citizen councils or committees established for this purpose. In other cases, although respondents did not describe decision-making as “joint,” they involved community members through mechanisms such as advisory committees and boards made up of local citizens, formal community and public consultation processes (mostly for city or town government ownerships), or various events, regular meetings, and other formal and informal mechanisms that sought community input (mostly for NGO ownerships). Local groups and volunteers contributed to day-to-day management of CFs across most ownerships ( SI Figure 2 ). In particular, various recreation-related volunteer groups helped to maintain trail systems. Otherwise, in many cases, forest consultants or forestry professionals from government agencies or NGOs contributed to forest planning and stewardship.

Management Goals and Allowed Activities

Survey respondents were asked to select the top four goals, from a list of options, that the CF was managed for ( figure 5 ). Across the country, the vast majority of CFs stated that recreation was a top management goal (82% of ninety-five reporting CFs). Collectively, conservation-oriented goals (watershed, habitat or open space protection, biodiversity conservation and restoration, and carbon sequestration, totaling 98% of reporting CFs), as well as other nonextractive goals (education, recreation, and cultural heritage protection, totaling 93% of reporting CFs) were much more prominent than extraction-oriented goals (timber production, nontimber forest products (NTFPs) management, agroforestry, and livestock grazing, totaling 47% of reporting CFs). However, timber production was among the top four management goals reported across the sample as a whole.

Primary management goals. Respondents were asked to list top four management goals for their CF.

There were few strong patterns between ownership type and management goals ( SI Table 3 ). Recreation was listed as one of the top management goals in over 75% of cases across CF ownership types, except for tribal (two of five CFs) and private corporate (one of two) owned CFs. All but two CFs owned by local governments listed a conservation-oriented goal. Half of local government-owned (twenty-two of forty-four CFs) and half of NGO-owned CFs (fifteen of thirty-two CFs) listed an extractive-oriented goal. Of the five tribal-owned CFs in our sample, only one listed an extractive-oriented goal (agroforestry) as a primary management goal and only one indicated that timber was produced but not as a primary goal. Local government and NGO-owned CFs reported slightly more often that producing timber was a primary goal (government: nineteen CFs listed it as a primary goal, twelve as a nonprimary goal, and twelve do not produce timber; NGO: thirteen, ten, and six, respectively).

Although timber production occurred on 70% of reporting CFs (sixty-five of ninety-three reporting CFs; figure 6A ), in almost half of those cases (twenty-eight of sixty-five cases) timber production was not one of the top four primary management goals of the CF. Geographically, no CFs in the southern region produced timber as a primary goal. In the North, slightly more CFs produced timber as a primary goal than not as a primary goal (twenty versus sixteen CFs), with only nine reporting no timber production. In the West, seventeen CFs reported producing timber as a primary goal, with ten producing but not primary and ten not producing. Timber production occurred across all acreages ( figure 6B ), including on almost two-thirds of the smallest CFs in our study (<1,000 ac) and on all CFs larger than 5,000 ac (although not always as a primary goal). Similarly, timber production occurred across all ownership types ( figure 6C ), whether as a primary goal or not. Of those engaged in timber production, a private consulting forester was used to oversee timber sales in 43% of fifty-one reporting cases, and internal staff from the CF owner in 26% of cases. Across ownerships, the entity that did the logging was most often a private contracting company (70% of fifty reporting cases). These entities were located at a place within 25 miles of the CF in 52% of forty-two reporting cases, or 26–50 miles in 33% of cases.

Status of timber production across CFs (a) by region, (b) CF size, and (c) ownership type.

Community forests had a variety of rules related to which activities were allowed and whether permits from CF owners were needed if allowed ( SI Figure 3 ). Motorized recreation, camping, and commercial uses of firewood or NTFPs were only allowed in a handful of CFs, often with the requirement of a free or paid permit. Hunting and fishing, in accordance with state regulations, were allowed in more than half of the reporting cases (69% of sixty-five reporting cases and 78% of sixty reporting cases, respectively) and rarely required a permit from CF owners. Personal use of firewood and other NTFPs were allowed in 22% and 40% of sixty-three reporting cases, respectively, although firewood use often required a permit. Altogether, 85% of sixty-six reporting cases allowed some nontimber extractive activities for personal use (either firewood, other NTFPs, hunting, or fishing). Only one CF did not allow recreation and four allowed it only with a free permit. In almost all cases, the same rules applied to the local community as to the general public, except for a few instances where NTFP and firewood use were limited to local community members.

Income Generation and Budgetary Support

A number of CFs across ownerships generated revenue from forest products and services (80% of forty-nine reporting CFs), mostly from timber sales ( figure 7 ; SI Table 4 ), although two-thirds of those reporting revenue generation stated that timber contributed to less than 30% of their budget. The few instances of revenue from hunting leases and payments for ecosystem services (mainly carbon offsets) were mostly reported in CFs owned by private nonprofits, whereas grazing permits or agriculture revenue were only reported in three state or local government-owned CFs ( SI Table 4 ). Timber revenue was reported across all ownerships where timber harvest occurred, except for the two cases of state government ownership, where it is anticipated in the future, once the forest regains commercial value following harvest by the previous owner.

Main sources of revenue generated from forest activities in 48 reporting CFs by region.

Grants from federal or state governments were the most frequently cited sources of annual budgetary support from 2018 to 2020, the period we asked about (70% of fifty-three reporting CFs; figure 8 ; SI Figure 4 ), although almost two-thirds of those CFs stated that grants contributed to less than 30% of their budget. Unsurprisingly, government-owned CFs more often reported (federal, state, or local) government sources for budgetary support. Local government-owned CFs were more reliant on local government funds: 71% of twenty-four reporting local government CFs stated they received funding from local governments (50% of them stating that they received more than 60% of their budget from this source), with only a handful of nongovernment owned CFs reporting support from this source. The NGO-owned CFs reported relying on donations from local community members and fundraiser events much more often than government-owned CFs (in three cases, community donations made up more than 60% of the budget). We did not track sources of funds used for acquiring forestlands in our survey.

Sources of budgetary support 2018–2020 by ownership type. Public ownership includes federal, state, and local governments, and private ownership includes both corporate and nonprofits. Polygons indicate largest differences between private and public ownerships.

As the results indicate, there are a variety of ownership and governance forms that CFs currently take in the United States, a variety of benefits that they provide, and a diversity of income sources that they rely on. As stated above, one goal of this study was to discuss the variability in CFs and develop a robust typology of them. Although Belsky (2008) proposed a CF typology based on ownership types, given the diversity of CFs we encountered in our survey (including within ownership types), we intended to develop a typology based on key characteristics, including ownership, decision-making, operational management, goals, size, and income sources. Two-step cluster analyses and Pearson’s χ 2 tests were performed to assess whether the CFs in our dataset could be empirically grouped according to various combinations of these characteristics. However, limited patterns emerged for creating definitive statistical typologies. Instead, we discuss here some emergent qualitative patterns based on the descriptive statistics reported in the Results section, reflect on the diversity of CFs in the United States, and propose a basic typology for practical purposes. Finally, we discuss the difficulties in creating a comprehensive CF inventory for the United States, given this diversity.

Ownership type emerged as a factor that seemed to shape some key functions of a CF—specifically, decision-making authority and sources of budgetary support. Publicly owned CFs (mostly by local city or town government) more often reported having either a government entity as ultimate decision-making authority or joint authority between local government and citizen councils or other local groups. They were also more reliant on government funding for budgetary support, either through federal or state grants, local government funds, or combinations of these. Privately owned CFs (mostly community-based organizations and local land trusts) more often reported having those same owners make decisions about the CF and less often reported that they formally engage in joint decision-making (although it is difficult to ascertain actual community participation in governance with our survey research design). They also more often reported relying on community donations and fundraiser events than local government funds. All five tribally owned CFs in our dataset were run by tribes themselves, including decision-making authority and operational management. Besides these basic characteristics, however, ownership type seems to have little influence on the size of CFs, management goals, allowed activities, timber production (equally present in public and private CFs), or earned income sources.

We saw moderate regional differences in ownership and size (more government ownership and larger sizes in the West), and who the CF owner bought their forestland from. Ownership history may help explain why the median size of CFs in the West was considerably larger than in the North. The majority of CF lands in the West were purchased from private corporate forest owners, whose holdings are often in the hundreds of thousands of acres ( Sass et al. 2021 ), and from TIMOs in particular, which typically sell land every 10 to 15 years ( Zhang 2021 ). In contrast, the majority of CF lands in the North were purchased from family forest owners; approximately 90% of these ownerships in the United States are under 50 ac ( Butler et al. 2021 ). Yet CFs larger than 5,000 ac occur in both the North and the West.

In both these regions, timber production often occurred across CFs of all sizes and was a primary management goal in roughly equal frequency, although not in our small sample of southern CFs. Timber production was not limited to any particular ownership type, or size class, of CF; rather, the potential to harvest timber as a management goal and source of revenue generation is likely influenced by the nature of the forest assets contained in a particular CF. Those with productive timberlands are presumably more likely than those lacking them to have timber production as a primary management goal. However, it may take years for this goal to be realized if the former owner recently harvested a substantial amount of commercial timber. All CFs across regions emphasized conservation goals, but forest restoration (phrased in the survey as “forest restoration, including wildfire management”) was cited more often in the West. Almost all CFs allowed public access for recreation and many for nontimber extractive activities for personal use. It is likely that some CFs regulate access more than others, but we could not capture this variation in our survey.

The difficulty in creating a typology of CFs is unsurprising given that, by definition, CFs reflect the values and priorities of the communities in which they are situated. Other historical, social, economic, and environmental factors also likely influence their characteristics. Additionally, policies and programs that provide funding opportunities to support CFs and their operations vary by state, influencing their sources of budgetary support. Investigating underlying factors that lead to the diversity in CF models and characteristics is a rich area for further research.

The second phase of our research (a larger project than reported here, aiming to better understand how CFs contribute to conservation and rural prosperity in the United States) uses a case-study sampling approach based on two characteristics that we postulated would be important distinguishing features of a typology: ownership of the CF and whether timber production is a primary management goal of the CF ( Table 1 ). We acknowledge that our survey results do not show that these two characteristics are statistically related to many other factors examined here but reasoned that ownership can influence CF governance and financing mechanisms, and that the role (or lack thereof) of timber production reflects the CF’s management goals, forest resources, financing mechanisms, and benefit streams. We recognize that CFs produce a host of benefits for communities beyond timber production. However, whether a CF prioritizes timber, harvests timber but does not prioritize it, or does not harvest timber emerged as an effective way to distinguish groups of CFs from each other in terms of their management priorities and resulting benefit streams. Otherwise, most CFs shared recreation and conservation-related goals.

A basic typology based on ownership and whether timber is a primary management goal of the CF. Percentages (in parentheses) reflect percentage of eighty-two CFs in our inventory that reported on timber status and ownership.

The diversity of CFs in the United States also reflects the grassroots nature of community forests across the country, making them somewhat unique relative to community forests globally. In many low- and middle-income countries, community forests are forests managed using a top-down model imposed and defined by national CF policies or land reforms and extensive financial and technical support from external donor organizations (e.g., national or international NGOs, multilateral/bilateral aid agencies), with communities receiving some rights and many responsibilities for forest management ( Charnley 2023 ; Hajjar et al. 2021 ; Ribot et al. 2006 ). In contrast, in the United States, CF establishment is typically driven from the bottom up, in most cases through local governments, locally based NGOs, or groups of citizens that come together to protect their local forests. There is no distinct CF tenure category at the national level and few national or state-level policies associated with community forests in the United States. Exceptions include Washington and New York states, where there are legislatively approved funding sources 2 to support CF acquisition and associated policy requirements once established, and the national-level Forest Service Community Forest and Open Space Conservation Program, which has supported the acquisition of numerous CFs in our inventory. This more grassroots approach results in a broad range of ownership, management, governance types, and rights and responsibilities among community members relative to many other countries. It also makes CFs somewhat hard to pinpoint in the United States, posing challenges for efforts to inventory them.

Stemming from this diversity in CFs, a key difficulty we faced in undertaking this inventory was determining what to include. Our approach to including CFs that self-identify as such or had participated in a program or policy related to CFs and met our criteria was naturally limiting. Although this approach was necessary to make an inventory possible, we acknowledge that many more CFs potentially exist than we included here, depending on how a CF is defined. In particular, our inventory captured many town forests and land trust forestlands, some tribal forests, and some state and federal forests. Yet these general ownership categories need further examination.

Town forests are local government-owned forests common across much of New England and the Northeast and in many cases may be considered CFs. They have long been established to generate income from timber and other resources for town budgets or specific projects and public services, to protect water, soil, and wildlife habitat, and to provide recreation and education opportunities for local community members and others ( Baker and Kusel 2003 ; Brown 1941 ; Hovis et al. 2022 ; McCullough 1995 ). The local ownership, management, and benefits of many town forests fulfill most of the criteria of CFs as laid out above. However, the acquisition and designation of a town forest does not guarantee its long-term protection from sale or development, and depending on how much the community participates in governance, it may or may not fulfil the governance criterion of CFs ( McGinley et al. 2022 ).

Similarly, many land trusts own forestlands that could be considered CFs, depending on how these forests are governed and managed, potentially increasing the number and extent of CFs in the United States. However, land trusts may not provide access for local communities or the general public to their forested land, may not provide for local community participation in decision-making, or may not manage their forests specifically for local benefits.

The extent to which tribal forests should be considered CFs is also complicated. Most tribal lands are trust lands, with about 56 million acres of land held in trust for tribes by the federal government (2.3% of US land area; DOI 2023 ). Although these lands are managed for the benefit of individual tribes, forest management activities take place under the direction of forest management and integrated resource management plans developed under the federal Bureau of Indian Affairs (BIA) guidelines and are subject to BIA approval. Since the passage of the Indian Self-Determination and Education Assistance Act of 1975 (Public Law 93-638), an increasing number of tribes have established contracts, known as 638 contracts, with the BIA by which tribal government forestry departments assume management responsibilities for forests on trust lands. These contracts are initiated by a formal request by a tribe to the BIA. By 2011, 112 tribes had taken advantage of these self-determination/self-governance opportunities for forest management, compared to 187 that relied on BIA to manage their lands directly ( Gordon et al. 2013 ). Given this complexity in governance, it is unclear to what extent the trust lands of individual tribes meet the criteria of CFs; such classification should be undertaken by tribes themselves. Tribes can also purchase and own fee lands to which they hold title. The five tribally owned CFs in our sample (they self-identify as such) were purchased this way from private landowners. Further research on tribal forests could explore the variations in ownership, benefits, and management of these forests on trust and fee lands.

Our inventory includes two CFs owned by Washington State and one that occurs on federal lands in California. These cases may appear to contradict our defining attributes of a CF, namely that they have local, long-term ownership or tenure, and that communities have significant decision-making authority. We included the state and federal CFs in our inventory primarily because they self-identified as CFs. However, they also display several attributes of a CF. The two state-owned CFs were acquired through Washington’s 2011 Community Forest Trust Program ( WA DNR, n.d. ). The legislation that created the program stipulated that CFs acquired with program funds (from state budget appropriations) be state-owned, and that state agencies have ultimate decision-making authority. But the legislation also stipulated that state-owned CFs have an advisory committee composed of roughly twenty members representing diverse stakeholder interests to inform those decisions and co-develop forest management plans with citizen input, and that CF management objectives should reflect the values of local communities ( WA Legislature 2011 ).

Regarding the federally owned case, Weaverville CF, the community manages the CF through a 10-year renewable cooperative stewardship agreement between the Forest Service and Bureau of Land Management (who own and administer different parts of the CF), and the local county resource conservation district (RCD) ( Frost 2014 ; Kelly 2018 ). The RCD is responsible for implementing forest management activities and is governed by a board of directors that oversees CF management, with input from a steering committee composed of ten to fifteen members, including local citizens and agency and RCD staff. Local residents have opportunities to provide input at community meetings that occur once or twice annually. The CF is managed to meet local community needs and priorities, such as wildfire risk reduction, habitat improvement for fish and wildlife, and recreation ( Frost 2014 ; Kelly 2018 ).

The question of whether CFs in the United States that self-identify as such should be considered CFs if they occur on land that is state- or federally owned—with the government retaining ultimate decision-making authority—deserves more attention and is a matter of debate among some practitioners and scholars (see Frey et al. forthcoming ). The international literature recognizes CFs that occur on national government-owned land where communities have concessions to manage the forests for a specified time period (e.g., several CFs in Canada [ Teitelbaum et al. 2006 ], Cameroon [ Piabuo et al. 2018 ], Guatemala [ Taylor 2010 ]); and CFs on national government land that are comanaged by the state and local communities (e.g., Tanzania; Blomley and Ramadhani, 2006 ). This highlights the importance of taking into account the governance criterion in defining CFs in the United States—the level of community involvement in decision-making—just as with town forests and land trusts, and opens the door for potential additional CFs on public lands that might fit the criteria but were not captured here.

The CFs we identified comprise less than 0.1% of all forests in the United States but are a rapidly developing model of forest ownership, governance, and management that provides local community benefits. They take a creative approach to funding and managing local forestlands through public, NGO, or tribal structures, generated income sources, and grant and donor fundraising. They have continued long-standing town and tribal forest ownership and management, helped protect forestlands and open space from imminent development, and offered innovative ways to form explicit community partnerships to manage existing public and private landscapes. As they solidify income sources and management capability, they also might serve as a new model of how market and nonmarket goods and services can be produced on forestlands for broad and enduring community benefits.

We have likely not included all individual CFs in the United States in this study and may have significant undercounts of certain types of CFs. Potential undercounts stem largely from ambiguity over which town, tribal, and private (e.g., land trust-held) forests meet our CF definition and criteria and lingering questions over whether CFs exist on federal lands. Nevertheless, the inventory will increase continually as communities develop proposals for CFs and obtain acquisition funding each year and new research is carried out. To help address this research limitation, we plan to create a centralized, publicly accessible repository that can serve as a living inventory to be updated as more CFs are either acknowledged as such or created. Although incomplete, our current inventory captures a fair representation of the variety of CF models in the United States, reflecting a diversity of ownerships, governance structures, management goals, benefit streams, and more.

This initial research to inventory and describe US CFs provides a sound base for further exploration. Future research could further explore levels of local participation in forest management and governance and when and how these variables would qualify a forest as a CF on public, private, or tribal lands. More in-depth research could also help refine our CF typology to include characteristics hard to ascertain from a survey instrument, such as level of community involvement or capacity and organizational development stage (e.g., incipient or mature). Furthermore, as more NGO-owned and town-owned forests self-identify with the label “community forest,” the consequences, advantages, and disadvantages of using that label will need further examination.

Future research could also compare CF models with traditional (noncommunity based) private and public forest ownerships to highlight their relative differences, advantages, and disadvantages. For example, some CF models share similarities but also have important differences with private family forest ownerships in terms of priority management objectives and timber production ( Butler et al. 2021 ; Shanafelt et al. 2023 ), warranting a systematic comparison of ownership types. Finally, we began this exercise of inventorying CFs in the United States to better understand their contributions to conservation and rural prosperity. Better understanding the ability of communities to capture CF monetary and nonmonetary benefits (and to do so equitably) can help inform the design of policies, programs, and actions to best support CFs.

Supplementary data are available at Journal of Forestry online.

This study was funded in part by the USDA National Institute of Food and Agriculture, Agriculture and Food Research Initiative (AFRI) Award number 2021-67023-34426. Partial funding was also provided by the USDA Forest Service’s Southern Research Station, Pacific Northwest Research Station, and International Institute of Tropical Forestry as well as Oregon State University and North Carolina State University.

The authors are developing a publicly accessible repository of community forests. In the meantime, the data used in this study will be made available upon reasonable request.

Abrams , Jesse. 2023 . Forest Policy and Governance in the United States . New York, NY : Routledge .

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Abrams , Jesse , E.J. Davis , and C. Moseley . 2015 . “Community-Based Organizations and Institutional Work in the Remote Rural West.” Review of Policy Research 32 ( 6 ): 675 – 698 . doi: 10.1111/ropr.12148 .

Baker , M. , and J. Kusel . 2003 . Community Forestry in the United States: Learning from the Past, Crafting the Future . Washington, DC : Island Press .

Belsky , Jill M. 2008 . “Creating Community Forests.” In Forest Community Connections: Implications for Research, Management, and Governance , edited by E.M. Donoghue and V.E. Sturtevant . New York, NY : Resources for the Future .

Belsky , Jill M. 2015 . “Community Forestry Engagement with Market Forces: A Comparative Perspective from Bhutan and Montana.” Forest Policy and Economics 58 ( 2015 ): 29 – 36 . doi: 10.1016/j.forpol.2014.11.004 .

Belsky , Jill M. , and Alexander Barton . 2018 . “Constitutionality in Montana: A Decade of Institution Building in the Blackfoot Community Conservation Area.” Human Ecology 46 ( 1 ): 91 – 92 . doi: 10.1007/s10745-018-9979-9 .

Blomley , T. , and H. Ramadhani . 2006 . “Going to Scale with Participatory Forest Management: Early Lessons from Tanzania.” International Forestry Review 8 ( 1 ): 93 – 100 . doi: 10.1505/ifor.8.1.93 .

Brosius , J. Peter , Anna Lowenhaupt Tsing , and Charles Zerner . 2005 . Communities and Conservation: Histories and Politics of Community-Based Natural Resource Management . Lanham, MD : Altamira Press .

Brown , N.C. 1941 . “Community Forests: Their Place in the American Forestry Program.” Journal of Forestry 39 ( 2 ): 171 – 179 .

Butler , Brett J. , Sarah M. Butler , Jesse Caputo , Jacqueline Dias , Amanda Robillard , and Emma M. Sass . 2021 . Family Forest Ownerships of the United States, 2018: Results from the USDA Forest Service, National Woodland Owner Survey. General Technical Report NRS-199 . Madison, WI : USDA Forest Service, Northern Research Station . https://www.fs.usda.gov/nrs/pubs/gtr/gtr_nrs199.pdf .

Charnley , Susan. 2023 . “Livelihood Investments as Incentives for Community Forestry in Africa.” World Development 168 ( August 2023 ): 106260 . doi: 10.1016/j.worlddev.2023.106260 .

Charnley , Susan , and Melissa R. Poe . 2007 . “Community Forestry in Theory and Practice: Where Are We Now?” Annual Review of Anthropology 36 ( 1 ): 301 – 336 . doi: 10.1146/annurev.anthro.36.081705.123143 .

Christoffersen , Nils , Don Harker , Martha West Lyman , and Barbara Wyckoff . 2008 . The Status of Community-Based Forestry in the United States: A Report to the US Endowment for Forestry and Communities . Greenville, SC : US Endowment for Forestry and Communities, Community Forest Consortium .

Davis , Emily Jane , Reem Hajjar , Susan Charnley , Cassandra Moseley , Kendra Wendel , and Meredith Jacobson . 2020 . “Community-Based Forestry on Federal Lands in the Western United States: A Synthesis and Call for Renewed Research.” Forest Policy and Economics 111 ( 2020 ): 102042 . doi: 10.1016/j.forpol.2019.102042 .

Dillman , D.A. , J.D. Smyth , and L.M. Christian . 2014 . Internet, Phone, Mail, and Mixed-Mode Surveys: The Tailored Design Method , fourth edition. Hoboken, NJ : Wiley Blackwell .

Frey , G.E. , R. Hajjar , S. Charnley , K. McGinley , J. Schelhas , N. Tarr , L. McCaskill , and F.W. Cubbage . Forthcoming . “‘Community Forests’ in the United States – How Do We Know One When We See One?” Submitted to Society and Natural Resources .

Frost , Pat. 2014 . Stitching the West Back Together: Conservation of Working Landscapes, edited by Susan Charnley , T.E. Sheridan , and G.P. Nabhan , 177 – 180 . Chicago, IL : University of Chicago Press .

Gordon , J.C. , J. Sessions , J. Bailey , D. Cleaves , V. Corrao , A. Leighton , L. Mason , M. Rasmussen , H. Salwasser , and M. Sterner . 2013 . Assessment of Indian Forests and Forest Management in the United States . Portland, OR : Indian Forest Management Assessment Team .

Hajjar , Reem , and Augusta Molnar . 2016 . “Decentralized and Community-Based Approaches.” In Forests, Business and Sustainability , edited by Rajat Panwar , Robert Kozak , and Eric Hansen . Abigdon, UK : Routledge .

Hajjar , Reem , Johan A. Oldekop , Peter Cronkleton , Peter Newton , Aaron J.M. Russell , and Wen Zhou . 2021 . “A Global Analysis of the Social and Environmental Outcomes of Community Forests.” Nature Sustainability 4 ( March ): 216 – 224 . doi: 10.1038/s41893-020-00633-y .

Hovis , Meredith , Gregory Frey , Kathleen McGinley , Frederick Cubbage , Xue Han , and Megan Lupek . 2022 . “Ownership, Governance, Uses, and Ecosystem Services of Community Forests in the Eastern United States.” Forests 13 ( 10 ): 1577 – 1523 . doi: 10.3390/f13101577 .

Kelly , Erin C. 2018 . “The Role of the Local Community on Federal Lands: The Weaverville Community Forest.” Humboldt Journal of Social Relations 1 ( 40 ): 163 – 177 . doi: 10.55671/0160-4341.1076 .

Lund , Jens Friis , Rebecca Leigh Rutt , Jesse Ribot . 2018 . “Trends in Research on Forestry Decentralization Policies.” Current Opinion in Environmental Sustainability 32 ( June 2018 ): 17 – 22 . doi: 10.1016/j.cosust.2018.02.003 .

Lyman , M.W. , C. Grimm , and J.R. Evans . 2014 . “Community Forests as a Wealth Creation Strategy for Rural Communities.” Community Development 45 ( 5 ): 474 – 489 .

McCarthy , James. 2006 . “Neoliberalism and the Politics of Alternatives: Community Forestry in British Columbia and the United States.” Annals of the Association of American Geographers 96 ( 1 ): 84 – 104 .

McCullough , R. 1995 . The Landscape of Community: A History of Communal Forests in New England . Hanover, NH : University Press of New England .

McDermott , M.H.K. , and K. Schreckenberg . 2009 . “Equity in Community Forestry: Insights from North and South.” International Forestry Review 11 ( 2 ): 157 – 170 . doi: 10.1505/ifor.11.2.155 .

McGinley , Kathleen , Susan Charnley , Frederick W. Cubbage , Reem Hajjar , Gregory E. Frey , John Schelhas , Meredith Hovis , and Kailey Kornahauser . 2022 . “Community Forest Ownership, Rights, and Governance Regimes in the United States.” In Routledge Handbook on Community Forestry , edited by J. Bulkan , J. Palmer , A.M. Larson , and M. Hobley , 11 – 28 . London : Routledge . doi: 10.4324/9780367488710-13 .

Piabuo , Serge Mandiefe , Divine Foundjem-Tita , and Peter A. Minang . 2018 . “Community Forest Governance in Cameroon: A Review.” Ecology and Society 23 ( 3 ): 15 . doi: 10.5751/ES-10330-230334 .

Ribot , Jesse C. , Arun Agrawal , and Anne M. Larson . 2006 . “Recentralizing While Decentralizing: How National Governments Reappropriate Forest Resources.” World Development 34 ( 11 ): 1864 – 1886 . doi: 10.1016/j.worlddev.2005.11.020 .

Rights and Resources Initiative . 2018 . At a Crossroads: Consequential Trends in Recognition of Community-Based Forest Tenure . Washington, DC : Rights and Resources Initiative .

Sass , Emma M. , Marla Markowski-Lindsay , Brett J. Butler , Jesse Caputo , Andrew Hartsell , Emily Huff , and Amanda Robillard . 2021 . “Dynamics of Large Corporate Forestland Ownerships in the United States.” Journal of Forestry 119 ( 4 ): 363 – 375 . doi: 10.1093/jofore/fvab013 .

Shanafelt , David W. , Jesse Caputo , Jens Abildtrup , and Brett J. Butler . 2023 . “If A Tree Falls in A Forest, Why Do People Care? An Analysis of Private Family Forest Owners’ Reasons for Owning Forest in the United States National Woodland Owner Survey.” Small-Scale Forestry 22 ( 2 ): 303 – 321 . doi: 10.1007/s11842-022-09530-y .

Taylor , Peter Leigh. 2010 . “Conservation, Community, and Culture? New Organizational Challenges of Community Forest Concessions in the Maya Biosphere Reserve of Guatemala.” Journal of Rural Studies 26 ( 2 ): 173 – 184 . doi: 10.1016/j.jrurstud.2009.09.006 .

Teitelbaum , S. , T.M. Beckely , and S. Nadeau . 2006 . “A National Portrait of Community Forestry in Canada.” The Forestry Chronicle 82 ( 3 ): 416 – 428 .

US Department of the Interior (DOI) . 2023 . “Native American Ownership and Governance of Natural Resources.” Natural Resources Revenue Data 2023 . https://revenuedata.doi.gov/how-revenue-works/native-american-ownership-governance/ .

Washington Department of Natural Resources (WA DNR) . n.d . “Washington Community Forest Trust Program.” https://www.dnr.wa.gov/managed-lands/washington-community-forest-trust-program .

Washington Legislature (WA Legislature) . 2011 . “Senate Bill Report ESHB 1421.” Washington State Legislature . https://lawfilesext.leg.wa.gov/biennium/2011-12/Pdf/Bill%20Reports/Senate/1421-S.E%20SBA%20NRMW%2011.pdf?q=20231016011547 .

Zhang , Daowei. 2021 . From Backwoods to Boardrooms: The Rise of Institutional Investment in Timberland . Corvallis, OR : Oregon State University Press .

Community forests, community forestry, and community-based forestry are terms that are often used interchangeably in the U.S. literature; however, see Frey et al. (forthcoming) and Belsky (2008) for a discussion of important differences.

The Washington State Community Forests Program was established by the state legislature in 2019 to provide grant funding for CF acquisition ( https://rco.wa.gov/grant/community-forests-program/ ). The New York Community Forest Conservation Grant program similarly funds municipal land acquisitions for community forests ( https://www.dec.ny.gov/lands/124345.html#:~:text=and%20contact%20information-,Program%20Overview,Leadership%20and%20Community%20Protection%20Act ).

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• Open access
• Published: 13 May 2024

Sexual and reproductive health implementation research in humanitarian contexts: a scoping review

• Alexandra Norton 1 &
• Hannah Tappis 2  

Reproductive Health volume  21 , Article number:  64 ( 2024 ) Cite this article

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Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited.

A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included.

Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process.

This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Plain English summary

Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Peer Review reports

Over the past few decades, the field of public health implementation research (IR) has grown as a means by which the real-world conditions affecting health improvement efforts can be better understood. Peters et al. put forward the following broad definition of IR for health: “IR is the scientific inquiry into questions concerning implementation – the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions)” [ 1 ].

As IR emphasizes real-world circumstances, the context within which a health intervention is delivered is a core consideration. However, much IR implemented to date has focused on higher-resource settings, with many proposed frameworks developed with particular utility for a higher-income setting [ 2 ]. In recognition of IR’s potential to increase evidence across a range of settings, there have been numerous reviews of the use of IR in lower-resource settings as well as calls for broader use [ 3 , 4 ]. There have also been more focused efforts to modify various approaches and frameworks to strengthen the relevance of IR to low- and middle-income country settings (LMICs), such as the work by Means et al. to adapt a specific IR framework for increased utility in LMICs [ 2 ].

Within LMIC settings, the centrality of context to a health intervention’s impact is of particular relevance in humanitarian settings, which present a set of distinct implementation challenges [ 5 ]. Humanitarian responses to crisis situations operate with limited resources, under potential security concerns, and often under pressure to relieve acute suffering and need [ 6 ]. Given these factors, successful implementation of a particular health intervention may require different qualities than those that optimize intervention impact under more stable circumstances [ 7 ]. Despite increasing recognition of the need for expanded evidence of health interventions in humanitarian settings, the evidence base remains limited [ 8 ]. Furthermore, despite its potential utility, there is not standardized guidance on IR in humanitarian settings, nor are there widely endorsed recommendations for the frameworks best suited to analyze implementation in these settings.

Sexual and reproductive health (SRH) is a core aspect of the health sector response in humanitarian settings [ 9 ]. Yet, progress in addressing SRH needs has lagged far behind other services because of challenges related to culture and ideology, financing constraints, lack of data and competing priorities [ 10 ]. The Minimum Initial Service Package (MISP) for SRH in Crisis Situations is the international standard for the minimum set of SRH services that should be implemented in all crisis situations [ 11 ]. However, as in other areas of health, there is need for expanded evidence for planning and implementation of SRH interventions in humanitarian settings. Recent systematic reviews of SRH in humanitarian settings have focused on the effectiveness of interventions and service delivery strategies, as well as factors affecting utilization, but have not detailed whether IR frameworks were used [ 12 , 13 , 14 , 15 ]. There have also been recent reviews examining IR frameworks used in various settings and research areas, but none have explicitly focused on humanitarian settings [ 2 , 16 ].

Given the need for an expanded evidence base for SRH interventions in humanitarian settings and the potential for IR to be used to expand the available evidence, a scoping review was undertaken. This scoping review sought to identify IR approaches that have been used in the last ten years to evaluate SRH interventions in humanitarian settings.

This review also sought to shed light on whether there is a need for a common framework to guide research design, analysis, and reporting for SRH interventions in humanitarian settings and if so, if there are any established frameworks already in use that would be fit-for-purpose or could be tailored to meet this need.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was utilized to guide the elements of this review [ 17 ]. The review protocol was retrospectively registered with the Open Science Framework ( https://osf.io/b5qtz ).

Search strategy

A two-fold search strategy was undertaken for this review, which covered the last 10 years (2013–2022). First, recent systematic reviews pertaining to research or evaluation of SRH interventions in humanitarian settings were identified through keyword searches on PubMed and Google Scholar. Four relevant systematic reviews were identified [ 12 , 13 , 14 , 15 ] Table 1 .

Second, a literature search mirroring these reviews was conducted to identify relevant papers published since the completion of searches for the most recent review (April 2017). Additional file 1 includes the search terms that were used in the literature search [see Additional file 1 ].

The literature search was conducted for papers published from April 2017 to December 2022 in the databases that were searched in one or more of the systematic reviews: PubMed, Embase, PsycInfo, CINAHL and Global Health. Searches were completed in January 2023 Table 2 .

Two reviewers screened each identified study for alignment with inclusion criteria. Studies in the four systematic reviews identified were considered potentially eligible if published during the last 10 years. These papers then underwent full-text review to confirm satisfaction of all inclusion criteria, as inclusion criteria were similar but not fully aligned across the four reviews.

Literature search results were exported into a citation manager (Covidence), duplicates were removed, and a step-wise screening process for inclusion was applied. First, all papers underwent title and abstract screening. The remaining papers after abstract screening then underwent full-text review to confirm satisfaction of all inclusion criteria. Title and abstract screening as well as full-text review was conducted independently by both authors; disagreements after full-text review were resolved by consensus.

Data extraction and synthesis

The following content areas were summarized in Microsoft Excel for each paper that met inclusion criteria: publication details including author, year, country, setting [rural, urban, camp, settlement], population [refugees, internally displaced persons, general crisis-affected], crisis type [armed conflict, natural disaster], crisis stage [acute, chronic], study design, research methods, SRH intervention, and intervention target population [specific beneficiaries of the intervention within the broader population]; the use of an IR framework; details regarding the IR framework, how it was used, and any rationale given for the framework used; factors cited as impacting SRH interventions, either positively or negatively; and other key findings deemed relevant to this review.

As the focus of this review was on the approach taken for SRH intervention research and evaluation, the quality of the studies themselves was not assessed.

Twenty papers underwent full-text review due to their inclusion in one or more of the four systematic reviews and meeting publication date inclusion criteria. The literature search identified 7,016 unique papers. After full-text screening, 69 met all inclusion criteria and were included in the review. Figure  1 illustrates the search strategy and screening process.

Flow chart of paper identification

Papers published in each of the 10 years of the review timeframe (2013–2022) were included. 29% of the papers originated from the first five years of the time frame considered for this review, with the remaining 71% papers coming from the second half. Characteristics of included publications, including geographic location, type of humanitarian crisis, and type of SRH intervention, are presented in Table  3 .

A wide range of study designs and methods were used across the papers, with both qualitative and quantitative studies well represented. Twenty-six papers were quantitative evaluations [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 17 were qualitative [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], and 26 used mixed methods [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. Within the quantitative evaluations, 15 were observational, while five were quasi-experimental, five were randomized controlled trials, and one was an economic evaluation. Study designs as classified by the authors of this review are summarized in Table  4 .

Six papers (9%) explicitly cited use of an IR framework. Three of these papers utilized the Consolidated Framework for Implementation Research (CFIR) [ 51 , 65 , 70 ]. The CFIR is a commonly used determinant framework that—in its originally proposed form in 2009—is comprised of five domains, each of which has constructs to further categorize factors that impact implementation. The CFIR domains were identified as core content areas influencing the effectiveness of implementation, and the constructs within each domain are intended to provide a range of options for researchers to select from to “guide diagnostic assessments of implementation context, evaluate implementation progress, and help explain findings.” [ 87 ] To allow for consistent terminology throughout this review, the original 2009 CFIR domains and constructs are used.

Guan et al. conducted a mixed methods study to assess the feasibility and effectiveness of a neonatal hepatitis B immunization program in a conflict-affected rural region of Myanmar. Guan et al. report mapping data onto the CFIR as a secondary analysis step. They describe that “CFIR was used as a comprehensive meta-theoretical framework to examine the implementation of the Hepatitis B Virus vaccination program,” and implementation themes from multiple study data sources (interviews, observations, examination of monitoring materials) were mapped onto CFIR constructs. They report their results in two phases – Pre-implementation training and community education, and Implementation – with both anchored in themes that they had mapped onto CFIR domains and constructs. All but six constructs were included in their analysis, with a majority summarized in a table and key themes explored further in the narrative text. They specify that most concerns were identified within the Outer Setting and Process domains, while elements identified within the Inner Setting domain provided strength to the intervention and helped mitigate against barriers [ 70 ].

Sarker et al. conducted a qualitative study to assess provision of maternal, newborn and child health services to Rohingya refugees residing in camps in Cox’s Bazar, Bangladesh. They cite using CFIR as a guide for thematic analysis, applying it after a process of inductive and deductive coding to index these codes into the CFIR domains. They utilized three of the five CFIR domains (Outer Setting, Inner Setting, and Process), stating that the remaining two domains (Intervention Characteristics and Characteristics of Individuals) were not relevant to their analysis. They then proposed two additional CFIR domains, Context and Security, for use in humanitarian contexts. In contrast to Guan et al., CFIR constructs are not used nor mentioned by Sarker et al., with content under each domain instead synthesized as challenges and potential solutions. Regarding the CFIR, Sarker et al. write, “The CFIR guided us for interpretative coding and creating the challenges and possible solutions into groups for further clarification of the issues related to program delivery in a humanitarian crisis setting.” [ 51 ]

Sami et al. conducted a mixed methods case study to assess the implementation of a package of neonatal interventions at health facilities within refugee and internally displaced persons camps in South Sudan. They reference use of the CFIR earlier in the study than Sarker et al., basing their guides for semi-structured focus group discussions on the CFIR framework. They similarly reference a general use of the CFIR framework as they conducted thematic analysis. Constructs are referenced once, but they do not specify whether their application of the CFIR framework included use of domains, constructs, or both. This may be in part because they then applied an additional framework, the World Health Organization (WHO) Health System Framework, to present their findings. They describe a nested approach to their use of these frameworks: “Exploring these [CFIR] constructs within the WHO Health Systems Framework can identify specific entry points to improve the implementation of newborn interventions at critical health system building blocks.” [ 65 ]

Three papers cite use of different IR frameworks. Bolan et al. utilized the Theoretical Domains Framework in their mixed methods feasibility study and pilot cluster randomized trial evaluating pilot use of the Safe Delivery App by maternal and newborn health workers providing basic emergency obstetric and newborn care in facilities in the conflict-affected Maniema province of the Democratic Republic of the Congo (DRC). They used the Theroetical Domains Framework in designing interview questions, and further used it as the coding framework for their analysis. Similar to the CFIR, the Theoretical Domains Framework is a determinant framework that consists of domains, each of which then includes constructs. Bolan et al. utilized the Theoretical Domains Framework at the construct level in interview question development and at the domain level in their analysis, mapping interview responses to eight of the 14 domains [ 83 ]. Berg et al. report using an “exploratory design guided by the principles of an evaluation framework” developed by the Medical Research Council to analyze the implementation process, mechanisms of impact, and outcomes of a three-pillar training intervention to improve maternal and neonatal healthcare in the conflict-affected South Kivu province of the DRC [ 67 , 88 ]. Select components of this evaluation framework were used to guide deductive analysis of focus group discussions and in-depth interviews [ 67 ]. In their study of health workers’ knowledge and attitudes toward newborn health interventions in South Sudan, before and after training and supply provision, Sami et al. report use of the Conceptual Framework of the Role of Attitudes in Evidence-Based Practice Implementation in their analysis process. The framework was used to group codes following initial inductive coding analysis of in-depth interviews [ 72 ].

Three other papers cite use of specific frameworks in their intervention evaluation [ 19 , 44 , 76 ]. As a characteristic of IR is the use of an explicit framework to guide the research, the use of the frameworks in these three papers meets the intention of IR and serves the purpose that an IR framework would have in strengthening the analytical rigor. Castle et al. cite use of their program’s theory of change as a framework for a mixed methods evaluation of the provision of family planning services and more specifically uptake of long-acting reversible contraception use in the DRC. They describe use of the theory of change to “enhance effectiveness of [long-acting reversible contraception] access and uptake.” [ 76 ] Thommesen et al. cite use of the AAAQ (Availability, Accessibility, Acceptability and Quality) framework in their qualitative study assessing midwifery services provided to pregnant women in Afghanistan. This framework is focused on the “underlying elements needed for attainment of optimum standard of health care,” but the authors used it in this paper to evaluate facilitators and barriers to women accessing midwifery services [ 44 ]. Jarrett et al. cite use of the Centers for Disease Control and Prevention’s (CDC) Guidelines for Evaluating Public Health Surveillance Systems to explore the characteristics of a population mobility, mortality and birth surveillance system in South Kivu, DRC. Use of these CDC guidelines is cited as one of four study objectives, and commentary is included in the Results section pertaining to each criteria within these guidelines, although more detail regarding use of these guidelines or the authors’ experience with their use in the study is not provided [ 19 ].

Overall, 22 of the 69 papers either explicitly or implicitly identified IR as relevant to their work. Nineteen papers include a focus on feasibility (seven of which did not otherwise identify the importance of exploring questions concerning implementation), touching on a common outcome of interest in implementation research [ 89 ].

While a majority of papers did not explicitly or implicitly use an IR framework to evaluate their SRH intervention of focus, most identified factors that facilitated implementation when they were present or served as a barrier when absent. Sixty cite factors that served as facilitators and 49 cite factors that served as barriers, with just three not citing either. Fifty-nine distinct factors were identified across the papers.

Three of the six studies that explicitly used an IR framework used the CFIR, and the CFIR is the only IR framework that was used by multiple studies. As previously mentioned, Means et al. put forth an adaptation of the CFIR to increase its relevance in LMIC settings, proposing a sixth domain (Characteristics of Systems) and 11 additional constructs [ 2 ]. Using the expanded domains and constructs as proposed by Means et al., the 59 factors cited by papers in this review were thematically grouped into the six domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Within each domain, alignment with CFIR constructs was assessed for, and alignment was found with 29 constructs: eight of Means et al.’s 11 constructs, and 21 of the 39 standard CFIR constructs. Three factors did not align with any construct (all fitting within the Outer Setting domain), and 14 aligned with a construct label but not the associated definition. Table 5 synthesizes the mapping of factors affecting SRH intervention implementation to CFIR domains and constructs, with the construct appearing in italics if it is considered to align with that factor by label but not by definition.

Table 6 lists the CFIR constructs that were not found to have alignment with any factor cited by the papers in this review.

This scoping review sought to assess how IR frameworks have been used to bolster the evidence base for SRH interventions in humanitarian settings, and it revealed that IR frameworks, or an explicit IR approach, are rarely used. All four of the systematic reviews identified with a focus on SRH in humanitarian settings articulate the need for more research examining the effectiveness of SRH interventions in humanitarian settings, with two specifically citing a need for implementation research/science [ 12 , 13 ]. The distribution of papers across the timeframe included in this review does suggest that more research on SRH interventions for crisis-affected populations is taking place, as a majority of relevant papers were published in the second half of the review period. The papers included a wide range of methodologies, which reflect the differing research questions and contexts being evaluated. However, it also invites the question of whether there should be more standardization of outcomes measured or frameworks used to guide analysis and to facilitate increased comparison, synthesis and application across settings.

Three of the six papers that used an IR framework utilized the CFIR. Guan et al. used the CFIR at both a domain and construct level, Sarker et al. used the CFIR at the domain level, and Sami et al. did not specify which CFIR elements were used in informing the focus group discussion guide [ 51 , 65 , 70 ]. It is challenging to draw strong conclusions about the applicability of CFIR in humanitarian settings based on the minimal use of CFIR and IR frameworks within the papers reviewed, although Guan et al. provides a helpful model for how analysis can be structured around CFIR domains and constructs. It is worth considering that the minimal use of IR frameworks, and more specifically CFIR constructs, could be in part because that level of prescriptive categorization does not allow for enough fluidity in humanitarian settings. It also raises questions about the appropriate degree of standardization to pursue for research done in these settings.

The mapping of factors affecting SRH intervention implementation provides an example of how a modified CFIR framework could be used for IR in humanitarian contexts. This mapping exercise found factors that mapped to all five of the original CFIR domains as well as the sixth domain proposed by Means et al. All factors fit well within the definition for the selected domain, indicating an appropriate degree of fit between these existing domains and the factors identified as impacting SRH interventions in humanitarian settings. On a construct level, however, the findings were more variable, with one-quarter of factors not fully aligning with any construct. Furthermore, over 40% of the CFIR constructs (including the additional constructs from Means et al.) were not found to align with any factors cited by the papers in this review, also demonstrating some disconnect between the parameters posed by the CFIR constructs and the factors cited as relevant in a humanitarian context.

It is worth noting that while the CFIR as proposed in 2009 was used in this assessment, as well as in the included papers which used the CFIR, an update was published in 2022. Following a review of CFIR use since its publication, the authors provide updates to construct names and definitions to “make the framework more applicable across a range of innovations and settings.” New constructs and subconstructs were also added, for a total of 48 constructs and 19 subconstructs across the five domains [ 90 ]. A CFIR Outcomes Addendum was also published in 2022, based on recommendations for the CFIR to add outcomes and intended to be used as a complement to the CFIR determinants framework [ 91 ]. These expansions to the CFIR framework may improve applicability of the CFIR in humanitarian settings. Several constructs added to the Outer Setting domain could be of particular utility – critical incidents, local attitudes, and local conditions, each of which could help account for unique challenges faced in contexts of crisis. Sub-constructs added within the Inner Setting domain that seek to clarify structural characteristics and available resources would also be of high utility based on mapping of the factors identified in this review to the original CFIR constructs. As outcomes were not formally included in the CFIR until the 2022 addendum, a separate assessment of implementation outcomes was not undertaken in this review. However, analysis of the factors cited by papers in this review as affecting implementation was derived from the full text of the papers and thus captures content relevant to implementation determinants that is contained within the outcomes.

Given the demonstrated need for additional flexibility within an IR framework for humanitarian contexts, while not a focus of this review, it is worth considering whether a different framework could provide a better fit than the CFIR. Other frameworks have differing points of emphasis that would create different opportunities for flexibility but that do not seem to resolve the challenges experienced in applying the CFIR to a humanitarian context. As one example, the EPIS (Exploration, Preparation, Implementation, Sustainment) Framework considers the impact of inner and outer context on each of four implementation phases; while the constructs within this framework are broader than the CFIR, an emphasis on the intervention characteristics is missing, a domain where stronger alignment within the CFIR is also needed [ 92 ]. Alternatively, the PRISM (Practical, Robust Implementation and Sustainability Model) framework is a determinant and evaluation framework that adds consideration of context factors to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes framework. It has a stronger emphasis on intervention aspects, with sub-domains to account for both organization and patient perspectives within the intervention. While PRISM does include aspects of context, external environment considerations are less robust and intentionally less comprehensive in scope, which would not provide the degree of alignment possible between the Characteristics of Systems and Outer Setting CFIR domains for the considerations unique to humanitarian environments [ 93 ].

Reflecting on their experience with the CFIR, Sarker et al. indicate that it can be a “great asset” in both evaluating current work and developing future interventions. They also encourage future research of humanitarian health interventions to utilize the CFIR [ 51 ]. The other papers that used the CFIR do not specifically reflect on their experience utilizing it, referring more generally to having felt that it was a useful tool [ 65 , 70 ]. On their use of an evaluation framework, Berg et al. reflected that it lent useful structure and helped to identify aspects affecting implementation that otherwise would have gone un-noticed [ 67 ]. The remaining studies that utilized an IR framework did not specifically comment on their experience with its use [ 72 , 83 ]. While a formal IR framework was not engaged by other studies, a number cite a desire for IR to contribute further detail to their findings [ 21 , 37 ].

In their recommendations for strengthening the evidence base for humanitarian health interventions, Ager et al. speak to the need for “methodologic innovation” to develop methodologies with particular applicability in humanitarian settings [ 7 ]. As IR is not yet routinized for SRH interventions, this could be opportune timing for the use of a standardized IR framework to gauge its utility. Using an IR framework to assess factors influencing implementation of the MISP in initial stages of a humanitarian response, and interventions to support more comprehensive SRH service delivery in protracted crises, could lend further rigor and standardization to SRH evaluations, as well as inform strategies to improve MISP implementation over time. Based on categorizing factors identified by these papers as relevant for intervention evaluation, there does seem to be utility to a modified CFIR approach. Given the paucity of formal IR framework use within SRH literature, it would be worth conducting similar scoping exercises to assess for explicit use of IR frameworks within the evidence base for other health service delivery areas in humanitarian settings. In the interim, the recommended approach from this review for future IR on humanitarian health interventions would be a modified CFIR approach with domain-level standardization and flexibility for constructs that may standardize over time with more use. This would enable use of a common analytical framework and vocabulary at the domain level for stakeholders to describe interventions and the factors influencing the effectiveness of implementation, with constructs available to use and customize as most appropriate for specific contexts and interventions.

This review had a number of limitations. As this was a scoping review and a two-part search strategy was used, the papers summarized here may not be comprehensive of those written pertaining to SRH interventions over the past 10 years. Papers from 2013 to 2017 that would have met this scoping review’s inclusion criteria may have been omitted due to being excluded from the systematic reviews. The review was limited to papers available in English. Furthermore, this review did not assess the quality of the papers included or seek to assess the methodology used beyond examination of the use of an IR framework. It does, however, serve as a first step in assessing the extent to which calls for implementation research have been addressed, and identify entry points for strengthening the science and practice of SRH research in humanitarian settings.

With one in 23 people worldwide in need of humanitarian assistance, and financing required for response plans at an all-time high, the need for evidence to guide resource allocation and programming for SRH in humanitarian settings is as important as ever [ 94 ]. Recent research agenda setting initiatives and strategies to advance health in humanitarian settings call for increased investment in implementation research—with priorities ranging from research on effective strategies for expanding access to a full range of contraceptive options to integrating mental health and psychosocial support into SRH programming to capturing accurate and actionable data on maternal and perinatal mortality in a wide range of acute and protracted emergency contexts [ 95 , 96 ]. To truly advance guidance in these areas, implementation research will need to be conducted across diverse humanitarian settings, with clear and consistent documentation of both intervention characteristics and outcomes, as well as contextual and programmatic factors affecting implementation.

Conclusions

Implementation research has potential to increase impact of health interventions particularly in crisis-affected settings where flexibility, adaptability and context-responsive approaches are highlighted as cornerstones of effective programming. There remains significant opportunity for standardization of research in the humanitarian space, with one such opportunity occurring through increased utilization of IR frameworks such as a modified CFIR approach. Investing in more robust sexual and reproductive health research in humanitarian contexts can enrich insights available to guide programming and increase transferability of learning across settings.

Availability of data and materials

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Availability, Accessibility, Acceptability and Quality

Centers for Disease Control and Prevention

Consolidated Framework for Implementation Research

Democratic Republic of the Congo

Exploration, Preparation, Implementation, Sustainment

• Implementation research

Low and middle income country

Minimum Initial Service Package

Practical, Robust Implementation and Sustainability Model

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Reach, Effectiveness, Adoption, Implementation, Maintenance

• Sexual and reproductive health

World Health Organization

Peters DH, et al. Implementation research: what it is and how to do it. RESEARCH METHODS. 2013;347:7.

Means AR, et al. Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review. Implement Sci. 2020;15(1):17.

Article   PubMed   PubMed Central   Google Scholar  

Alonge O, et al. How is implementation research applied to advance health in low-income and middle-income countries? BMJ Glob Health. 2019;4(2):e001257.

Ridde V, Pérez D, Robert E. Using implementation science theories and frameworks in global health. BMJ Glob Health. 2020;5(4):e002269.

Gaffey MF, et al. Delivering health and nutrition interventions for women and children in different conflict contexts: a framework for decision making on what, when, and how. Lancet (London, England). 2021;397(10273):543–54.

Article   PubMed   Google Scholar  

Singh NS, et al. Delivering health interventions to women, children, and adolescents in conflict settings: what have we learned from ten country case studies? The Lancet. 2021;397(10273):533–42.

Article   Google Scholar  

Ager A, et al. Strengthening the evidence base for health programming in humanitarian crises. Science. 2014;345(6202):1290–2.

Article   CAS   PubMed   Google Scholar  

Blanchet K, et al. Evidence on public health interventions in humanitarian crises. The Lancet. 2017;390(10109):2287–96.

Sphere A. The Sphere Handbook | Standards for quality humanitarian response. 2018.

Google Scholar  

Barot S. In a State of Crisis: Meeting the Sexual and Reproductive Health Needs of Women in Humanitarian Situations. Guttmacher Policy Rev. 2017;20:7.

Crisis, I.-A.W.G.f.R.H.i., Minimum Initial Service Package. 2020: https://www.unfpa.org/resources/minimum-initial-service-package-misp-srh-crisis-situations .

Casey SE. Evaluations of reproductive health programs in humanitarian settings: a systematic review. Confl Heal. 2015;9(1):S1.

Singh NS, et al. A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises. BMJ Glob Health. 2018;3(2):e000682.

Singh NS, et al. Evaluating the effectiveness of sexual and reproductive health services during humanitarian crises: A systematic review. PLoS ONE. 2018;13(7):e0199300.

Warren E, et al. Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises. BMJ Open. 2015;5(12):e008226.

Dadich A, Piper A, Coates D. Implementation science in maternity care: a scoping review. Implement Sci. 2021;16(1):16.

Tricco AC, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.

Devine A, et al. Strategies for the prevention of perinatal hepatitis B transmission in a marginalized population on the Thailand-Myanmar border: a cost-effectiveness analysis. BMC Infect Dis. 2017;17(1):552.

Jarrett P, et al. Evaluation of a population mobility, mortality, and birth surveillance system in South Kivu. Democratic Republic of the Congo Disasters. 2020;44(2):390–407.

PubMed   Google Scholar  

Logie CH, et al. A Psycho-Educational HIV/STI Prevention Intervention for Internally Displaced Women in Leogane, Haiti: Results from a Non-Randomized Cohort Pilot Study. PLoS ONE. 2014;9(2):e89836.

O’Laughlin KN, et al. A cohort study to assess a communication intervention to improve linkage to HIV care in Nakivale Refugee Settlement. Uganda Glob Public Health. 2021;16(12):1848–55.

Adam I. The influence of maternal health education on the place of delivery in conflict settings of Darfur. Sudan Conflict and Health. 2015;9:31.

Adam IF, et al. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan. BMJ Open. 2015;5(9):e008285.

Edmond K, et al. Mobile outreach health services for mothers and children in conflict-affected and remote areas: a population-based study from Afghanistan. Arch Dis Child. 2020;105(1):18–25.

Nasir S, et al. Dissemination and implementation of the e-MCHHandbook, UNRWA’s newly released maternal and child health mobile application: a cross-sectional study. BMJ Open. 2020;10(3):e034885.

O’Laughlin KN, et al. Feasibility and acceptability of home-based HIV testing among refugees: a pilot study in Nakivale refugee settlement in southwestern Uganda. BMC Infect Dis. 2018;18(1):332.

Adam I. Evidence from cluster surveys on the association between home-based counseling and use of family planning in conflict-affected Darfur. Int J Gynecol Obstet. 2016;133(2):221–5.

Casey S, et al. Availability of long-acting and permanent family-planning methods leads to increase in use in conflict-affected northern Uganda: Evidence from cross-sectional baseline and endline cluster surveys. Glob Public Health. 2013;8(3):284–97.

Corna F, et al. Supporting maternal mental health of Rohingya refugee women during the perinatal period to promote child health and wellbeing: a field study in Cox’s Bazar. Intervention, the Journal of Mental Health & Psychosocial Support in Conflict Affected Areas. 2019;17(2):160–8.

Glass N, et al. Effectiveness of the Communities Care programme on change in social norms associated with gender-based violence (GBV) with residents in intervention compared with control districts in Mogadishu, Somalia. BMJ Open. 2019;9(3):e023819.

James LE, et al. Development and Testing of a Community-Based Intervention to Address Intimate Partner Violence among Rohingya and Syrian Refugees: A Social Norms-Based Mental Health-Integrated Approach. Int J Environ Res Public Health. 2021;18(21):11674.

Le Roux E, et al. Engaging with faith groups to prevent VAWG in conflict-affected communities: results from two community surveys in the DRC. BMC Int Health Hum Rights. 2020;20(1):27.

Morris CN, et al. When political solutions for acute conflict in Yemen seem distant, demand for reproductive health services is immediate: a programme model for resilient family planning and post-abortion care services. Sex Reprod Health Matters. 2019;27(2):1610279.

Anibueze AU, et al. Impact of counseling visual multimedia on use of family planning methods among displaced Nigerian families. Health Promot Int. 2022;37(3):daac060.

Doocy S, et al. Cash-based assistance and the nutrition status of pregnant and lactating women in the Somalia food crisis: A comparison of two transfer modalities. PLoS ONE. 2020;15(4):e0230989.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Draiko CV, et al. The effect of umbilical cord cleansing with chlorhexidine gel on neonatal mortality among the community births in South Sudan: a quasi-experimental study. Pan Afr Med J. 2021;38:78.

Edmond KM, et al. Can community health worker home visiting improve care-seeking and maternal and newborn care practices in fragile states such as Afghanistan? A population-based intervention study. BMC Med. 2018;16(1):106.

Edmond KM, et al. Conditional cash transfers to improve use of health facilities by mothers and newborns in conflict affected countries, a prospective population based intervention study from Afghanistan. BMC Pregnancy Childbirth. 2019;19(1):193.

Bakesiima R, et al. Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial. PLoS ONE. 2021;16(9):e0256479.

Greene MC, et al. Evaluation of an integrated intervention to reduce psychological distress and intimate partner violence in refugees: Results from the Nguvu cluster randomized feasibility trial. PLoS ONE. 2021;16(6):e0252982.

Gupta J, et al. Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural Côte d’Ivoire: a randomized controlled pilot study. BMC Int Health Hum Rights. 2013;13(1):46.

Hossain M, et al. Working with men to prevent intimate partner violence in a conflict-affected setting: a pilot cluster randomized controlled trial in rural Côte d’Ivoire. BMC Public Health. 2014;14(1):339.

Vaillant J, et al. Engaging men to transform inequitable gender attitudes and prevent intimate partner violence: a cluster randomised controlled trial in North and South Kivu, Democratic Republic of Congo. BMJ Glob Health. 2020;5(5):e002223.

Thommesen T, et al. “The midwife helped me … otherwise I could have died”: women’s experience of professional midwifery services in rural Afghanistan - a qualitative study in the provinces Kunar and Laghman. BMC Pregnancy Childbirth. 2020;20(1):140.

Awasom-Fru A, et al. Doctors’ experiences providing sexual and reproductive health care at Catholic Hospitals in the conflict-affected North-West region of Cameroon: a qualitative study. Reprod Health. 2022;19(1):126.

Kabakian-Khasholian T, Makhoul J, Ghusayni A. “A person who does not have money does not enter”: a qualitative study on refugee women’s experiences of respectful maternity care. BMC Pregnancy and Childbirth. 2022;22(1):748.

Lilleston P, et al. Evaluation of a mobile approach to gender-based violence service delivery among Syrian refugees in Lebanon. Health Policy Plan. 2018;33(7):767–76.

Mugo NS, et al. Barriers Faced by the Health Workers to Deliver Maternal Care Services and Their Perceptions of the Factors Preventing Their Clients from Receiving the Services: A Qualitative Study in South Sudan. Matern Child Health J. 2018;22(11):1598–606.

Persson M, et al. A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh. Conflict and Health. 2021;15(1):6.

Phanwichatkul T, et al. The perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women: An ethnographic study. Women Birth. 2022;35(4):e356–68.

Sarker M, et al. Effective maternal, newborn and child health programming among Rohingya refugees in Cox’s Bazar, Bangladesh: Implementation challenges and potential solutions. PLoS ONE. 2020;15(3):e0230732.

Tousaw E, et al. “Without this program, women can lose their lives”: migrant women’s experiences with the Safe Abortion Referral Programme in Chiang Mai. Thailand Reprod Health Matters. 2017;25(51):58–68.

Tousaw E, et al. “It is just like having a period with back pain”: exploring women’s experiences with community-based distribution of misoprostol for early abortion on the Thailand-Burma border. Contraception. 2018;97(2):122–9.

West L, et al. Factors in use of family planning services by Syrian women in a refugee camp in Jordan. Journal of Family Planning and Reproductive Health Care. 2017;43(2):96–102.

O’Connell KA, et al. Meeting the Sexual and Reproductive Health Needs of Internally Displaced Persons in Ethiopia’s Somali Region: A Qualitative Process Evaluation. Glob Health Sci Pract. 2022;10(5):e2100818.

Orya E, et al. Strengthening close to community provision of maternal health services in fragile settings: an exploration of the changing roles of TBAs in Sierra Leone and Somaliland. BMC Health Serv Res. 2017;17(1):460.

Perera SM, et al. Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members. BMC Womens Health. 2021;21(1):390.

Tanabe M, et al. Piloting community-based medical care for survivors of sexual assault in conflict-affected Karen State of eastern Burma. Confl Heal. 2013;7(1):12.

Tran NT, et al. Clinical outreach refresher trainings in crisis settings (S-CORT): clinical management of sexual violence survivors and manual vacuum aspiration in Burkina Faso, Nepal, and South Sudan. Reprod Health Matters. 2017;25(51):103–13.

Yankah E, et al. Feasibility and acceptability of mobile phone platforms to deliver interventions to address gender-based violence among Syrian adolescent girls and young women in Izmir. Turkey Vulnerable Children and Youth Studies. 2020;15(2):133–43.

Muuo S, et al. Barriers and facilitators to care-seeking among survivors of gender-based violence in the Dadaab refugee complex. Sex Reprod Health Matters. 2020;28(1):1722404.

Amsalu R, et al. Essential newborn care practice at four primary health facilities in conflict affected areas of Bossaso, Somalia: a cross-sectional study. Conflict and Health. 2019;13(13):27.

Myers A, et al. Facilitators and barriers in implementing the Minimum Initial Services Package (MISP) for reproductive health in Nepal post-earthquake. Conflict and Health. 2018;12:35.

Santo L.C.d, et al. Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment. Conflict and Health. 2020;14:56.

Sami S, et al. Understanding health systems to improve community and facility level newborn care among displaced populations in South Sudan: a mixed methods case study. BMC Pregnancy Childbirth. 2018;18(1):325.

Amsalu R, et al. Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study. BMC Pediatr. 2020;20(1):215.

Berg M, Mwambali SN, Bogren M. Implementation of a three-pillar training intervention to improve maternal and neonatal healthcare in the Democratic Republic Of Congo: a process evaluation study in an urban health zone. Glob Health Action. 2022;15(1):2019391.

Castillo M, et al. Turning Disaster into an Opportunity for Quality Improvement in Essential Intrapartum and Newborn Care Services in the Philippines: Pre- to Posttraining Assessments. Biomed Res Int. 2016;2016:1–9.

Foster AM, Arnott G, Hobstetter M. Community-based distribution of misoprostol for early abortion: evaluation of a program along the Thailand-Burma border. Contraception. 2017;96(4):242–7.

Guan TH, et al. Implementation of a neonatal hepatitis B immunization program in rural Karenni State, Myanmar: A mixed-methods study. PLoS ONE. 2021;16(12):e0261470.

Logie, C.H., et al., Mixed-methods findings from the Ngutulu Kagwero (agents of change) participatory comic pilot study on post-rape clinical care and sexual violence prevention with refugee youth in a humanitarian setting in Uganda. Global Public Health, 2022((Logie C.H., [email protected]) Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada(Logie C.H., [email protected]) Women’s College Research Institute, Women’s College Hospital, Toronto, Canada(Logie C.H., carmen.l).

Sami S, et al. “You have to take action”: changing knowledge and attitudes towards newborn care practices during crisis in South Sudan. Reprod Health Matters. 2017;25(51):124–39.

Smith JR, et al. Clinical care for sexual assault survivors multimedia training: a mixed-methods study of effect on healthcare providers’ attitudes, knowledge, confidence, and practice in humanitarian settings. Confl Heal. 2013;7(1):14.

Stevens A, et al. Folate supplementation to prevent birth abnormalities: evaluating a community-based participatory action plan for refugees and migrant workers on the Thailand-Myanmar border. Public Health. 2018;161:83–9.

Nguyen Toan T, et al. Strengthening healthcare providers’ capacity for safe abortion and postabortion care services in humanitarian settings: lessons learned from the clinical outreach refresher training model (S-CORT) in Uganda, Nigeria, and the Democratic Republic of Congo. Conflict and Health. 2021;15(1):20.

Castle S, et al. Successful programmatic approaches to facilitating IUD uptake: CARE’s experience in DRC. BMC Womens Health. 2019;19(1):104.

Deitch J, et al. “They Love Their Patients”: Client Perceptions of Quality of Postabortion Care in North and South Kivu, the Democratic Republic of the Congo. Global health, science and practice. 2019;7(Suppl 2):S285–98.

Ferreyra C, et al. Evaluation of a community-based HIV test and start program in a conflict affected rural area of Yambio County, South Sudan. PLoS ONE. 2021;16(7):e0254331.

Ho LS, Wheeler E. Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo. Glob Health Sci Pract. 2018;6(1):161–77.

Klabbers RE, et al. Health Worker Perspectives on Barriers and Facilitators of Assisted Partner Notification for HIV for Refugees and Ugandan Nationals: A Mixed Methods Study in West Nile Uganda. AIDS Behav. 2021;25(10):3206–22.

Turner C, et al. Neonatal Intensive Care in a Karen Refugee Camp: A 4 Year Descriptive Study. PLoS ONE. 2013;8(8):e72721.

Vries Id, et al. Key lessons from a mixed-method evaluation of a postnatal home visit programme in the humanitarian setting of Gaza. Eastern Mediterr Health J. 2021;27(6):546–52.

Bolan NE, et al. mLearning in the Democratic Republic of the Congo: A Mixed-Methods Feasibility and Pilot Cluster Randomized Trial Using the Safe Delivery App. Global health, science and practice. 2018;6(4):693–710.

Khan MN, et al. Evaluating feasibility and acceptability of a local psycho-educational intervention for pregnant women with common mental problems affected by armed conflict in Swat, Pakistan: A parallel randomized controlled feasibility trial. Int J Soc Psychiatry. 2017;63(8):724–35.

Hynes M, et al. Using a quality improvement approach to improve maternal and neonatal care in North Kivu, Democratic Republic of Congo. Reprod Health Matters. 2017;25(51):140–50.

Gibbs A, et al. The impacts of combined social and economic empowerment training on intimate partner violence, depression, gender norms and livelihoods among women: an individually randomised controlled trial and qualitative study in Afghanistan. BMJ Glob Health. 2020;5(3):e001946.

Damschroder L, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation science: IS; 2009.

Moore GF, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258.

Proctor E, et al. Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda. Adm Policy Ment Health. 2011;38(2):65–76.

Damschroder LJ, et al. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.

Damschroder LJ, et al. Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum. Implement Sci. 2022;17(1):7.

Aarons GA, Hurlburt M, Horwitz SM. Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors. Administration and Policy in Mental Health and Mental Health Services Research. 2011;38(1):4–23.

Feldstein AC, Glasgow RE. A Practical, Robust Implementation and Sustainability Model (PRISM) for Integrating Research Findings into Practice. The Joint Commission Journal on Quality and Patient Safety. 2008;34(4):228–43.

OCHA. Global Humanitarian Overview 2023. 2022 [cited 2023 8/3/2023]; Available from: https://humanitarianaction.info/node/13073/article/glance-0 . Accessed 8 Mar 2023.

Kobeissi L, et al. Setting research priorities for sexual, reproductive, maternal, newborn, child and adolescent health in humanitarian settings. Confl Heal. 2021;15(1):16.

Save the, C., et al. Roadmap to Accelerate Progress for Every Newborn in Humanitarian Settings 2020 – 2024. 2020. p. 52.

Inter-Agency Working Group on Reproductive Health in, C. Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings. 2018.

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Cultural Relativity and Acceptance of Embryonic Stem Cell Research

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There is a debate about the ethical implications of using human embryos in stem cell research, which can be influenced by cultural, moral, and social values. This paper argues for an adaptable framework to accommodate diverse cultural and religious perspectives. By using an adaptive ethics model, research protections can reflect various populations and foster growth in stem cell research possibilities.

INTRODUCTION

Stem cell research combines biology, medicine, and technology, promising to alter health care and the understanding of human development. Yet, ethical contention exists because of individuals’ perceptions of using human embryos based on their various cultural, moral, and social values. While these disagreements concerning policy, use, and general acceptance have prompted the development of an international ethics policy, such a uniform approach can overlook the nuanced ethical landscapes between cultures. With diverse viewpoints in public health, a single global policy, especially one reflecting Western ethics or the ethics prevalent in high-income countries, is impractical. This paper argues for a culturally sensitive, adaptable framework for the use of embryonic stem cells. Stem cell policy should accommodate varying ethical viewpoints and promote an effective global dialogue. With an extension of an ethics model that can adapt to various cultures, we recommend localized guidelines that reflect the moral views of the people those guidelines serve.

Stem cells, characterized by their unique ability to differentiate into various cell types, enable the repair or replacement of damaged tissues. Two primary types of stem cells are somatic stem cells (adult stem cells) and embryonic stem cells. Adult stem cells exist in developed tissues and maintain the body’s repair processes. [1] Embryonic stem cells (ESC) are remarkably pluripotent or versatile, making them valuable in research. [2] However, the use of ESCs has sparked ethics debates. Considering the potential of embryonic stem cells, research guidelines are essential. The International Society for Stem Cell Research (ISSCR) provides international stem cell research guidelines. They call for “public conversations touching on the scientific significance as well as the societal and ethical issues raised by ESC research.” [3] The ISSCR also publishes updates about culturing human embryos 14 days post fertilization, suggesting local policies and regulations should continue to evolve as ESC research develops. [4]  Like the ISSCR, which calls for local law and policy to adapt to developing stem cell research given cultural acceptance, this paper highlights the importance of local social factors such as religion and culture.

I.     Global Cultural Perspective of Embryonic Stem Cells

Views on ESCs vary throughout the world. Some countries readily embrace stem cell research and therapies, while others have stricter regulations due to ethical concerns surrounding embryonic stem cells and when an embryo becomes entitled to moral consideration. The philosophical issue of when the “someone” begins to be a human after fertilization, in the morally relevant sense, [5] impacts when an embryo becomes not just worthy of protection but morally entitled to it. The process of creating embryonic stem cell lines involves the destruction of the embryos for research. [6] Consequently, global engagement in ESC research depends on social-cultural acceptability.

a.     US and Rights-Based Cultures

In the United States, attitudes toward stem cell therapies are diverse. The ethics and social approaches, which value individualism, [7] trigger debates regarding the destruction of human embryos, creating a complex regulatory environment. For example, the 1996 Dickey-Wicker Amendment prohibited federal funding for the creation of embryos for research and the destruction of embryos for “more than allowed for research on fetuses in utero.” [8] Following suit, in 2001, the Bush Administration heavily restricted stem cell lines for research. However, the Stem Cell Research Enhancement Act of 2005 was proposed to help develop ESC research but was ultimately vetoed. [9] Under the Obama administration, in 2009, an executive order lifted restrictions allowing for more development in this field. [10] The flux of research capacity and funding parallels the different cultural perceptions of human dignity of the embryo and how it is socially presented within the country’s research culture. [11]

b.     Ubuntu and Collective Cultures

African bioethics differs from Western individualism because of the different traditions and values. African traditions, as described by individuals from South Africa and supported by some studies in other African countries, including Ghana and Kenya, follow the African moral philosophies of Ubuntu or Botho and Ukama , which “advocates for a form of wholeness that comes through one’s relationship and connectedness with other people in the society,” [12] making autonomy a socially collective concept. In this context, for the community to act autonomously, individuals would come together to decide what is best for the collective. Thus, stem cell research would require examining the value of the research to society as a whole and the use of the embryos as a collective societal resource. If society views the source as part of the collective whole, and opposes using stem cells, compromising the cultural values to pursue research may cause social detachment and stunt research growth. [13] Based on local culture and moral philosophy, the permissibility of stem cell research depends on how embryo, stem cell, and cell line therapies relate to the community as a whole . Ubuntu is the expression of humanness, with the person’s identity drawn from the “’I am because we are’” value. [14] The decision in a collectivistic culture becomes one born of cultural context, and individual decisions give deference to others in the society.

Consent differs in cultures where thought and moral philosophy are based on a collective paradigm. So, applying Western bioethical concepts is unrealistic. For one, Africa is a diverse continent with many countries with different belief systems, access to health care, and reliance on traditional or Western medicines. Where traditional medicine is the primary treatment, the “’restrictive focus on biomedically-related bioethics’” [is] problematic in African contexts because it neglects bioethical issues raised by traditional systems.” [15] No single approach applies in all areas or contexts. Rather than evaluating the permissibility of ESC research according to Western concepts such as the four principles approach, different ethics approaches should prevail.

Another consideration is the socio-economic standing of countries. In parts of South Africa, researchers have not focused heavily on contributing to the stem cell discourse, either because it is not considered health care or a health science priority or because resources are unavailable. [16] Each country’s priorities differ given different social, political, and economic factors. In South Africa, for instance, areas such as maternal mortality, non-communicable diseases, telemedicine, and the strength of health systems need improvement and require more focus. [17] Stem cell research could benefit the population, but it also could divert resources from basic medical care. Researchers in South Africa adhere to the National Health Act and Medicines Control Act in South Africa and international guidelines; however, the Act is not strictly enforced, and there is no clear legislation for research conduct or ethical guidelines. [18]

Some parts of Africa condemn stem cell research. For example, 98.2 percent of the Tunisian population is Muslim. [19] Tunisia does not permit stem cell research because of moral conflict with a Fatwa. Religion heavily saturates the regulation and direction of research. [20] Stem cell use became permissible for reproductive purposes only recently, with tight restrictions preventing cells from being used in any research other than procedures concerning ART/IVF.  Their use is conditioned on consent, and available only to married couples. [21] The community's receptiveness to stem cell research depends on including communitarian African ethics.

c.     Asia

Some Asian countries also have a collective model of ethics and decision making. [22] In China, the ethics model promotes a sincere respect for life or human dignity, [23] based on protective medicine. This model, influenced by Traditional Chinese Medicine (TCM), [24] recognizes Qi as the vital energy delivered via the meridians of the body; it connects illness to body systems, the body’s entire constitution, and the universe for a holistic bond of nature, health, and quality of life. [25] Following a protective ethics model, and traditional customs of wholeness, investment in stem cell research is heavily desired for its applications in regenerative therapies, disease modeling, and protective medicines. In a survey of medical students and healthcare practitioners, 30.8 percent considered stem cell research morally unacceptable while 63.5 percent accepted medical research using human embryonic stem cells. Of these individuals, 89.9 percent supported increased funding for stem cell research. [26] The scientific community might not reflect the overall population. From 1997 to 2019, China spent a total of $576 million (USD) on stem cell research at 8,050 stem cell programs, increased published presence from 0.6 percent to 14.01 percent of total global stem cell publications as of 2014, and made significant strides in cell-based therapies for various medical conditions. [27] However, while China has made substantial investments in stem cell research and achieved notable progress in clinical applications, concerns linger regarding ethical oversight and transparency. [28] For example, the China Biosecurity Law, promoted by the National Health Commission and China Hospital Association, attempted to mitigate risks by introducing an institutional review board (IRB) in the regulatory bodies. 5800 IRBs registered with the Chinese Clinical Trial Registry since 2021. [29] However, issues still need to be addressed in implementing effective IRB review and approval procedures.

The substantial government funding and focus on scientific advancement have sometimes overshadowed considerations of regional cultures, ethnic minorities, and individual perspectives, particularly evident during the one-child policy era. As government policy adapts to promote public stability, such as the change from the one-child to the two-child policy, [30] research ethics should also adapt to ensure respect for the values of its represented peoples.

Japan is also relatively supportive of stem cell research and therapies. Japan has a more transparent regulatory framework, allowing for faster approval of regenerative medicine products, which has led to several advanced clinical trials and therapies. [31] South Korea is also actively engaged in stem cell research and has a history of breakthroughs in cloning and embryonic stem cells. [32] However, the field is controversial, and there are issues of scientific integrity. For example, the Korean FDA fast-tracked products for approval, [33] and in another instance, the oocyte source was unclear and possibly violated ethical standards. [34] Trust is important in research, as it builds collaborative foundations between colleagues, trial participant comfort, open-mindedness for complicated and sensitive discussions, and supports regulatory procedures for stakeholders. There is a need to respect the culture’s interest, engagement, and for research and clinical trials to be transparent and have ethical oversight to promote global research discourse and trust.

d.     Middle East

Countries in the Middle East have varying degrees of acceptance of or restrictions to policies related to using embryonic stem cells due to cultural and religious influences. Saudi Arabia has made significant contributions to stem cell research, and conducts research based on international guidelines for ethical conduct and under strict adherence to guidelines in accordance with Islamic principles. Specifically, the Saudi government and people require ESC research to adhere to Sharia law. In addition to umbilical and placental stem cells, [35] Saudi Arabia permits the use of embryonic stem cells as long as they come from miscarriages, therapeutic abortions permissible by Sharia law, or are left over from in vitro fertilization and donated to research. [36] Laws and ethical guidelines for stem cell research allow the development of research institutions such as the King Abdullah International Medical Research Center, which has a cord blood bank and a stem cell registry with nearly 10,000 donors. [37] Such volume and acceptance are due to the ethical ‘permissibility’ of the donor sources, which do not conflict with religious pillars. However, some researchers err on the side of caution, choosing not to use embryos or fetal tissue as they feel it is unethical to do so. [38]

Jordan has a positive research ethics culture. [39] However, there is a significant issue of lack of trust in researchers, with 45.23 percent (38.66 percent agreeing and 6.57 percent strongly agreeing) of Jordanians holding a low level of trust in researchers, compared to 81.34 percent of Jordanians agreeing that they feel safe to participate in a research trial. [40] Safety testifies to the feeling of confidence that adequate measures are in place to protect participants from harm, whereas trust in researchers could represent the confidence in researchers to act in the participants’ best interests, adhere to ethical guidelines, provide accurate information, and respect participants’ rights and dignity. One method to improve trust would be to address communication issues relevant to ESC. Legislation surrounding stem cell research has adopted specific language, especially concerning clarification “between ‘stem cells’ and ‘embryonic stem cells’” in translation. [41] Furthermore, legislation “mandates the creation of a national committee… laying out specific regulations for stem-cell banking in accordance with international standards.” [42] This broad regulation opens the door for future global engagement and maintains transparency. However, these regulations may also constrain the influence of research direction, pace, and accessibility of research outcomes.

e.     Europe

In the European Union (EU), ethics is also principle-based, but the principles of autonomy, dignity, integrity, and vulnerability are interconnected. [43] As such, the opportunity for cohesion and concessions between individuals’ thoughts and ideals allows for a more adaptable ethics model due to the flexible principles that relate to the human experience The EU has put forth a framework in its Convention for the Protection of Human Rights and Dignity of the Human Being allowing member states to take different approaches. Each European state applies these principles to its specific conventions, leading to or reflecting different acceptance levels of stem cell research. [44]

For example, in Germany, Lebenzusammenhang , or the coherence of life, references integrity in the unity of human culture. Namely, the personal sphere “should not be subject to external intervention.” [45]  Stem cell interventions could affect this concept of bodily completeness, leading to heavy restrictions. Under the Grundgesetz, human dignity and the right to life with physical integrity are paramount. [46] The Embryo Protection Act of 1991 made producing cell lines illegal. Cell lines can be imported if approved by the Central Ethics Commission for Stem Cell Research only if they were derived before May 2007. [47] Stem cell research respects the integrity of life for the embryo with heavy specifications and intense oversight. This is vastly different in Finland, where the regulatory bodies find research more permissible in IVF excess, but only up to 14 days after fertilization. [48] Spain’s approach differs still, with a comprehensive regulatory framework. [49] Thus, research regulation can be culture-specific due to variations in applied principles. Diverse cultures call for various approaches to ethical permissibility. [50] Only an adaptive-deliberative model can address the cultural constructions of self and achieve positive, culturally sensitive stem cell research practices. [51]

II.     Religious Perspectives on ESC

Embryonic stem cell sources are the main consideration within religious contexts. While individuals may not regard their own religious texts as authoritative or factual, religion can shape their foundations or perspectives.

The Qur'an states:

“And indeed We created man from a quintessence of clay. Then We placed within him a small quantity of nutfa (sperm to fertilize) in a safe place. Then We have fashioned the nutfa into an ‘alaqa (clinging clot or cell cluster), then We developed the ‘alaqa into mudgha (a lump of flesh), and We made mudgha into bones, and clothed the bones with flesh, then We brought it into being as a new creation. So Blessed is Allah, the Best of Creators.” [52]

Many scholars of Islam estimate the time of soul installment, marked by the angel breathing in the soul to bring the individual into creation, as 120 days from conception. [53] Personhood begins at this point, and the value of life would prohibit research or experimentation that could harm the individual. If the fetus is more than 120 days old, the time ensoulment is interpreted to occur according to Islamic law, abortion is no longer permissible. [54] There are a few opposing opinions about early embryos in Islamic traditions. According to some Islamic theologians, there is no ensoulment of the early embryo, which is the source of stem cells for ESC research. [55]

In Buddhism, the stance on stem cell research is not settled. The main tenets, the prohibition against harming or destroying others (ahimsa) and the pursuit of knowledge (prajña) and compassion (karuna), leave Buddhist scholars and communities divided. [56] Some scholars argue stem cell research is in accordance with the Buddhist tenet of seeking knowledge and ending human suffering. Others feel it violates the principle of not harming others. Finding the balance between these two points relies on the karmic burden of Buddhist morality. In trying to prevent ahimsa towards the embryo, Buddhist scholars suggest that to comply with Buddhist tenets, research cannot be done as the embryo has personhood at the moment of conception and would reincarnate immediately, harming the individual's ability to build their karmic burden. [57] On the other hand, the Bodhisattvas, those considered to be on the path to enlightenment or Nirvana, have given organs and flesh to others to help alleviate grieving and to benefit all. [58] Acceptance varies on applied beliefs and interpretations.

Catholicism does not support embryonic stem cell research, as it entails creation or destruction of human embryos. This destruction conflicts with the belief in the sanctity of life. For example, in the Old Testament, Genesis describes humanity as being created in God’s image and multiplying on the Earth, referencing the sacred rights to human conception and the purpose of development and life. In the Ten Commandments, the tenet that one should not kill has numerous interpretations where killing could mean murder or shedding of the sanctity of life, demonstrating the high value of human personhood. In other books, the theological conception of when life begins is interpreted as in utero, [59] highlighting the inviolability of life and its formation in vivo to make a religious point for accepting such research as relatively limited, if at all. [60] The Vatican has released ethical directives to help apply a theological basis to modern-day conflicts. The Magisterium of the Church states that “unless there is a moral certainty of not causing harm,” experimentation on fetuses, fertilized cells, stem cells, or embryos constitutes a crime. [61] Such procedures would not respect the human person who exists at these stages, according to Catholicism. Damages to the embryo are considered gravely immoral and illicit. [62] Although the Catholic Church officially opposes abortion, surveys demonstrate that many Catholic people hold pro-choice views, whether due to the context of conception, stage of pregnancy, threat to the mother’s life, or for other reasons, demonstrating that practicing members can also accept some but not all tenets. [63]

Some major Jewish denominations, such as the Reform, Conservative, and Reconstructionist movements, are open to supporting ESC use or research as long as it is for saving a life. [64] Within Judaism, the Talmud, or study, gives personhood to the child at birth and emphasizes that life does not begin at conception: [65]

“If she is found pregnant, until the fortieth day it is mere fluid,” [66]

Whereas most religions prioritize the status of human embryos, the Halakah (Jewish religious law) states that to save one life, most other religious laws can be ignored because it is in pursuit of preservation. [67] Stem cell research is accepted due to application of these religious laws.

We recognize that all religions contain subsets and sects. The variety of environmental and cultural differences within religious groups requires further analysis to respect the flexibility of religious thoughts and practices. We make no presumptions that all cultures require notions of autonomy or morality as under the common morality theory , which asserts a set of universal moral norms that all individuals share provides moral reasoning and guides ethical decisions. [68] We only wish to show that the interaction with morality varies between cultures and countries.

III.     A Flexible Ethical Approach

The plurality of different moral approaches described above demonstrates that there can be no universally acceptable uniform law for ESC on a global scale. Instead of developing one standard, flexible ethical applications must be continued. We recommend local guidelines that incorporate important cultural and ethical priorities.

While the Declaration of Helsinki is more relevant to people in clinical trials receiving ESC products, in keeping with the tradition of protections for research subjects, consent of the donor is an ethical requirement for ESC donation in many jurisdictions including the US, Canada, and Europe. [69] The Declaration of Helsinki provides a reference point for regulatory standards and could potentially be used as a universal baseline for obtaining consent prior to gamete or embryo donation.

For instance, in Columbia University’s egg donor program for stem cell research, donors followed standard screening protocols and “underwent counseling sessions that included information as to the purpose of oocyte donation for research, what the oocytes would be used for, the risks and benefits of donation, and process of oocyte stimulation” to ensure transparency for consent. [70] The program helped advance stem cell research and provided clear and safe research methods with paid participants. Though paid participation or covering costs of incidental expenses may not be socially acceptable in every culture or context, [71] and creating embryos for ESC research is illegal in many jurisdictions, Columbia’s program was effective because of the clear and honest communications with donors, IRBs, and related stakeholders.  This example demonstrates that cultural acceptance of scientific research and of the idea that an egg or embryo does not have personhood is likely behind societal acceptance of donating eggs for ESC research. As noted, many countries do not permit the creation of embryos for research.

Proper communication and education regarding the process and purpose of stem cell research may bolster comprehension and garner more acceptance. “Given the sensitive subject material, a complete consent process can support voluntary participation through trust, understanding, and ethical norms from the cultures and morals participants value. This can be hard for researchers entering countries of different socioeconomic stability, with different languages and different societal values. [72]

An adequate moral foundation in medical ethics is derived from the cultural and religious basis that informs knowledge and actions. [73] Understanding local cultural and religious values and their impact on research could help researchers develop humility and promote inclusion.

IV.     Concerns

Some may argue that if researchers all adhere to one ethics standard, protection will be satisfied across all borders, and the global public will trust researchers. However, defining what needs to be protected and how to define such research standards is very specific to the people to which standards are applied. We suggest that applying one uniform guide cannot accurately protect each individual because we all possess our own perceptions and interpretations of social values. [74] Therefore, the issue of not adjusting to the moral pluralism between peoples in applying one standard of ethics can be resolved by building out ethics models that can be adapted to different cultures and religions.

Other concerns include medical tourism, which may promote health inequities. [75] Some countries may develop and approve products derived from ESC research before others, compromising research ethics or drug approval processes. There are also concerns about the sale of unauthorized stem cell treatments, for example, those without FDA approval in the United States. Countries with robust research infrastructures may be tempted to attract medical tourists, and some customers will have false hopes based on aggressive publicity of unproven treatments. [76]

For example, in China, stem cell clinics can market to foreign clients who are not protected under the regulatory regimes. Companies employ a marketing strategy of “ethically friendly” therapies. Specifically, in the case of Beike, China’s leading stem cell tourism company and sprouting network, ethical oversight of administrators or health bureaus at one site has “the unintended consequence of shifting questionable activities to another node in Beike's diffuse network.” [77] In contrast, Jordan is aware of stem cell research’s potential abuse and its own status as a “health-care hub.” Jordan’s expanded regulations include preserving the interests of individuals in clinical trials and banning private companies from ESC research to preserve transparency and the integrity of research practices. [78]

The social priorities of the community are also a concern. The ISSCR explicitly states that guidelines “should be periodically revised to accommodate scientific advances, new challenges, and evolving social priorities.” [79] The adaptable ethics model extends this consideration further by addressing whether research is warranted given the varying degrees of socioeconomic conditions, political stability, and healthcare accessibilities and limitations. An ethical approach would require discussion about resource allocation and appropriate distribution of funds. [80]

While some religions emphasize the sanctity of life from conception, which may lead to public opposition to ESC research, others encourage ESC research due to its potential for healing and alleviating human pain. Many countries have special regulations that balance local views on embryonic personhood, the benefits of research as individual or societal goods, and the protection of human research subjects. To foster understanding and constructive dialogue, global policy frameworks should prioritize the protection of universal human rights, transparency, and informed consent. In addition to these foundational global policies, we recommend tailoring local guidelines to reflect the diverse cultural and religious perspectives of the populations they govern. Ethics models should be adapted to local populations to effectively establish research protections, growth, and possibilities of stem cell research.

For example, in countries with strong beliefs in the moral sanctity of embryos or heavy religious restrictions, an adaptive model can allow for discussion instead of immediate rejection. In countries with limited individual rights and voice in science policy, an adaptive model ensures cultural, moral, and religious views are taken into consideration, thereby building social inclusion. While this ethical consideration by the government may not give a complete voice to every individual, it will help balance policies and maintain the diverse perspectives of those it affects. Embracing an adaptive ethics model of ESC research promotes open-minded dialogue and respect for the importance of human belief and tradition. By actively engaging with cultural and religious values, researchers can better handle disagreements and promote ethical research practices that benefit each society.

This brief exploration of the religious and cultural differences that impact ESC research reveals the nuances of relative ethics and highlights a need for local policymakers to apply a more intense adaptive model.

[1] Poliwoda, S., Noor, N., Downs, E., Schaaf, A., Cantwell, A., Ganti, L., Kaye, A. D., Mosel, L. I., Carroll, C. B., Viswanath, O., & Urits, I. (2022). Stem cells: a comprehensive review of origins and emerging clinical roles in medical practice.  Orthopedic reviews ,  14 (3), 37498. https://doi.org/10.52965/001c.37498

[2] Poliwoda, S., Noor, N., Downs, E., Schaaf, A., Cantwell, A., Ganti, L., Kaye, A. D., Mosel, L. I., Carroll, C. B., Viswanath, O., & Urits, I. (2022). Stem cells: a comprehensive review of origins and emerging clinical roles in medical practice.  Orthopedic reviews ,  14 (3), 37498. https://doi.org/10.52965/001c.37498

[3] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities . International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk ; Kimmelman, J., Hyun, I., Benvenisty, N.  et al.  Policy: Global standards for stem-cell research.  Nature   533 , 311–313 (2016). https://doi.org/10.1038/533311a

[4] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities . International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk

[5] Concerning the moral philosophies of stem cell research, our paper does not posit a personal moral stance nor delve into the “when” of human life begins. To read further about the philosophical debate, consider the following sources:

Sandel M. J. (2004). Embryo ethics--the moral logic of stem-cell research.  The New England journal of medicine ,  351 (3), 207–209. https://doi.org/10.1056/NEJMp048145 ; George, R. P., & Lee, P. (2020, September 26). Acorns and Embryos . The New Atlantis. https://www.thenewatlantis.com/publications/acorns-and-embryos ; Sagan, A., & Singer, P. (2007). The moral status of stem cells. Metaphilosophy , 38 (2/3), 264–284. http://www.jstor.org/stable/24439776 ; McHugh P. R. (2004). Zygote and "clonote"--the ethical use of embryonic stem cells.  The New England journal of medicine ,  351 (3), 209–211. https://doi.org/10.1056/NEJMp048147 ; Kurjak, A., & Tripalo, A. (2004). The facts and doubts about beginning of the human life and personality.  Bosnian journal of basic medical sciences ,  4 (1), 5–14. https://doi.org/10.17305/bjbms.2004.3453

[6] Vazin, T., & Freed, W. J. (2010). Human embryonic stem cells: derivation, culture, and differentiation: a review.  Restorative neurology and neuroscience ,  28 (4), 589–603. https://doi.org/10.3233/RNN-2010-0543

[7] Socially, at its core, the Western approach to ethics is widely principle-based, autonomy being one of the key factors to ensure a fundamental respect for persons within research. For information regarding autonomy in research, see: Department of Health, Education, and Welfare, & National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1978). The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research.; For a more in-depth review of autonomy within the US, see: Beauchamp, T. L., & Childress, J. F. (1994). Principles of Biomedical Ethics . Oxford University Press.

[8] Sherley v. Sebelius , 644 F.3d 388 (D.C. Cir. 2011), citing 45 C.F.R. 46.204(b) and [42 U.S.C. § 289g(b)]. https://www.cadc.uscourts.gov/internet/opinions.nsf/6c690438a9b43dd685257a64004ebf99/$file/11-5241-1391178.pdf

[9] Stem Cell Research Enhancement Act of 2005, H. R. 810, 109 th Cong. (2001). https://www.govtrack.us/congress/bills/109/hr810/text ; Bush, G. W. (2006, July 19). Message to the House of Representatives . National Archives and Records Administration. https://georgewbush-whitehouse.archives.gov/news/releases/2006/07/20060719-5.html

[10] National Archives and Records Administration. (2009, March 9). Executive order 13505 -- removing barriers to responsible scientific research involving human stem cells . National Archives and Records Administration. https://obamawhitehouse.archives.gov/the-press-office/removing-barriers-responsible-scientific-research-involving-human-stem-cells

[11] Hurlbut, W. B. (2006). Science, Religion, and the Politics of Stem Cells.  Social Research ,  73 (3), 819–834. http://www.jstor.org/stable/40971854

[12] Akpa-Inyang, Francis & Chima, Sylvester. (2021). South African traditional values and beliefs regarding informed consent and limitations of the principle of respect for autonomy in African communities: a cross-cultural qualitative study. BMC Medical Ethics . 22. 10.1186/s12910-021-00678-4.

[13] Source for further reading: Tangwa G. B. (2007). Moral status of embryonic stem cells: perspective of an African villager. Bioethics , 21(8), 449–457. https://doi.org/10.1111/j.1467-8519.2007.00582.x , see also Mnisi, F. M. (2020). An African analysis based on ethics of Ubuntu - are human embryonic stem cell patents morally justifiable? African Insight , 49 (4).

[14] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics , 22 (2), 112–122. https://doi.org/10.1111/dewb.12324

[15] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics, 22(2), 112–122. https://doi.org/10.1111/dewb.12324

[16] Jackson, C.S., Pepper, M.S. Opportunities and barriers to establishing a cell therapy programme in South Africa.  Stem Cell Res Ther   4 , 54 (2013). https://doi.org/10.1186/scrt204 ; Pew Research Center. (2014, May 1). Public health a major priority in African nations . Pew Research Center’s Global Attitudes Project. https://www.pewresearch.org/global/2014/05/01/public-health-a-major-priority-in-african-nations/

[17] Department of Health Republic of South Africa. (2021). Health Research Priorities (revised) for South Africa 2021-2024 . National Health Research Strategy. https://www.health.gov.za/wp-content/uploads/2022/05/National-Health-Research-Priorities-2021-2024.pdf

[18] Oosthuizen, H. (2013). Legal and Ethical Issues in Stem Cell Research in South Africa. In: Beran, R. (eds) Legal and Forensic Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32338-6_80 , see also: Gaobotse G (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142

[19] United States Bureau of Citizenship and Immigration Services. (1998). Tunisia: Information on the status of Christian conversions in Tunisia . UNHCR Web Archive. https://webarchive.archive.unhcr.org/20230522142618/https://www.refworld.org/docid/3df0be9a2.html

[20] Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142

[21] Kooli, C. Review of assisted reproduction techniques, laws, and regulations in Muslim countries.  Middle East Fertil Soc J   24 , 8 (2020). https://doi.org/10.1186/s43043-019-0011-0 ; Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142

[22] Pang M. C. (1999). Protective truthfulness: the Chinese way of safeguarding patients in informed treatment decisions. Journal of medical ethics , 25(3), 247–253. https://doi.org/10.1136/jme.25.3.247

[23] Wang, L., Wang, F., & Zhang, W. (2021). Bioethics in China’s biosecurity law: Forms, effects, and unsettled issues. Journal of law and the biosciences , 8(1).  https://doi.org/10.1093/jlb/lsab019 https://academic.oup.com/jlb/article/8/1/lsab019/6299199

[24] Wang, Y., Xue, Y., & Guo, H. D. (2022). Intervention effects of traditional Chinese medicine on stem cell therapy of myocardial infarction.  Frontiers in pharmacology ,  13 , 1013740. https://doi.org/10.3389/fphar.2022.1013740

[25] Li, X.-T., & Zhao, J. (2012). Chapter 4: An Approach to the Nature of Qi in TCM- Qi and Bioenergy. In Recent Advances in Theories and Practice of Chinese Medicine (p. 79). InTech.

[26] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students.  Stem cells international ,  2021 , 6667743. https://doi.org/10.1155/2021/6667743

[27] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students.  Stem cells international ,  2021 , 6667743. https://doi.org/10.1155/2021/6667743

[28] Zhang, J. Y. (2017). Lost in translation? accountability and governance of Clinical Stem Cell Research in China. Regenerative Medicine , 12 (6), 647–656. https://doi.org/10.2217/rme-2017-0035

[29] Wang, L., Wang, F., & Zhang, W. (2021). Bioethics in China’s biosecurity law: Forms, effects, and unsettled issues. Journal of law and the biosciences , 8(1).  https://doi.org/10.1093/jlb/lsab019 https://academic.oup.com/jlb/article/8/1/lsab019/6299199

[30] Chen, H., Wei, T., Wang, H.  et al.  Association of China’s two-child policy with changes in number of births and birth defects rate, 2008–2017.  BMC Public Health   22 , 434 (2022). https://doi.org/10.1186/s12889-022-12839-0

[31] Azuma, K. Regulatory Landscape of Regenerative Medicine in Japan.  Curr Stem Cell Rep   1 , 118–128 (2015). https://doi.org/10.1007/s40778-015-0012-6

[32] Harris, R. (2005, May 19). Researchers Report Advance in Stem Cell Production . NPR. https://www.npr.org/2005/05/19/4658967/researchers-report-advance-in-stem-cell-production

[33] Park, S. (2012). South Korea steps up stem-cell work.  Nature . https://doi.org/10.1038/nature.2012.10565

[34] Resnik, D. B., Shamoo, A. E., & Krimsky, S. (2006). Fraudulent human embryonic stem cell research in South Korea: lessons learned.  Accountability in research ,  13 (1), 101–109. https://doi.org/10.1080/08989620600634193 .

[35] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6

[36] Association for the Advancement of Blood and Biotherapies.  https://www.aabb.org/regulatory-and-advocacy/regulatory-affairs/regulatory-for-cellular-therapies/international-competent-authorities/saudi-arabia

[37] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia.  BMC medical ethics ,  21 (1), 35. https://doi.org/10.1186/s12910-020-00482-6

[38] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics , 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6

Culturally, autonomy practices follow a relational autonomy approach based on a paternalistic deontological health care model. The adherence to strict international research policies and religious pillars within the regulatory environment is a great foundation for research ethics. However, there is a need to develop locally targeted ethics approaches for research (as called for in Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6), this decision-making approach may help advise a research decision model. For more on the clinical cultural autonomy approaches, see: Alabdullah, Y. Y., Alzaid, E., Alsaad, S., Alamri, T., Alolayan, S. W., Bah, S., & Aljoudi, A. S. (2022). Autonomy and paternalism in Shared decision‐making in a Saudi Arabian tertiary hospital: A cross‐sectional study. Developing World Bioethics , 23 (3), 260–268. https://doi.org/10.1111/dewb.12355 ; Bukhari, A. A. (2017). Universal Principles of Bioethics and Patient Rights in Saudi Arabia (Doctoral dissertation, Duquesne University). https://dsc.duq.edu/etd/124; Ladha, S., Nakshawani, S. A., Alzaidy, A., & Tarab, B. (2023, October 26). Islam and Bioethics: What We All Need to Know . Columbia University School of Professional Studies. https://sps.columbia.edu/events/islam-and-bioethics-what-we-all-need-know

[39] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics.  Research Ethics ,  17 (2), 228-241.  https://doi.org/10.1177/1747016120966779

[40] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics.  Research Ethics ,  17 (2), 228-241.  https://doi.org/10.1177/1747016120966779

[41] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[42] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[43] The EU’s definition of autonomy relates to the capacity for creating ideas, moral insight, decisions, and actions without constraint, personal responsibility, and informed consent. However, the EU views autonomy as not completely able to protect individuals and depends on other principles, such as dignity, which “expresses the intrinsic worth and fundamental equality of all human beings.” Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3

[44] Council of Europe. Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) https://www.coe.int/en/web/conventions/full-list?module=treaty-detail&treatynum=164 (forbidding the creation of embryos for research purposes only, and suggests embryos in vitro have protections.); Also see Drabiak-Syed B. K. (2013). New President, New Human Embryonic Stem Cell Research Policy: Comparative International Perspectives and Embryonic Stem Cell Research Laws in France.  Biotechnology Law Report ,  32 (6), 349–356. https://doi.org/10.1089/blr.2013.9865

[45] Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3

[46] Tomuschat, C., Currie, D. P., Kommers, D. P., & Kerr, R. (Trans.). (1949, May 23). Basic law for the Federal Republic of Germany. https://www.btg-bestellservice.de/pdf/80201000.pdf

[47] Regulation of Stem Cell Research in Germany . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-germany

[48] Regulation of Stem Cell Research in Finland . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-finland

[49] Regulation of Stem Cell Research in Spain . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-spain

[50] Some sources to consider regarding ethics models or regulatory oversights of other cultures not covered:

Kara MA. Applicability of the principle of respect for autonomy: the perspective of Turkey. J Med Ethics. 2007 Nov;33(11):627-30. doi: 10.1136/jme.2006.017400. PMID: 17971462; PMCID: PMC2598110.

Ugarte, O. N., & Acioly, M. A. (2014). The principle of autonomy in Brazil: one needs to discuss it ...  Revista do Colegio Brasileiro de Cirurgioes ,  41 (5), 374–377. https://doi.org/10.1590/0100-69912014005013

Bharadwaj, A., & Glasner, P. E. (2012). Local cells, global science: The rise of embryonic stem cell research in India . Routledge.

For further research on specific European countries regarding ethical and regulatory framework, we recommend this database: Regulation of Stem Cell Research in Europe . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-europe   

[51] Klitzman, R. (2006). Complications of culture in obtaining informed consent. The American Journal of Bioethics, 6(1), 20–21. https://doi.org/10.1080/15265160500394671 see also: Ekmekci, P. E., & Arda, B. (2017). Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights.  Cultura (Iasi, Romania) ,  14 (2), 159–172.; For why trust is important in research, see also: Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent?  Research Ethics ,  13 (1), 23-41.  https://doi.org/10.1177/1747016116650235

[52] The Qur'an  (M. Khattab, Trans.). (1965). Al-Mu’minun, 23: 12-14. https://quran.com/23

[53] Lenfest, Y. (2017, December 8). Islam and the beginning of human life . Bill of Health. https://blog.petrieflom.law.harvard.edu/2017/12/08/islam-and-the-beginning-of-human-life/

[54] Aksoy, S. (2005). Making regulations and drawing up legislation in Islamic countries under conditions of uncertainty, with special reference to embryonic stem cell research. Journal of Medical Ethics , 31: 399-403.; see also: Mahmoud, Azza. "Islamic Bioethics: National Regulations and Guidelines of Human Stem Cell Research in the Muslim World." Master's thesis, Chapman University, 2022. https://doi.org/10.36837/ chapman.000386

[55] Rashid, R. (2022). When does Ensoulment occur in the Human Foetus. Journal of the British Islamic Medical Association , 12 (4). ISSN 2634 8071. https://www.jbima.com/wp-content/uploads/2023/01/2-Ethics-3_-Ensoulment_Rafaqat.pdf.

[56] Sivaraman, M. & Noor, S. (2017). Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia. Asian Biomedicine,8(1) 43-52.  https://doi.org/10.5372/1905-7415.0801.260

[57] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[58] Lecso, P. A. (1991). The Bodhisattva Ideal and Organ Transplantation.  Journal of Religion and Health ,  30 (1), 35–41. http://www.jstor.org/stable/27510629 ; Bodhisattva, S. (n.d.). The Key of Becoming a Bodhisattva . A Guide to the Bodhisattva Way of Life. http://www.buddhism.org/Sutras/2/BodhisattvaWay.htm

[59] There is no explicit religious reference to when life begins or how to conduct research that interacts with the concept of life. However, these are relevant verses pertaining to how the fetus is viewed. (( King James Bible . (1999). Oxford University Press. (original work published 1769))

Jerimiah 1: 5 “Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee…”

In prophet Jerimiah’s insight, God set him apart as a person known before childbirth, a theme carried within the Psalm of David.

Psalm 139: 13-14 “…Thou hast covered me in my mother's womb. I will praise thee; for I am fearfully and wonderfully made…”

These verses demonstrate David’s respect for God as an entity that would know of all man’s thoughts and doings even before birth.

[60] It should be noted that abortion is not supported as well.

[61] The Vatican. (1987, February 22). Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day . Congregation For the Doctrine of the Faith. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html

[62] The Vatican. (2000, August 25). Declaration On the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells . Pontifical Academy for Life. https://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_20000824_cellule-staminali_en.html ; Ohara, N. (2003). Ethical Consideration of Experimentation Using Living Human Embryos: The Catholic Church’s Position on Human Embryonic Stem Cell Research and Human Cloning. Department of Obstetrics and Gynecology . Retrieved from https://article.imrpress.com/journal/CEOG/30/2-3/pii/2003018/77-81.pdf.

[63] Smith, G. A. (2022, May 23). Like Americans overall, Catholics vary in their abortion views, with regular mass attenders most opposed . Pew Research Center. https://www.pewresearch.org/short-reads/2022/05/23/like-americans-overall-catholics-vary-in-their-abortion-views-with-regular-mass-attenders-most-opposed/

[64] Rosner, F., & Reichman, E. (2002). Embryonic stem cell research in Jewish law. Journal of halacha and contemporary society , (43), 49–68.; Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[65] Schenker J. G. (2008). The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law).  Journal of assisted reproduction and genetics ,  25 (6), 271–276. https://doi.org/10.1007/s10815-008-9221-6

[66] Ruttenberg, D. (2020, May 5). The Torah of Abortion Justice (annotated source sheet) . Sefaria. https://www.sefaria.org/sheets/234926.7?lang=bi&with=all&lang2=en

[67] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[68] Gert, B. (2007). Common morality: Deciding what to do . Oxford Univ. Press.

[69] World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA , 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Declaration of Helsinki – WMA – The World Medical Association .; see also: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979).  The Belmont report: Ethical principles and guidelines for the protection of human subjects of research . U.S. Department of Health and Human Services.  https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

[70] Zakarin Safier, L., Gumer, A., Kline, M., Egli, D., & Sauer, M. V. (2018). Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes.  Journal of assisted reproduction and genetics ,  35 (7), 1219–1225. https://doi.org/10.1007/s10815-018-1171-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063839/ see also: Riordan, N. H., & Paz Rodríguez, J. (2021). Addressing concerns regarding associated costs, transparency, and integrity of research in recent stem cell trial. Stem Cells Translational Medicine , 10 (12), 1715–1716. https://doi.org/10.1002/sctm.21-0234

[71] Klitzman, R., & Sauer, M. V. (2009). Payment of egg donors in stem cell research in the USA.  Reproductive biomedicine online ,  18 (5), 603–608. https://doi.org/10.1016/s1472-6483(10)60002-8

[72] Krosin, M. T., Klitzman, R., Levin, B., Cheng, J., & Ranney, M. L. (2006). Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa.  Clinical trials (London, England) ,  3 (3), 306–313. https://doi.org/10.1191/1740774506cn150oa

[73] Veatch, Robert M.  Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict . Georgetown University Press, 2012.

[74] Msoroka, M. S., & Amundsen, D. (2018). One size fits not quite all: Universal research ethics with diversity.  Research Ethics ,  14 (3), 1-17.  https://doi.org/10.1177/1747016117739939

[75] Pirzada, N. (2022). The Expansion of Turkey’s Medical Tourism Industry.  Voices in Bioethics ,  8 . https://doi.org/10.52214/vib.v8i.9894

[76] Stem Cell Tourism: False Hope for Real Money . Harvard Stem Cell Institute (HSCI). (2023). https://hsci.harvard.edu/stem-cell-tourism , See also: Bissassar, M. (2017). Transnational Stem Cell Tourism: An ethical analysis.  Voices in Bioethics ,  3 . https://doi.org/10.7916/vib.v3i.6027

[77] Song, P. (2011) The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation,  New Genetics and Society , 30:2, 141-153, DOI:  10.1080/14636778.2011.574375

[78] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[79] International Society for Stem Cell Research. (2024). Standards in stem cell research . International Society for Stem Cell Research. https://www.isscr.org/guidelines/5-standards-in-stem-cell-research

[80] Benjamin, R. (2013). People’s science bodies and rights on the Stem Cell Frontier . Stanford University Press.

Mifrah Hayath

SM Candidate Harvard Medical School, MS Biotechnology Johns Hopkins University

Olivia Bowers

MS Bioethics Columbia University (Disclosure: affiliated with Voices in Bioethics)

Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License .

• Open access
• Published: 14 May 2024

Rain, rain, go away, come again another day: do climate variations enhance the spread of COVID-19?

• Masha Menhat 1 ,
• Effi Helmy Ariffin   ORCID: orcid.org/0000-0002-8534-0113 2 ,
• Wan Shiao Dong 3 ,
• Junainah Zakaria 2 ,
• Aminah Ismailluddin 3 ,
• Hayrol Azril Mohamed Shafril 4 ,
• Mahazan Muhammad 5 ,
• Ahmad Rosli Othman 6 ,
• Thavamaran Kanesan 7 ,
• Suzana Pil Ramli 8 ,
• Mohd Fadzil Akhir 2 &
• Amila Sandaruwan Ratnayake 9  

Globalization and Health volume  20 , Article number:  43 ( 2024 ) Cite this article

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The spread of infectious diseases was further promoted due to busy cities, increased travel, and climate change, which led to outbreaks, epidemics, and even pandemics. The world experienced the severity of the 125 nm virus called the coronavirus disease 2019 (COVID-19), a pandemic declared by the World Health Organization (WHO) in 2019. Many investigations revealed a strong correlation between humidity and temperature relative to the kinetics of the virus’s spread into the hosts. This study aimed to solve the riddle of the correlation between environmental factors and COVID-19 by applying RepOrting standards for Systematic Evidence Syntheses (ROSES) with the designed research question. Five temperature and humidity-related themes were deduced via the review processes, namely 1) The link between solar activity and pandemic outbreaks, 2) Regional area, 3) Climate and weather, 4) Relationship between temperature and humidity, and 5) the Governmental disinfection actions and guidelines. A significant relationship between solar activities and pandemic outbreaks was reported throughout the review of past studies. The grand solar minima (1450-1830) and solar minima (1975-2020) coincided with the global pandemic. Meanwhile, the cooler, lower humidity, and low wind movement environment reported higher severity of cases. Moreover, COVID-19 confirmed cases and death cases were higher in countries located within the Northern Hemisphere. The Blackbox of COVID-19 was revealed through the work conducted in this paper that the virus thrives in cooler and low-humidity environments, with emphasis on potential treatments and government measures relative to temperature and humidity.

• The coronavirus disease 2019 (COIVD-19) is spreading faster in low temperatures and humid area.

• Weather and climate serve as environmental drivers in propagating COVID-19.

• Solar radiation influences the spreading of COVID-19.

• The correlation between weather and population as the factor in spreading of COVID-19.

Graphical abstract

Introduction

The revolution and rotation of the Earth and the Sun supply heat and create differential heating on earth. The movements and the 23.5° inclination of the Earth [ 1 ] separate the oblate-ellipsoid-shaped earth into northern and southern hemispheres. Consequently, the division results in various climatic zones at different latitudes and dissimilar local temperatures (see Fig.  1 ) and affects the seasons and length of a day and night in a particular region [ 2 ]. Global differential heating and climate variability occur due to varying solar radiation received by each region [ 3 ]. According to Trenberth and Fasullo [ 4 ] and Hauschild et al. [ 5 ] the new perspective on the issue of climate change can be affected relative to the changes in solar radiation patterns. Since the study by Trenberth and Fasullo [ 4 ] focused on climate model changes from 1950 to 2100, it was found that the role of changing clouds and trapped sunlight can lead to an opening of the aperture for solar radiation.

The annual average temperature data for 2021 in the northern and southern hemispheres ( Source: meteoblue.com ). Note: The black circles mark countries with high Coronavirus disease 2019 (COVID-19) infections

Furthermore, the heat from sunlight is essential to humans; several organisms could not survive without it. Conversely, the spread of any disease-carrying virus tends to increase with less sunlight exposure [ 6 ]. Historically, disease outbreaks that led to epidemic and pandemic eruptions were correlated to atmospheric changes. Pandemic diseases, such as the flu (1918), Asian flu (1956–1958), Hong Kong flu (1968), and recently, the coronavirus disease 2019 (COVID-19) (2019), recorded over a million death toll each during the winter season or minimum temperature conditions [ 7 ]. The total number of COVID-19 cases is illustrated in Fig.  2 .

A graphical representation of the total number of COVID-19 cases across various periods between 2020 and 2021. ( Source : www.worldometers.info ). Note: The black circles indicate countries with high numbers COVID-19-infections

In several previous outbreaks, investigations revealed a significant association between temperature and humidity with a particular focus on the transmission dynamics of the infection from the virus into the hosts [ 8 , 9 , 10 ]. Moreover, disease outbreaks tended to heighten in cold temperatures and low humidity [ 11 ]. Optimal temperature and sufficient relative humidity during evaporation are necessary for cloud formation, resulting in the precipitated liquid falling to the ground as rain, snow, or hail due to the activity of solar radiation balancing [ 4 ].

Consequently, the radiation balancing processes in the atmosphere are directly linked to the living beings on the earth, including plants and animals, and as well as viruses and bacterias. According to Carvalho et al. [ 12 ]‘s study, the survival rate of the Coronaviridae Family can decrease during summer seasons. Nevertheless, numerous diseases were also developed from specific viruses, such as influenza, malaria, and rubella, and in November 2019, a severe health threat originated from a 125 nm size of coronavirus, had resulted in numerous deaths worldwide.

Transmission and symptoms of COVID-19

The COVID-19, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an infectious disease caused by a newly discovered pathogenic virus from the coronavirus family, the novel coronavirus (2019-nCoV) [ 13 ]. The first case was recorded in Wuhan, China, in December 2019 [ 14 ]. The pathogenic virus is transmitted among humans when they breathe in air contaminated with droplets and tiny airborne particles containing the virus [ 14 , 15 , 16 , 17 , 18 ].

According to the World Health Organization (WHO), the most common symptoms of COVID-19 infection include fever, dry cough, and tiredness. Nevertheless, older people and individuals with underlying health problems (lung and heart problems, high blood pressure, diabetes, or cancer) are at higher risk of becoming seriously ill and developing difficulty breathing [ 19 ]. The COVID-19 was initially only predominant in China but rapidly spread to other countries globally. The remarkably swift acceleration of the number of infections and mortality forced WHO to declare COVID-19 a global public health emergency on the 30th of January 2020, which was later declared as a pandemic on the 11th of March 2020 [ 20 ].

Since no vaccine was available then, WHO introduced the COVID-19 preventative measures to reduce the chances of virus transmission. The guideline for individual preventative included practising hand and respiratory hygiene by regularly cleaning hands with soap and water or alcohol-based sanitisers, wear a facemask and always maintaining at least a one-meter physical distance [ 21 ]. Nevertheless, the worldwide transmission of COVID-19 has resulted in fear and forced numerous countries to impose restrictions rules, such as lockdown, travel bans, closed country borders, restrictions on shipping activities, and movement limitations, to diminish the spread of COVID-19 [ 22 ].

According to WHO, by the 2nd of December 2020, 63,379,338 confirmed cases and 1,476,676 mortalities were recorded globally. On the 3rd of December 2021, 263,655,612 confirmed cases and deaths were recorded, reflecting increased COVID-19 infections compared to the previous year. The American and European regions documented the highest COVID-19 patients with 97,341,769 and 88,248,591 cases, respectively (see Fig. 2 ), followed by Southeast Asia with 44,607,287, Eastern Mediterranean accounted 16,822,791, Western Pacific recorded 6,322,034, and Africa reported the lowest number of cases at 6,322,034 [ 19 ].

Recently, an increasing number of studies are investigating the association between environmental factors (temperature and humidity) and the viability, transmission, and survival of the coronavirus [ 23 , 24 , 25 , 26 ]. The results primarily demonstrated that temperature was more significantly associated with the transmission of COVID-19 [ 27 , 28 , 29 ] and its survival period on the surfaces of objects [ 30 ]. Consequently, the disease was predominant in countries with low temperature and humidity [ 31 ], which was also proven by Diao et al. [ 32 ]‘s study demonstrating higher rates of COVID-19 transmission in China, England, Germany, and Japan.

A comprehensive systematic literature review (SLR) is still lacking despite numerous research on environmental factors linked to coronavirus. Accordingly, this article aimed to fill the gap in understanding and identifying the correlation between environmental factors and COVID-19 by analysing existing reports. Systematically reviewing existing literature is essential to contribute to the body of knowledge and provide beneficial information for public health policymakers.

Methodology

The present study reviewed the protocols, formulation of research questions, selection of studies, appraisal of quality, and data abstraction and analysis.

The protocol review

The present SLR was performed according to the reporting standards for systematic evidence syntheses (ROSES) and followed or adapted the guidelines as closely as possible. Thus, in this study, a systematic literature review was guided by the ROSES review protocol (Fig.  3 ). Compared to preferred reporting items for systematic review and meta-analysis (PRISMA), ROSES is a review protocol specifically designed for a systematic review in the conservation or environment management fields [ 33 ]. Compared to PRISMA, ROSES offers several advantages, as it is tailored to environmental systematic review, which reduces emphasis on quantitative synthesis (e.g. meta-analysis etc.) that is only reliable when used with appropriate data [ 34 ].

The flow diagram guide by ROSES protocol and Thematical Analysis

The current SLR started by determining the appropriate research questions, followed by the selection criteria, including the review, specifically on the keywords employed and the selection of journals database. Subsequently, the appraisal quality process and data abstraction and analysis were conducted.

Formulation of research questions

The entire process of this SLR was guided by the specific research questions, while sources to be reviewed and data abstraction and analysis were in line with the determined research question [ 35 , 36 ]. In the present article, a total of five research questions were formed, namely:

What the link between solar activity and COVID-19 pandemic outbreaks?

Which regions were more prone to COVID-19?

What were the temporal and spatial variabilities of high temperature and humidity during the spread of COVID-19?

What is the relationship between temperature and humidity in propagating COVID-19?

How did the government’s disinfection actions and guidelines can be reducing the spread of COVID-19?

Systematic searching strategies

Selection of studies.

In this stage of the study, the appropriate keywords to be employed in the searching process were determined. After referring to existing literature, six main keywords were chosen for the searching process, namely COVID-19, coronavirus, temperature, humidity, solar radiation and population density. The current study also utilised the boolean operators (OR, AND, AND NOT) and phrase searching.

Scopus was employed as the main database during the searching process, in line with the suggestion by Gusenbauer and Haddaway [ 37 ], who noted the strength of the database in terms of quality control and search and filtering functions. Furthermore, Google Scholar was selected as the supporting database. Although Halevi et al. [ 38 ] expressed concerns about its quality, Haddaway et al. [ 39 ] reported that due to its quantity, Google Scholar was suitable as a supporting database in SLR studies.

In the first stage of the search, 2550 articles were retrieved, which were then screened. The suitable criteria were also determined to control the quality of the articles reviewed [ 40 ]. The criteria are: any documents published between 2000 to 2022, documents that consist previously determined keywords, published in English, and any environment-related studies that focused on COVID-19. Based on these criteria, 2372 articles were excluded and 178 articles were proceeded to the next step namely eligibility. In the eligibility process, the title and the abstract of the articles were examined to ensure its relevancy to the SLR and in this process a total of 120 articles were excluded and only 58 articles were processed in the next stage.

Appraisal of the quality

The study ensured the rigor of the chosen articles based on best evidence synthesis. In the process, predefined inclusion criteria for the review were appraised by the systematic review team based on previously established guidelines and the studies were then judged as being scientifically admissible or not [ 40 ]. Hence, by controlling the quality based on the best evidence synthesis, the present SLR controls its quality by including articles that are in line with the inclusion criteria. It means that any article published within the timeline (in the year 2000 and above), composed of predetermined keywords, in English medium, and environment-related investigations focusing on COVID-19 are included in the review. Based on this process, all 58 articles fulfilled all the inclusion criteria and are considered of good quality and included in the review.

Data abstraction and analysis

The data abstraction process in this study was performed based on five research questions (please refer to 2.2, formulation of research questions). The data that was able to answer the questions were abstracted and placed in a table to ease the data analysis process. The primary data analysis technique employed in the current study was qualitative and relied on thematic analysis.

The thematic technique is a descriptive method that combines data flexibly with other information evaluation methods [ 41 ], aiming to identify the patterns in studies. Any similarities and relationships within the abstracted data emerge as patterns. Subsequently, suitable themes and sub-themes would be developed based on obtained patterns [ 42 ]. Following the thematic process, five themes were selected in this study.

Background of the selected articles

The current study selected 58 articles for the SLR. Five themes were developed based on the thematic analysis from the predetermined research questions: the link between solar activity and pandemic outbreaks, regional area, climate and weather, the relationship between temperature and humidity, and government disinfection action guidelines. Among the articles retrieved between 2000 and 2022; two were published in 2010, one in 2011, four in 2013, three in 2014, two in 2015, six in 2016 and 2017, respectively, one in 2018, six in 2019, twelve in 2020, eight in 2021, and seven in 2022.

Temperature- and humidity-related themes

The link between solar activity and pandemic outbreaks.

Numerous scientists have investigated the relationship between solar activities and pandemic outbreaks over the years ([ 43 ]; A [ 27 , 44 , 45 ].). Nuclear fusions from solar activities have resulted in minimum and maximum solar sunspots. Maximum solar activities are characterised by a high number of sunspots and elevated solar flare frequency and coronal mass injections. Minimum solar sunspot occurrences are identified by low interplanetary magnetic field values entering the earth [ 1 ].

A diminished magnetic field was suggested to be conducive for viruses and bacteria to mutate, hence the onset of pandemics. Nonetheless, Hoyle and Wickramasinghe [ 46 ] reported that the link between solar activity and pandemic outbreaks is only speculative. The literature noted that the data recorded between 1930 and 1970 demonstrated that virus transmissions and pandemic occurrences were coincidental. Moreover, no pandemic cases were reported in 1979, when minimum solar activity was recorded [ 47 ].

Chandra Wickramasinghe et al. [ 48 ] suggested a significant relationship between pandemic outbreaks and solar activities as several grand solar minima, including Sporer (1450–1550 AD), Mounder (1650–1700 AD), and Dalton (1800–1830) minimums, were recorded coinciding with global pandemics of diseases, such as smallpox, the English sweat, plague, and cholera pandemics. Furthermore, since the Dalton minimum, which recorded minimum sunspots, studies from 2002 to 2015 have documented the reappearance of previous pandemics. For example, influenza subtype H1N1 1918/1919 episodically returned in 2009, especially in India, China, and other Asian countries. Zika virus, which first appeared in 1950, flared and became endemic in 2015, transmitted sporadically, specifically in African countries. Similarly, SARS-CoV was first recorded in China in 2002 and emerged as an outbreak, MERS-CoV, in middle east countries a decade later, in 2012.

In 2020, the World Data Centre Sunspot Index and Long-term Solar Observations ( http://sidc.be ) confirmed that a new solar activity was initiated in December 2019, during which a novel coronavirus pandemic also occurred, and present a same as the previous hypothesis. Nevertheless, a higher number of pandemic outbreaks were documented during low minimum solar activities, including Ebola (1976), H5N1 (Nipah) (1967–1968), H1N1 (2009), and COVID-19 (2019–current). Furthermore, Wickramasinghe and Qu [ 49 ] reported that since 1918 or 1919, more devastating and recurrent pandemics tend to occur, particularly after a century. Consequently, within 100 years, a sudden surge of influenza was recorded, and novel influenza was hypothesised to emerge.

Figure  4 demonstrates that low minimum solar activity significantly reduced before 2020, hence substantiating the claim that pandemic events are closely related to solar activities. Moreover, numerous studies (i.e. [ 43 ], Chandra [ 46 , 47 , 48 ]) reported that during solar minimums, new viruses could penetrate the surfaces of the earth and high solar radiation would result in lower infection rates, supporting the hypothesis mentioned above.

The number of sunspots in the last 13 years. Note : The yellow curve indicates the daily sunspot number and the 2010–2021 delineated curve illustrates the minimum solar activity recorded (source: http://sidc.be/silso )

Regional area

In early December 2019, Wuhan, China, was reported as the centre of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak [ 50 ]. Chinese health authorities immediately investigated and controlled the spread of the disease. Nevertheless, by late January 2020, the WHO announced that COVID-19 was a global public health emergency. The upgrade was due to the rapid rise in confirmed cases, which were no longer limited to Wuhan [ 28 ]. The disease had spread to 24 other countries, which were mainly in the northern hemisphere, particularly the European and Western Pacific regions, such as France, United Kingdom, Spain, South Korea, Japan, Malaysia, and Indonesia [ 51 , 52 ]. The migration or movement of humans was the leading agent in the spread of COVID-19, resulting in an almost worldwide COVID-19 pandemic [ 53 ].

The first hotspots of the epidemic outspread introduced by the Asian and Western Pacific regions possessed similar winter climates with an average temperature and humidity rate of 5–11 °C and 47–79%. Consequently, several publications reviewed in the current study associated the COVID-19 outbreak with regional climates (i.e. [ 1 , 29 , 54 , 55 ]) instead of its close connection to China. This review also discussed the effects of a range of specific climatological variables on the transmission and epidemiology of COVID-19 in regional climatic conditions.

America and Europe documented the highest COVID-19 cases, outnumbering the number reported in Asia [ 19 ] and on the 2nd of December 2020, the United States of America (USA) reported the highest number of confirmed COVID-19 infections, with over 13,234,551 cases and 264,808 mortalities (Da S [ 56 ].). The cases in the USA began emerging in March 2020 and peaked in late November 2020, during the wintertime in the northern hemisphere (December to March) [ 53 ]. Figure  5 demonstrates the evolution of the COVID-19 pandemic in several country which represent comparison two phase of summer and one phase of winter. Most of these countries tend to increase of COVID cases close to winter season. Then, it can be worsening on phase two of summer due to do not under control of human movement although the normal trend it is presenting during winter phase.

The evolution of the COVID-19 pandemic from the 15th of February 2020 to the 2nd of December 2020 ( Source: https://www.worldometers.info/coronavirus )

The coronavirus spread aggressively across the European region, which recorded the second highest COVID-19 confirmed cases after America. At the end of 2020, WHO reported 19,071,275 Covid-19 cases in the area, where France documented 2,183,275 cases, the European country with the highest number of confirmed cases, followed by the United Kingdom (1,629,661 cases) and Spain (1,652,801 cases) [ 19 ]. Europe is also located in the northern hemisphere and possesses a temperate climate.

The spatial and temporal transmission patterns of coronavirus infection in the European region were similar to America and the Eastern Mediterranean, where the winter season increased COVID-19 cases. Typically, winter in Europe occurs at the beginning of October and ends in March. Hardy et al. [ 57 ] also stated that temperature commonly drops below freezing (approximately − 1 °C) when snow accumulates between December to mid-March, resulting in an extreme environment. Figure 5 indicates that COVID-19 cases peaked in October when the temperature became colder [ 21 ]. Similarly, the cases were the highest in the middle of the year in Australia and South Asian countries, such as India, that experience winter and monsoon, respectively, during the period.

In African regions, the outbreak of COVID-19 escalated rapidly from June to October before falling from October to March, as summer in South Africa generally occurs from November to March, while winter from June to August. Nevertheless, heavy rainfall generally transpires during summer, hence the warm and humid conditions in South Africa and Namibia during summer, while the opposite happens during winter (cold and dry). Consequently, the outbreak in the region recorded an increasing trend during winter and subsided during the summer, supporting the report by Gunthe et al. [ 58 ]. Novel coronavirus disease presents unique and grave challenges in Africa, as it has for the rest of the world. However, the infrastructure and resources have limitations for Africa countries facing COVID-19 pandemic and the threat of other diseases [ 59 ].

Conclusively, seasonal and regional climate patterns were associated with COVID-19 outbreaks globally. According to Kraemer et al. [ 60 ], they used real-time mobility data in Wuhan and early measurement presented a positive correlation between human mobility and spread of COVID-19 cases. However, after the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside of Wuhan.

Climate and weather

The term “weather” represents the changes in the environment that occur daily and in a short period, while “climate” is defined as atmospheric changes happening over a long time (over 3 months) in specific regions. Consequently, different locations would experience varying climates. Numerous reports suggested climate and weather variabilities as the main drivers that sped or slowed the transmission of SARS-CoV-2 worldwide [ 44 , 61 , 62 , 63 ].

From a meteorological perspective, a favourable environment has led to the continued existence of the COVID-19 virus in the atmosphere [ 64 ]. Studies demonstrated that various meteorological conditions, such as the rate of relative humidity (i.e. [ 28 ]), precipitation (i.e. [ 65 ]), temperature (i.e. [ 66 ]), and wind speed factors (i.e. [ 54 ]), were the crucial components that contributed to the dynamic response of the pandemic, influencing either the mitigation or exacerbation of novel coronavirus transmission. In other words, the environment was considered the medium for spreading the disease when other health considerations were put aside. Consequently, new opinions, knowledge, and findings are published and shared to increase awareness, thus encouraging preventive measures within the public.

The coronavirus could survive in temperatures under 30 °C with a relative humidity of less than 80% [ 67 ], suggesting that high temperatures and lower relative humidity contributed to the elicitation of COVID-19 cases [ 18 , 51 , 58 , 68 ]. Lagtayi et al. [ 7 ] highlighted temperature as a critical factor, evidently from the increased transmission rate of MERS-Cov in African states with a warm and dry climate. Similarly, the highest COVID-19 cases were recorded in dry temperate regions, especially in western Europe (France and Spain), China, and the USA, while the countries nearer to the equator were less affected. Nevertheless, the temperature factor relative to viral infections depends on the protein available in the viruses. According to Chen and Shakhnovich [ 69 ], there is a good correlation between decreasing temperature and the growth of proteins in virus. Consequently, preventive measures that take advantage of conducive environments for specific viruses are challenging.

Precipitation also correlates with influenza [ 43 ]. A report demonstrated that regions with at least 150 mm of monthly precipitation threshold level experienced fewer cases than regions with lower precipitation rates. According to Martins et al. [ 70 ], influenza and COVID-19 can be affected by climate, where virus can be spread through the respiratory especially during rainfall season. The daily spread of Covid-19 cases in tropical countries, which receive high precipitation levels, are far less than in temperate countries [ 27 ]. Likewise, high cases of COVID-19 were reported during the monsoon season (mid-year) in India during which high rainfall is recorded [ 71 ]. Moreover, the majority of the population in these regions has lower vitamin D levels, which may contribute to weakened immune responses during certain seasons [ 27 ].

Rainfall increases the relative atmospheric humidity, which is unfavourable to the coronaviruses as its transmission requires dry and cold weather. Moreover, several reports hypothesised that rain could wash away viruses on object surfaces, which is still questioned. Most people prefer staying home on rainy days, allowing less transmission or close contact. Conversely, [ 72 ] exhibited that precipitation did not significantly impact COVID-19 infectiousness in Oslo, Norway due the location in northern hemisphere which are during winter season presenting so cold.

Coşkun et al. [ 54 ] and Wu et al. [ 29 ] claimed that wind could strongly correlate with the rate of COVID-19 transmission. Atmospheric instability (turbulent occurrences) leads to increased wind speed and reduces the dispersion of particulate matter (PM 2.5 and PM 10 ) in the environment and among humans. An investigation performed in 55 cities in Italy during the COVID-19 outbreak proved that the areas with low wind movement (stable atmospheric conditions) possessed a higher correlation coefficient and exceeded the threshold value of the safe level of PM 2.5 and PM 10 . Resultantly, more individuals were recorded infected with the disease in the regions. As mentioned in Martins et al. [ 70 ] the COVID-19 can be affected by climate and the virus can be spread through respiratory which is the virus moving in the wind movement.

The relationship between temperature and humidity

Climatic parameters, such as temperature and humidity, were investigated as the crucial factors in the epidemiology of the respiratory virus survival and transmission of COVID-19 ([ 61 ]; S [ 73 , 74 ].). The rising number of confirmed cases indicated the strong transmission ability of COVID-19 and was related to meteorological parameters. Furthermore, several studies found that the disease transmission was associated with the temperature and humidity of the environment [ 55 , 64 , 68 , 75 ], while other investigations have examined and reviewed environmental factors that could influence the epidemiological aspects of Covid-19.

Generally, increased COVID-19 cases and deaths corresponded with temperature, humidity, and viral transmission and mortality. Various studies reported that colder and dryer environments favoured COVID-19 epidemiologically [ 45 , 76 , 77 ]. As example tropical region, the observations indicated that the summer (middle of year) and rainy seasons (end of the year) could effectively diminish the transmission and mortality from COVID-19. High precipitation statistically increases relative air humidity, which is unfavourable for the survival of coronavirus, which prefers dry and cold conditions [ 32 , 34 , 78 , 79 ]. Consequently, warmer conditions could reduce COVID-19 transmission. A 1 °C increase in the temperature recorded a decrease in confirmed cases by 8% increase [ 45 ].

Several reports established that the minimum, maximum, and average temperature and humidity correlated with COVID-19 occurrence and mortality [ 55 , 80 , 81 ]. The lowest and highest temperatures of 24 and 27.3 °C and a humidity between 76 and 91% were conducive to spreading the virulence agents. The propagation of the disease peaked at the average temperature of 26 °C and humidity of 55% before gradually decreasing with elevated temperature and humidity [ 78 ].

Researchers are still divided on the effects of temperature and humidity on coronavirus transmission. Xu et al. [ 26 ] confirmed that COVID-19 cases gradually increased with higher temperature and lower humidity, indicating that the virus was actively transmitted in warm and dry conditions. Nevertheless, several reports stated that the spread of COVID-19 was negatively correlated with temperature and humidity [ 10 , 29 , 63 ]. The conflicting findings require further investigation. Moreover, other factors, such as population density, elderly population, cultural aspects, and health interventions, might potentially influence the epidemiology of the disease and necessitate research.

Governmental disinfection actions and guidelines

The COVID-19 is a severe health threat that is still spreading worldwide. The epidemiology of the SAR-CoV-2 virus might be affected by several factors, including meteorological conditions (temperature and humidity), population density, and healthcare quality, that permit it to spread rapidly [ 16 , 17 ]. Nevertheless, in 2020, no effective pharmaceutical interventions or vaccines were available for the diagnosis, treatment, and epidemic prevention against COVID-19 [ 73 , 82 ]. Consequently, after 2020 the governments globally have designed and executed non-pharmacological public health measures, such as lockdown, travel bans, social distancing, quarantine, public place closure, and public health actions, to curb the spread of COVID-19 infections and several studies have reported on the effects of these plans [ 13 , 83 ].

The COVID-19 is mainly spread via respiratory droplets from an infected person’s mouth or nose to another in close contact [ 84 ]. Accordingly, WHO and most governments worldwide have recommended wearing facemasks in public areas to curb the transmission of COVID-19. The facemasks would prevent individuals from breathing COVID-19-contaminated air [ 85 ]. Furthermore, the masks could hinder the transmission of the virus from an infected person as the exhaled air is trapped in droplets collected on the masks, suspending it in the atmosphere for longer. The WHO also recommended adopting a proper hand hygiene routine to prevent transmission and employing protective equipment, such as gloves and body covers, especially for health workers [ 86 ].

Besides wearing protective equipment, social distancing was also employed to control the Covid-19 outbreak [ 74 , 87 ]. Social distancing hinders the human-to-human transmission of the coronavirus in the form of droplets from the mouth and nose, as evidenced by the report from Sun and Zhai [ 88 ]. Conversely, Nair & Selvaraj [ 89 ] demonstrated that social distancing was less effective in communities and cultures where gatherings are the norm. Nonetheless, the issue could be addressed by educating the public and implementing social distancing policies, such as working from home and any form of plague treatment.

Infected persons, individuals who had contact with confirmed or suspected COVID-19 patients, and persons living in areas with high transmission rates were recommended to undergo quarantine by WHO. The quarantine could be implemented voluntarily or legally enforced by authorities and applicable to individuals, groups, or communities (community containment) [ 90 ]. A person under mandatory quarantine must stay in a place for a recommended 14-day period, based on the estimated incubation period of the SARS-CoV-2 [ 19 , 91 ]. According to Stasi et al. [ 92 ], 14-days period for mandatory quarantine it is presenting a clinical improvement after they found 5-day group and 10-day group can be decrease number of patient whose getting effect of COVID-19 from 64 to 54% respectively. This also proven by Ahmadi et al. [ 43 ] and Foad et al. [ 93 ], quarantining could reduce the transmission of COVID-19.

Lockdown and travel bans, especially in China, the centre of the coronavirus outbreak, reduced the infection rate and the correlation of domestic air traffic with COVID-19 cases [ 17 ]. The observations were supported by Sun & Zhai [ 88 ] and Sun et al. [ 94 ], who noted that travel restrictions diminished the number of COVID-19 reports by 75.70% compared to baseline scenarios without restrictions. Furthermore, example in Malaysia, lockdowns improved the air quality of polluted areas especially in primarily at main cities [ 95 ]. As additional, Martins et al. [ 70 ] measure the Human Development Index (HDI) with the specific of socio-economic variables as income, education and health. In their study, the income and education levels are the main relevant factors that affect the socio-economic.

A mandatory lockdown is an area under movement control as a preventive measure to stop the coronavirus from spreading to other areas. Numerous governments worldwide enforced the policy to restrict public movements outside their homes during the pandemic. Resultantly, human-to-human transmission of the virus was effectively reduced. The lockdown and movement control order were also suggested for individuals aged 80 and above or with low or compromised immunities, as these groups possess a higher risk of contracting the disease [ 44 ].

Governments still enforced movement orders even after the introduction of vaccines by Pfizer, Moderna, and Sinovac, as the vaccines only protect high-risk individuals from the worst effects of COVID-19. Consequently, in most countries, after receiving the first vaccine dose, individuals were allowed to resume life as normal but were still required to follow the standard operating procedures (SOP) outlined by the government.

The government attempted to balance preventing COVID-19 spread and recovering economic activities, for example, local businesses, maritime traders, shipping activities, oil and gas production and economic trades [ 22 , 96 ]. Nonetheless, the COVID-19 cases demonstrated an increasing trend during the summer due to the higher number of people travelling and on vacation, primarily to alleviate stress from lockdowns. Several new variants were discovered, including the Delta and Omicron strains, which spread in countries such as the USA and the United Kingdom. The high number of COVID-19 cases prompted the WHO to suggest booster doses to ensure full protection.

As mentioned in this manuscript, the COVID-19 still uncertain for any kind factors that can be affected on spreading of this virus. However, regarding many sources of COVID-19 study, the further assessment on this factor need to be continue to be sure, that we ready to facing probably in 10 years projection of solar minimum phase can be held in same situation for another pandemic.

The sun has an eleven-year cycle known as the solar cycle, related to its magnetic field, which controls the activities on its surface through sunspots. When the magnetic fields are active, numerous sunspots are formed on its surface, hence the sun produces more radiation energy emitted to the earth. The condition is termed solar maximum (see Fig.  6 , denoted by the yellow boxes). Alternatively, as the magnetic field of the sun weakens, the number of sunspots decreases, resulting in less radiation energy being emitted to the earth. The phenomenon is known as the solar minimum (see Fig. 6 , represented by the blue boxes).

The emergence and recurrence of pandemics every 5 years in relation to solar activities ( Source: www.swpc.noaa.gov/ ). Note: The yellow boxes indicate the solar maximum, while the blue boxes represent the solar minimum

The magnetic field of the sun protects the earth from cosmic or galactic cosmic rays emitted by supernova explosions, stars, and gamma-ray bursts [ 97 ]. Nevertheless, galactic cosmic rays could still reach the earth during the solar minimum, the least solar radiation energy period. In the 20th and early 21st centuries, several outbreaks of viral diseases that affected the respiratory system (pneumonia or influenza), namely the Spanish (1918–1919), Asian (1957–1958) and Hong Kong (1968) flu, were documented. Interestingly, the diseases that claimed numerous lives worldwide occurred at the peak of the solar maximum.

Figure  6 illustrates the correlation between the number of sunspots and disease outbreaks from 1975 to 2021, including COVID-19, that began to escalate in December 2019. Under the solar minimum conditions, the spread of Ebola (1976), H5N1 (1997–1998), H1N1 (2009), and COVID-19 (2019-2020) were documented, while the solar maximum phenomenon recorded SARS (2002) and H7N9 (2012–2013) or MERS outbreaks. Nonetheless, solar activity through the production of solar sunspots began to decline since the 22nd solar cycle. Accordingly, further studies are necessary to investigate the influence such solar variations could impart or not on pandemic development.

Despite the findings mentioned above, the sun and cosmic radiations could influence the distribution or outspread of disease-spreading viruses. The rays could kill the viruses via DNA destruction or influence their genetic mutations, which encourage growth and viral evolution. Nevertheless, the connection between radiation and the evolutionary process requires further study by specialists in the field it is become true or not.

The spread of viral diseases transpires naturally in our surroundings and occurs unnoticed by humans. According to records, the spread of pandemic diseases, including the Black Death (fourteenth century) and the Spanish flu (1919), was significantly influenced by the decline and peak of solar activities. Furthermore, in the past 20 years, various diseases related to the influenza virus have been recorded. According to the pattern observed, if all diseases were related to the solar cycle (solar maximum and minimum), the viral diseases would reoccur every 5 to 6 years since they first appeared between 1995 and 2020. Accordingly, the next pandemic might occur around 2024 or 2025 and need to have a proper study for prove these statements. Nonetheless, the activities on the surface of the sun have been weakening since the 23rd solar cycle and it can be proven later after the proper study can be make it.

The beginning of the COVID-19 spread, only several countries with the same winter climate with an average temperature of 5–11 °C and an average humidity rate of 47–79% located at latitudes 30–50 N reported cases. The areas included Wuhan distribution centres in China, the United Kingdom, France, Spain, South Korea, Japan, and the USA (see Fig.  5 ). Other than biological aspects, the higher number of confirmed cases recorded in colder environments was due to the human body secreting less lymphoproliferative hormone, leading to decreased immunogenicity effects and increased risk of infection [ 24 ]. Consequently, the virus could attack and rapidly infect humans during the period [ 1 , 54 ].

The lymphoproliferative response is a protective immune response that plays a vital role in protecting and eradicating infections and diseases. On the other hand, staying in warm conditions or being exposed to more sunlight would lower the risks of infection. According to Asyary and Veruswati [ 98 ], sunlight triggers vitamin D, which increases immunity and increases the recovery rates of infected individuals.

Researchers believe that viruses could survive in the environment for up to 3 to 4 years or even longer. The survival rate of the microorganisms is relatively high, which is related to their biological structures, adaptability on any surfaces, and transmission medium to spread diseases. Viruses possess simple protein structures, namely the spike, membrane, and envelope protein; therefore, when they enter living organisms (such as through the respiratory system), the viruses are easily transmitted.

Once they have entered a host, the viruses duplicate exponentially and swarm the lungs. Subsequently, after the targeted organs, such as the lungs, are invaded, the viruses attack the immune system and create confusion in protective cells to destroy healthy cells. The situation is still considered safe in younger and healthy individuals as their immune systems could differentiate and counter-attack the viruses, curing them. Nonetheless, in elders and individuals with several chronic diseases, most of their protective cells are dead, hence their immune system is forced to work hard to overcome the infection. Pneumonia and death tend to occur when the situation is overwhelming [ 85 ]. Consequently, the viruses are harmful to humans as they could multiply in a short period, enter the blood, and overrun the body.

The coronavirus could attach to surfaces without a host, including door knobs and steel and plastic materials. The microorganisms could survive alone, but virologists have yet to determine how long. If someone touches any surface with the virus, the individual would then be infected. The situation would worsen if the infected person contacted numerous people and became a super spreader. A super spreader does not exhibit any symptoms and continuously transmits the virus without realising it. An infected individual transmits the coronavirus via droplets from coughs or sneezes. Nevertheless, scientists have yet to determine if coronavirus is spread via airborne or droplets, hence requiring thorough evaluation [ 99 ].

The COVID-19 virus mutates over time, and it can be changing any times. Mutations alter the behaviour and genetic structure of the virus, resulting in a new strain. Numerous research have been conducted to procure vaccines and anti-viral medications, but mutations have led to evolutionary disadvantages. The novel strains are more infectious than the original ones. As of November 2020, approximately six new coronavirus strains have been detected, each displaying different transmission behaviours [ 100 ].

Recent studies demonstrated that the mutated viruses exhibit little variability, allowing scientists to produce viable vaccines [ 71 ]. Furthermore, different types of vaccines are manufactured by different countries, which could be advantageous. Currently, most countries also recommend booster doses to attain extra protection after receiving the mandatory two vaccine doses. In same time, the social and physical interactions between humans also necessitate to be aware.

The COVID-19 virus is primarily transmitted through droplets produced by an infected person. Accordingly, physical distancing, a one-metre minimum distance between individuals [ 19 ], and following the SOP might prevent or avoid spreading the disease. Moreover, self-quarantine, school closures, working from home, cancelling large events, limiting gatherings, and avoiding spending long periods in crowded places are essential strategies in enforcing physical distancing at a community level. The policies are essential precautions that could reduce the further spreading of coronavirus and break the chain of transmission.

Government support also need to control the spread of COVID-19 with the strict SOP. The SOP enforcement in public places would enhance adherence to the new practice among the public and the community, aiding in curbing disease transmission. Practising limited meetings and social gatherings, avoiding crowded places, workplace distancing, preventing non-necessary travels of high-risk family members, especially those with chronic disease, and adhering to the recommended SOP could reduce coronavirus outbreaks. Nonetheless, individual awareness is also necessary to achieve COVID-19 spread prevention.

Many researchers are focused on identifying the primary drivers of pandemic outbreaks. Seasonal, temperature, and humidity differences significantly impacted COVID-19 growth rate variations. It is crucial to highlight the potential link between the recurrence of pandemics every 5 years and solar activities, which can influence temperature and humidity variations. Notable variations in COVID-19 mortality rates were observed between northern and southern hemisphere countries, with the former having higher rates. One hypothesis suggests that populations in the northern hemisphere may receive insufficient sunlight to maintain optimal vitamin D levels during winter, possibly leading to higher mortality rates.

The first COVID-19 case was detected in Wuhan, China, which is in the northern hemisphere. The number of cases rapidly propagated in December during the winter season. At the time, the temperature in Wuhan was recorded at 13–18 °C. Accordingly, one theory proposes that the survival and transmission of the coronavirus were due to meteorological conditions, namely temperatures between 13 and 18 °C and 50–80% humidity.

Daily rainfall directly impacts humidity levels. The coronavirus exhibited superior survival rates in cold and dry conditions. Furthermore, transmissible gastroenteritis (TGEV) suspensions and possibly other coronaviruses remain viable longer in their airborne states, which are more reliably collected in low relative humidity than in high humidity. Consequently, summer rains would effectively reduce COVID-19 transmission in southern hemisphere regions.

In southern hemisphere regions, the summer seasons are accompanied by a high average temperature at the end and beginning of the year. Countries with temperatures exceeding 24 °C reported fewer infections. As temperatures rise from winter to summer, virus transmission is expected to decline. Nonetheless, the activities and transmission of the virus were expected to decrease during winter to summer transitions, when the countries would be warmer. The peak intensity of infections strongly depends on the level of seasonal transmissions.

Social distancing plays a critical role in preventing the overload of healthcare systems. Many respiratory pathogens, including those causing mild common cold-like syndromes, show seasonal fluctuations, often peaking in winter. This trend can be attributed to increased indoor crowding, school reopening, and climatic changes during autumn.

The spread of COVID-19 to neighbouring regions can be attributed to population interactions. Migration patterns, such as the movement from northern to southern regions during the warmer months, have significant epidemiological impacts. This trend mirrors the behavior of influenza pandemics where minor outbreaks in spring or summer are often followed by major waves in autumn or winter.

Availability of data and materials

Not applicable.

Abbreviations

Novel coronavirus

Coronavirus disease 2019

Deoxyribonucleic acid

Swine influenza

Influenza A virus subtype H5N1

Asian Lineage Avian Influenza A(H7N9) Virus

Middle East respiratory syndrome

Middle East respiratory syndrome Coronavirus

Particulate matter

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

RepOrting standards for Systematic Evidence Syntheses

Severe Acute Respiratory Syndrome

Severe Acute Respiratory Syndrome Coronavirus

Syndrome coronavirus 2

Systematic literature review

Standard operating procedure

Transmissible gastroenteritis Virus

United States of America

World Health Organization

Apanovich I. Climate and man. Opposition or natural stage of the earth’s evolution? Norwegian journal of development of the international. Science. 2019;26(25):12–27.

Google Scholar  

Borah P, Singh MK, Mahapatra S. Estimation of degree-days for different climatic zones of north-East India. Sustain Cities Soc. 2015;14(1):70–81.

Article   Google Scholar  

Chen D, Chen HW. Using the Köppen classification to quantify climate variation and change: an example for 1901-2010. Environmental Development. 2013;6(1):69–79.

Trenberth KE, Fasullo JT. Global warming due to increasing absorbed solar radiation. Geophys Res Lett. 2009;36

Hauschild MZ, Huijbregts MAJ, Guinée L, Lane J, Fantke P, Zelm v R, et al. Life Cycle Impact Assessment – The Complete World of Life Cycle Assessment; 2015. p. 345.

Book   Google Scholar  

Nakada LYK, Urban RC. COVID-19 pandemic: environmental and social factors influencing the spread of SARS-CoV-2 in São Paulo. Brazil Environmental Science and Pollution Research. 2021;28(30):40322–8.

Article   CAS   PubMed   Google Scholar  

Lagtayi, R., Lairgi, L., Daya, A., & Khouya, A. (2021). The impact of the average temperature, humidity, wind speed, altitude and population density on daily COVID-19 infections’ evolution. January, 9094.

Majumder MS, Liu D, Poirier C, Mandl KD, Lipsitch M, The MS. The role of absolute humidity on transmission rates of the COVID-19 outbreak; 2020.

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): A review. JAMA - Journal of the American Medical Association. 2020;324(8):782–93.

Zhang X, Maggioni V, Houser P, Xue Y, Mei Y. The impact of weather condition and social activity on COVID-19 transmission in the United States. J Environ Manag. 2022;302:114085.

Article   CAS   Google Scholar  

Mäkinen TM, Juvonen R, Jokelainen J, Harju TH, Peitso A, Bloigu A, et al. Cold temperature and low humidity are associated with increased occurrence of respiratory tract infections. Respir Med. 2009;103(3):456–62.

Article   PubMed   Google Scholar  

Carvalho FRS, Henriques DV, Correia O, Schmalwieser AW. Potential of solar UV radiation for inactivation of Coronaviridae family. Photochem Photobiol. 2021;97:213–20.

Ali I, Alharbi OM. COVID-19: disease, management, treatment, and social impact. Sci Total Environ. 2020;728:138861.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of covid-19. Viruses. 2020;12(4):1–17.

Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World health organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71–6.

Article   PubMed   PubMed Central   Google Scholar  

Wang J, Tang K, Feng K, Lv W. High temperature and high humidity reduce the transmission of COVID-19; 2020a.

Wang L, Duan Y, Zhang W, Liang J, Xu J, Zhang Y, et al. Epidemiologic and clinical characteristics of 26 cases of covid-19 arising from patient-to-patient transmission in Liaocheng, China. Clinical Epidemiology. 2020b;12:387–91.

Xie J, Zhu Y. Science of the Total environment association between ambient temperature and COVID-19 infection in 122 cities from China. Sci Total Environ. 2020;724:138201.

World Health Organization. (2020a). Director-General’s opening remarks at the media briefing on COVID-19-10April 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—10- april-2020.

Bostock B. South Korea is testing 200,000 members of a doomsday church linked to more than 60% of its coronavirus cases; 2020.

World Health Organization. (2020b). Health topics/coronavirus. https://www.who.int/health-topics/coronavirus#tab=tab_1.

Menhat M, Mohd Zaideen IM, Yusuf Y, Salleh NHM, Zamri MA, Jeevan J. The impact of Covid-19 pandemic: A review on maritime sectors in Malaysia. Ocean Coast Manag. 2021;209:105638.

Byun WS, Heo SW, Jo G, Kim JW, Kim S, Lee S, et al. Is coronavirus disease (COVID-19) seasonal? A critical analysis of empirical and epidemiological studies at global and local scales. Environ Res. 2021;196:110972.

Dhakal P, Pokhrel P, B. Seasonal variation and COVID-19 pandemic in Nepal. Nepal Medical Journal. 2020;3(2):77–80.

Mehmet Ş. Science of the Total environment impact of weather on COVID-19 pandemic in Turkey. 728; 2020.

Xu H, Yan C, Fu Q, Xiao K, Yu Y, Han D, et al. Science of the Total environment possible environmental effects on the spread of COVID-19 in China. Sci Total Environ. 2020;731:139211.

Rosario DKA, Mutz YS, Bernardes PC, Conte-Junior CA. Relationship between COVID-19 and weather: case study in a tropical country. Int J Hyg Environ Health. 2020;229:113587.

Wang J, Tang K, Feng K, Lin X, Lv W, Chen K, et al. Impact of temperature and relative humidity on the transmission of COVID-19: A modelling study in China and the United States. BMJ Open. 2021;11(2):1–16.

Wu Y, Jing W, Liu J, Ma Q, Yuan J, Wang Y, et al. Effects of temperature and humidity on the daily new cases and new deaths of COVID-19 in 166 countries. Sci Total Environ. 2020;729:1–7.

Casanova LM, Jeon S, Rutala WA, Weber DJ, Sobsey MD. Effects of air temperature and relative humidity on coronavirus survival on surfaces. Appl Environ Microbiol. 2010;76(9):2712–7.

Islam N, Bukhari Q, Jameel Y, Shabnam S, Erzurumluoglu AM, Siddique MA, et al. COVID-19 and climatic factors: A global analysis. Environ Res. 2021;193:110355.

Diao Y, Kodera S, Anzai D, Gomez-Tames J, Rashed EA, Hirata A. Influence of population density, temperature, and absolute humidity on spread and decay durations of COVID-19: A comparative study of scenarios in China, England, Germany, and Japan. One Health. 2021;12:100203.

Haddaway NR, Macura B, Whaley P, Pullin AS. ROSES reporting standards for systematic evidence syntheses: pro forma, flow-diagram and descriptive summary of the plan and conduct of environmental systematic reviews and systematic maps. Environ Evid. 2018;7(1):4–11.

Sharif N, Dey SK. Impact of population density and weather on COVID-19 pandemic and SARS-CoV-2 mutation frequency in Bangladesh. Epidemiol Infect. 2021:1–10.

Kraus S, Breier Dasí-Rodríguez S. El arte de elaborar una revisión bibliográfica sistemática en la investigación sobre el espíritu empresarial. Int Entrep Manag J. 2020;16:1023–42.

Xiao Y, Watson M. Guidance on conducting a systematic literature review. J Plan Educ Res. 2019;39(1):93–112.

Gusenbauer M, Haddaway NR. Which academic search systems are suitable for systematic reviews or meta-analyses? Evaluating retrieval qualities of Google scholar, PubMed, and 26 other resources. Res Synth Methods. 2020;11(2):181–217.

Halevi G, Moed H, Bar-Ilan J. Suitability of Google scholar as a source of scientific information and as a source of data for scientific evaluation—review of the literature. Journal of Informetrics. 2017;11(3):823–34.

Haddaway NR, Collins AM, Coughlin D, Kirk S. The role of google scholar in evidence reviews and its applicability to grey literature searching. PLoS One. 2015;10(9):1–17.

Littlewood C, Chance-Larsen K, McLean S. Quality appraisal as a part of the systematic review. International Journal of Physiotherapy and Rehabilitation. 2010;1(1):53–8.

Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.

Ahmadi M, Sharifi A, Dorosti S, Jafarzadeh Ghoushchi S, Ghanbari N. Investigation of effective climatology parameters on COVID-19 outbreak in Iran. Sci Total Environ. 2020;729

Gupta A, Banerjee S, Das S. Significance of geographical factors to the COVID-19 outbreak in India. Modeling Earth Systems and Environment. 2020;6(4):2645–53.

Pequeno P, Mendel B, Rosa C, Bosholn M, Souza JL, Baccaro F, et al. Air transportation, population density and temperature predict the spread of COVID-19 in Brazil. PeerJ. 2020;2020(6):1–15.

Hoyle F, Wickramasinghe NC. Sunspots and influenza [6]. Nature. 1990;343(6256):304.

Wickramasinghe NC, Rocca MC, Tokoro G, Temple R. Journal of infectious diseases. Scienctific Research and Community. 2020;1(4):1–10.

Wickramasinghe NC, Steele EJ, Wainwright M, Tokoro G, Fernando M, Qu J. Sunspot cycle minima and pandemics : A case for vigilance at the present time. Journal of Astrobiology & Outreach. 2017;5:2332–519.

Wickramasinghe NC, Qu J. Are we approaching a new influenza pandemic. Virol Curr Res. 2018;2(107):2.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Disease 2019 in China; 2020.

Bashir MF, Ma B, Bilal K, Bashir MA, Tan D, Bashir M. Correlation between climate indicators and COVID-19 pandemic in New York, USA. Sci Total Environ. 2020;728:138835.

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:157–60.

PubMed   PubMed Central   Google Scholar  

Lin C, Lau AKH, Fung JCH, Guo C, Chan JWM, Yeung DW, et al. A mechanism-based parameterisation scheme to investigate the association between transmission rate of COVID-19 and meteorological factors on plains in China. Sci Total Environ. 2020;737:140348.

Coşkun H, Yıldırım N, Gündüz S. The spread of COVID-19 virus through population density and wind in Turkey cities. Sci Total Environ. 2021;751

Yang HY, Lee JKW. The impact of temperature on the risk of covid-19: A multinational study. Int J Environ Res Public Health. 2021;18(8)

Candido DD, Watts A, Abade L, Kraemer MUG, Pybus OG, Croda J, et al. Routes for COVID-19 importation in Brazil. Journal of Travel Medicine. 2020;27(3):1–3.

Hardy JP, Groffman PM, Fitzhugh RD, Henry KS, Welman AT, Demers JD, et al. Snow depth manipulation and its influence on soil frost and water dynamics in a northern hardwood forest. Biogeochemistry. 2001;56(2):151–74.

Gunthe SS, Swain B, Patra SS, Amte A. On the global trends and spread of the COVID-19 outbreak: preliminary assessment of the potential relation between location-specific temperature and UV index. Journal of Public Health (Germany). 2020:1–10.

Rosenthal PJ, et al. COVID-19: shining the light on Africa. Am J Trop Med Hyg. 2020;102(6):1145–8.

Kraemer MUG, et al. The effect of human mobility and control measures on the COVID-19 epidemic in China. Science. 2020;368:493–7.

Dalziel BD, Kissler S, Gog JR, Viboud C, Bjørnstad ON, Metcalf CJE, et al. Urbanization and humidity shape the intensity of influenza epidemics in U.S. cities. Science. 2018;362:75–9.

Sahoo PK, Powell MA, Mittal S, Garg VK. Is the transmission of novel coronavirus disease (COVID-19) weather dependent? J Air Waste Manage Assoc. 2020;70(11):1061–4.

Selcuk M, Gormus S, Guven M. Impact of weather parameters and population density on the COVID-19 transmission: evidence from 81 provinces of Turkey. Earth Syst Environ. 2021;5(1):87–100.

Abraham J, Turville C, Dowling K, Florentine S. Does climate play any role in covid-19 spreading?—an Australian perspective. Int J Environ Res Public Health. 2021;18(17)

Sehra ST, Salciccioli JD, Wiebe DJ, Fundin S, Baker JF. Maximum daily temperature, precipitation, ultraviolet light, and rates of transmission of severe acute respiratory syndrome coronavirus 2 in the United States. Clin Infect Dis. 2020;71(9):2482–7.

CAS   PubMed   Google Scholar  

Rubin D, Huang J, Fisher BT, Gasparrini A, Tam V, Song L, et al. Association of Social Distancing, population density, and temperature with the instantaneous reproduction number of SARS-CoV-2 in counties across the United States. JAMA Netw Open. 2020;3(7):1–12.

Comunian S, Dongo D, Milani C, Palestini P. Air pollution and covid-19: The role of particulate matter in the spread and increase of covid-19’s morbidity and mortality. Int J Environ Res Public Health. 2020;17(12):1–22.

Tosepu R, Gunawan J, Effendy DS, Ahmad LOAI, Lestari H, Bahar H, et al. Correlation between weather and Covid-19 pandemic in Jakarta, Indonesia. Sci Total Environ. 2020;725

Chen and Shakhnovich. Thermal adaptation of viruses and Bacteria. Biophys J. 2010;98:1109–18.

Martins LD, da Silva I, Batista WV, Andrade MF, Freitas ED, Jorge Alberto Martins JA. How socio-economic and atmospheric variables impact COVID-19 and influenza outbreaks in tropical and subtropical regions of Brazil. Environ Res. 2020;191:110184.

Kulkarni H, Khandait H, Narlawar UW, Rathod P, Mamtani M. Independent association of meteorological characteristics with initial spread of Covid-19 in India. Sci Total Environ. 2021;764:142801.

Menebo MM. Science of the Total environment temperature and precipitation associate with Covid-19 new daily cases : A correlation study between weather and Covid-19 pandemic in. Sci Total Environ. 2020;737:139659.

Gupta S, Patel KK. Global Epidemiology of First 90 Days into COVID-19 Pandemic :Disease Incidence , Prevalence , Case Fatality Population Density, Urbanisation. J Health Manag. 2020;22(2):117–28.

Haque SE, Rahman M. Association between temperature, humidity, and COVID-19 outbreaks in Bangladesh. Environ Sci Pol. 2020;114:253–5.

Sharma P, Singh AK, Agrawal B, Sharma A. Correlation between weather and COVID-19 pandemic in India: an empirical investigation. J Public Aff. 2020;20(4)

Fu S, Wang B, Zhou J, Xu X, Liu J, Ma Y, et al. Meteorological factors, governmental responses and COVID-19: evidence from four European countries. Environ Res. 2021;194:110596.

Mecenas P, Bastos RT, Vallinoto AC, Normando D. Effects of temperature and humidity on the spread of COVID-19: A systematic review. PLoS One. 2020;15:1–21.

Malki Z, Atlam ES, Hassanien AE, Dagnew G, Elhosseini MA, Gad I. Association between weather data and COVID-19 pandemic predicting mortality rate: machine learning approaches. Chaos, Solitons Fractals. 2020;138:110137.

Sasikumar K, Nath D, Nath R, Chen W. Impact of extreme hot climate on COVID-19 outbreak in India. GeoHealth. 2020;4(12)

Kodera S, Rashed EA, Hirata A. Correlation between COVID-19 morbidity and mortality rates in Japan and local population density, temperature, and absolute humidity. Int J Environ Res Public Health. 2020;17(15):1–14.

Sobral MFF, Duarte GB, da Penha Sobral AIG, Marinho MLM, de Souza Melo A. Association between climate variables and global transmission oF SARS-CoV-2. Sci Total Environ. 2020;729:138997.

Patel SK, Pathak M, Tiwari R, Yatoo MI, Malik YS. A vaccine is not too far for COVID-19 coronavirus pandemic A vaccine is not too far for COVID-19. May; 2020.

Nicola M, Neill NO, Sohrabi C, Khan M, Agha M, Agha R. Evidence based management guideline for the COVID-19 pandemic - review article. Int J Surg. 2020;77:206–16.

Atangana E, Atangana A. Facemasks simple but powerful weapons to protect against COVID-19 spread: can they have sides effects? Results in Physics. 2020;19:103425.

Sarmadi M, Moghanddam VK, Dickerson AS, Martelletti L. Association of COVID-19 distribution with air quality, sociodemographic factors, and comorbidities: an ecological study of US states. Air Qual Atmos Health. 2021;14(4):455–65.

Chung CJ, Nazif TM, Wolbinski M, Hakemi E, Lebehn M, Brandwein R, et al. The restructuring of structural heart disease practice during The Covid-19 pandemic. J Am Coll Cardiol. 2020; InPress

Bukhari Q, Massaro JM, D’agostino RB, Khan S. Effects of weather on coronavirus pandemic. Int J Environ Res Public Health. 2020;17(15):1–12.

Sun C, Zhai Z. The efficacy of social distance and ventilation effectiveness in preventing COVID-19 transmission. Sustain Cities Soc. 2020;62:102390.

Nair N, Selvaraj P. Using a cultural and social identity lens to understand pandemic responses in the US and India. Int J Cross-cult Manag. 2021;21(3):545–68.

Cetron M, Landwirth J. Public health and ethical considerations in planning for quarantine. Yale J Biol Med. 2005;78(5):325–30.

Jernigan DB. Update: public health response to the coronavirus disease 2019 outbreak—United States, February 24, 2020. MMWR. Morbidity and mortality weekly report, 69. 2020.

Stasi C, Fallani S, Voller F, Silvestri C. Treatment for COVID-19: an overview. Eur J Pharmacol. 2020;889:173644.

Foad CAKK, Xun N, Pejman J, Nataraj RC. Nonlinear dynamic analysis of an epidemiological model for COVID-19 including public behavior and government action. Nonlinear Dynamics. 2020;101(3):1545–59.

Sun Z, Zhang H, Yang Y, Wan H, Wang Y. Science of the Total environment impacts of geographic factors and population density on the COVID-19 spreading under the lockdown policies of China. Sci Total Environ. 2020;746(666):141347.

Abdullah S, Mansor AA, Napi NNLM, Mansor WNW, Ahmed AN, Ismail M, et al. Air quality status during 2020 Malaysia movement control order (MCO) due to 2019 novel coronavirus (2019-nCoV) pandemic. Sci Total Environ. 2020;729:139022.

Menhat M, Yusuf Y. Factors influencing the choice of performance measures for the oil and gas supply chain - exploratory study. IOP Conference Series: Materials Science and Engineering. 2018;342(1)

Ćirkovića MM, Vukotića B. Long-term prospects: mitigation of supernova and gamma-ray burst threat to intelligent beings. Acta Astronautica. 2016;129:438–46.

Asyary A, Veruswati M. Science of the Total environment sunlight exposure increased Covid-19 recovery rates : A study in the central pandemic area of Indonesia. Sci Total Environ. 2020;729:139016.

Jayaweeraa M, Pererab H, Gunawardanaa B, Manatungea J. Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environ Res. 2020;188:1–18.

Leung K, Shum MHH, Leung GM, Lam TTY, Wu JT. Early transmissibility assessment of the N501Y mutant strains of SARS-CoV-2 in the United Kingdom, October to November 2020. Euro Surveill. 2020;26(1)

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The authors would also like to acknowledge the Editors and an anonymous reviewer, who contributed immensely to improving the quality of this publication and a special thanks to Muhammad Hafiy Nauwal Effi Helmy, that contributed an excellent idea through singing during the COVID-19 lockdown period.

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Menhat, M., Ariffin, E.H., Dong, W.S. et al. Rain, rain, go away, come again another day: do climate variations enhance the spread of COVID-19?. Global Health 20 , 43 (2024). https://doi.org/10.1186/s12992-024-01044-w

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R&D investment and corporate total factor productivity under the heterogeneous environmental regulations: evidence from Chinese micro firms

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• Published: 19 May 2024

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• X. Ding   ORCID: orcid.org/0000-0001-7213-1948 1 ,
• Y. Zhang 2   na1 ,
• Y. Fu 2   na1 &

Technological innovation activities are the most effective way to achieve corporate leapfrog development. Based on the Porter effect theory, this paper uses panel data on Chinese manufacturing firms from 2015 to 2018 to construct two-way fixed effects and threshold effects models to explore the impact mechanism of research and development (R&D) investment on corporate total factor productivity (CTFP) under heterogeneous environmental regulations. Baseline regression results indicate that R&D investment significantly promotes CTFP. Meanwhile, we also test the robustness of baseline regression results by replacing the dependent variable, shortening the time windows and adding omitted variables. Moreover, heterogeneity analyses indicate that the contribution of R&D investment to CTFP is more significant in the subgroup regressions of non-SOEs, CEO-dual enterprises and non-heavily polluting enterprises. Economic consequence analysis shows that R&D investment contributes to green innovation performance, financial performance and corporate social responsibility performance by increasing CTFP. Additionally, there is heterogeneity in the moderating effects of market-incentivized environmental regulation (MER), command-and-control environmental regulation (CER) and public participation environmental regulation (PER). MER and PER have moderated mediating effects, but CER does not have a moderated mediating effect. Extended analysis shows that according to the threshold effect test findings, two thresholds exist for MER and one threshold each for PER and CER in the relationship between R&D investment and CTFP. Our findings have important implications in that the government should adopt differentiated environmental regulation policies to support companies in actively carrying out innovation activities, thereby promoting high-quality development.

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Bae J, Oh H, Kim S (2022) Advertising role of CSR and strategic investment in R&D: evidence from the biohealth industry. J Curr Issues Res Advert 44(1):105–121. https://doi.org/10.1080/10641734.2022.2131655

Article   Google Scholar  

Baldi G, Bodmer A (2017) R&D investments and Corporate cash holdings. Econ Innov New Technol. https://doi.org/10.1080/10438599.2017.1378191

Bao Q, Chai H (2022) Environmental regulation, financial resource allocation, and regional green technology innovation efficiency. Discrete Dyn Nat Soc 2022:1–11. https://doi.org/10.1155/2022/7415769

Bengoa M, Román VMS, Pérez P (2017) Do R&D activities matter for productivity? A regional spatial approach assessing the role of human and social capital. Econ Model 60:448–461. https://doi.org/10.1016/j.econmod.2016.09.005

Chen W, Chen S, Wu T (2022a) Research of the impact of heterogeneous environmental regulation on the performance of China’s manufacturing enterprises. Front Environ Sci. https://doi.org/10.3389/fenvs.2022.948611

Chen J, Wang X, Shen W, Tan Y, Matac LM, Samad S (2022b) Environmental Uncertainty, environmental regulation and enterprises’ green technological innovation. Int J Environ Res Public Health 19(16):9781. https://doi.org/10.3390/ijerph19169781

Chen M, Shi V, Wei X (2022c) Environmental regulations, R&D intensity, and enterprise profit rate: understanding firm performance in heavy pollution industries. Front Environ Sci. https://doi.org/10.3389/fenvs.2022.1077209

Dai L, Zhang J, Luo S (2022) Effective R&D capital and total factor productivity: evidence using spatial panel data models. Technol Forecast Soc Chang 183:121886. https://doi.org/10.1016/j.techfore.2022.121886

Dechezleprêtre A, Sato M (2017) The impacts of environmental regulations on competitiveness. Rev Environ Econ Policy 11(2):183–206. https://doi.org/10.1093/reep/rex013

Ding X, Xu Z, Petrovskaya MV, Wu K, Ye L, Sun Y, Makarov VM (2023) Exploring the impact mechanism of executives’ environmental attention on corporate green transformation: evidence from the textual analysis of Chinese companies’ management discussion and analysis. Environ Sci Pollut Res 30(31):76640–76659. https://doi.org/10.1007/s11356-023-27725-4

Edquist H, Henrekson M (2017) Do R&D and ICT affect total factor productivity growth differently? Telecommun Policy 41(2):106–119. https://doi.org/10.1016/j.telpol.2016.11.010

Erdin C, Ozkaya G (2020) R&D investments and quality of life in Turkey. Heliyon. https://doi.org/10.1016/j.heliyon.2020.e04006

Ezzi F, Jarboui A, Zouari-Hadiji R (2020) Exploring the relationship between managerial emotional intelligence, R&D and CSR performance: a mediated moderation analysis. J High Technol Manag Res 31(2):100387. https://doi.org/10.1016/j.hitech.2020.100387

Fan J, Teo T (2022) Will China’s R&D investment improve green innovation performance? an empirical study. Environ Sci Pollut Res 29(26):39331–39344. https://doi.org/10.1007/s11356-021-18464-5

Gao X, Dong Z (2022) Technological innovation and the complexity of imported technology: moderating effects based on environmental regulation. Front Environ Sci. https://doi.org/10.3389/fenvs.2022.996867

Guo X, Li K, Yu S, Wei B (2021) Enterprises’ R&D investment, venture capital syndication and IPO underpricing. Sustainability 13(13):7290. https://doi.org/10.3390/su13137290

Hadlock CJ, Pierce JR (2010) New evidence on measuring financial constraints: moving beyond the KZ index. Rev Financ Stud 23(5):1909–1940. https://doi.org/10.1093/rfs/hhq009

Han C, Zhang WG, Feng ZB (2017) How does environmental regulation remove resource misallocation-an analysis of the first obligatory pollution control in china. China Ind Econ 4:115–134. https://doi.org/10.19581/j.cnki.ciejournal.2017.04.007

Hansen BE (2000) Sample splitting and threshold estimation. Econometrica 68(3):575–603. https://doi.org/10.1111/1468-0262.00124

Huang MC, Liou MH, Iwaki Y (2020) The impact of R&D and innovation on global supply Chain transition: GTAP analysis on Japan’s public R&D investment. J Soc Econ Dev 23(S3):447–467. https://doi.org/10.1007/s40847-020-00113-1

Huang H, Qi B, Chen L (2022) Innovation and high-quality development of enterprises—also on the effect of innovation driving the transformation of China’s economic development model. Sustainability 14(14):8440. https://doi.org/10.3390/su14148440

Igartua JJ, Hayes AF (2021) Mediation, moderation, and conditional process analysis: concepts, computations, and some common confusions. Span J Psychol 24:E49. https://doi.org/10.1017/sjp.2021.46

Jiang Y, Qin S, Xu Y (2022) Impact of green credit policy on sustainability performance of high-pollution enterprises. Environ Sci Pollut Res 29:79199–79213. https://doi.org/10.1007/s11356-022-21315-6

Kim SI, Kim KT (2020) The differentiated CSR activities and corporate value. Asian Rev Account 29(1):19–41. https://doi.org/10.1108/ara-05-2020-0067

Lee M, Choi M (2015) Analysis on time-lag effect of research and development investment in the pharmaceutical industry in Korea. Osong Public Health Res Perspect 6(4):241–248. https://doi.org/10.1016/j.phrp.2015.07.001

Levinsohn J, Petrin A (2003) Estimating production functions using inputs to control for unobservables. Rev Econ Stud 70(2):317–341. https://doi.org/10.1111/1467-937x.00246

Li J, Wu X (2022) The S-shaped relationship between R&D investment and green innovation after cross-border merge and acquisition: evidence from China. Environ Sci Pollut Res 29(36):55039–55057. https://doi.org/10.1007/s11356-022-19739-1

Li X, Yang Y (2022) The relationship between air pollution and company risk-taking: the moderating role of Digital Finance. Front Environ Sci 10:988450. https://doi.org/10.3389/fenvs.2022.988450

Li X, Cheng B, Li Y, Duan J, Tian Y (2022) The relationship between enterprise financial risk and R&D investment under the influence of the COVID-19. Front Public Health. https://doi.org/10.3389/fpubh.2022.910758

Liu Z, Ling Y (2022) Structural transformation, total factor productivity and high-quality development. China Econom 17(1):70–82. https://doi.org/10.19602/j.chinaeconomist.2022.01.06

Lu XD, Lian YJ (2012) Estimation of total factor productivity of industrial enterprises in China:1999–2007. China Econ Q 11(02):179–196. https://doi.org/10.13821/j.cnki.ceq.2012.02.013

Lv K, Zhu S, Liang R, Zhao Y (2023) Environmental regulation, breakthrough technological innovation and total factor productivity of firms–evidence from emission charges of China. Appl Econ. https://doi.org/10.1080/00036846.2023.2175776

Mbanyele W, Wang F (2021) Environmental regulation and technological innovation: evidence from China. Environ Sci Pollut Res 29(9):12890–12910. https://doi.org/10.1007/s11356-021-14975-3

Michelino F, Lamberti E, Cammarano A, Caputo M (2015) Open innovation in the pharmaceutical industry: an empirical analysis on context features, internal R&D, and financial performances. IEEE Trans Eng Manage 62(3):421–435. https://doi.org/10.1109/tem.2015.2437076

Mulaessa N, Lin L (2021) How do proactive environmental strategies affect green innovation? The moderating role of environmental regulations and firm performance. Int J Environ Res Public Health 18(17):9083. https://doi.org/10.3390/ijerph18179083

Nandy M (2020) Is there any impact of R&D on financial performance? Evidence from Indian Pharmaceutical Companies. FIIB Bus Rev 9(4):319–334. https://doi.org/10.1177/2319714520981816

Olley GS, Pakes A (1996) The dynamics of productivity in the telecommunications equipment industry. Econometrica 64(6):1263. https://doi.org/10.2307/2171831

Qiu W, Zhang J, Wu H, Irfan M, Ahmad M (2021) The role of innovation investment and institutional quality on green total factor productivity: evidence from 46 countries along the “Belt and Road.” Environ Sci Pollut Res 29(11):16597–16611. https://doi.org/10.1007/s11356-021-16891-y

Salim R, Hassan K, Rahman S (2019) Impact of R&D expenditures, rainfall and temperature variations in agricultural productivity: empirical evidence from Bangladesh. Appl Econ 52(27):2977–2990. https://doi.org/10.1080/00036846.2019.1697422

Shah IH, Kollydas K, Lee PY, Malki I, Chu C (2022) Does R&D investment drive employment growth? Empirical evidence at industry level from japan. Int J Financ Econ. https://doi.org/10.1002/ijfe.2677

Shang Y, Song M, Zhao X (2022) The development of China’s circular economy: from the perspective of environmental regulation. Waste Manag 149:186–198. https://doi.org/10.1016/j.wasman.2022.05.027

Shao L, Liu Q (2022) Decision-making and the contract of the complementary product supply chain considering consumers’ environmental awareness and government green subsidies. Int J Environ Res Public Health 19(5):3100. https://doi.org/10.3390/ijerph19053100

Shi Y, Yang C (2022) How does multidimensional R&D investment affect green innovation? Evidence from China. Front Psychol. https://doi.org/10.3389/fpsyg.2022.947108

Tsamadias C, Pegkas P, Mamatzakis E, Staikouras C (2018) Does R&D, human capital and FDI matter for TFP in OECD countries? Econ Innov New Technol 28(4):386–406. https://doi.org/10.1080/10438599.2018.1502394

Voutsinas I, Tsamadias C (2014) Does research and development capital affect total factor productivity? Evidence from Greece. Econ Innov New Technol 23(7):631–651. https://doi.org/10.1080/10438599.2013.871169

Wang QY (2015) Fixed-effect panel threshold model using Stata. Stata J 15(1):121–13410

Wang J, Zhang Q, Li Q (2020) R&D investment and total factor productivity: an empirical study of the listed companies in the coastal regions of China. J Coastal Res 106(sp1):13. https://doi.org/10.2112/si106-004.1

Wang X, Fan M, Fan Y, Li Y, Tang X (2022a) R&D investment, financing constraints and corporate financial performance: empirical evidence from China. Front Environ Sci. https://doi.org/10.3389/fenvs.2022.1056672

Wang L, Long Y, Li C (2022b) Research on the impact mechanism of heterogeneous environmental regulation on enterprise green technology innovation. J Environ Manag 322:116127. https://doi.org/10.1016/j.jenvman.2022.116127

Woo Y, Kim E, Lim J (2017) The impact of education and R&D investment on regional economic growth. Sustainability 9(5):676. https://doi.org/10.3390/su9050676

Wu YQ, Li J, Ma JC (2022) The effect of innovation investment on environmental total factor productivity. Math Probl Eng 2022:1–13. https://doi.org/10.1155/2022/3100174

Wu J, Segerson K, Wang C (2023) Is environmental regulation the answer to pollution problems in urbanizing economies? J Environ Econ Manag 117:102754. https://doi.org/10.1016/j.jeem.2022.102754

Xiao Z, Peng H, Pan Z (2021) Innovation, external technological environment and the total factor productivity of enterprises. Account Finance 62(1):3–29. https://doi.org/10.1111/acfi.12779

Xu J, Liu F, Shang Y (2020) R&D investment, ESG performance and green innovation performance: evidence from China. Kybernetes 50(3):737–756. https://doi.org/10.1108/k-12-2019-0793

Yan J, Feng L, Denisov A, Steblyanskaya A, Oosterom J-P (2020) Complexity theory for the modern Chinese economy from an information entropy perspective: modeling of economic efficiency and growth potential. PLoS ONE 15(1):e0227206. https://doi.org/10.1371/journal.pone.0227206

Article   CAS   Google Scholar  

Yang B, Zhao Q (2023) The effects of environmental regulation and environmental protection investment on green technology innovation of enterprises in heavily polluting industries—based on threshold and mediation effect models. Front Environ Sci. https://doi.org/10.3389/fenvs.2023.1167581

Ye HY, Jiang S (2020) The impact of technological innovation on industrial green growth under the constraints of heterogeneous environmental regulations. West Forum Econ Manag 31(4):38–46. https://doi.org/10.12181/jjgl.2020.04.05

Yu X (2017) The mechanism of environmental regulation policy and its practice changes-based on the evolution of environmental regulation policy from 1978 to 2016. Forum Sci Technol China 12:15–31. https://doi.org/10.13580/j.cnki.fstc.2017.12.002

Yu F, Shi Y, Wang T (2020) R&D investment and Chinese manufacturing smes’ corporate social responsibility: the moderating role of regional innovative milieu. J Clean Prod 258:120840. https://doi.org/10.1016/j.jclepro.2020.120840

Yu F, Jiang D, Wang T (2022) The impact of green innovation on manufacturing small and medium enterprises corporate social responsibility fulfillment: the moderating role of regional environmental regulation. Corp Soc Responsib Environ Manag 29(3):712–727. https://doi.org/10.1002/csr.2231

Zhang Y, Chen H, He Z (2022) Environmental regulation, R&D investment, and green technology innovation in China: based on the PVAR model. PLoS ONE. https://doi.org/10.1371/journal.pone.0275498

Zhao X, Jia M (2022) Sincerity or hypocrisy: can green M&A achieve corporate environmental governance? Environ Sci Pollut Res 29(18):27339–27351. https://doi.org/10.1007/s11356-021-17464-9

Zhong QL, Liao GM, Lu ZF (2016) Does R&D investment improve the firm productivity? Based on the instrumental variable analysis of talent introduction policy. J Account Econ 30(5):3–16. https://doi.org/10.16314/j.cnki.31-2074/f.2016.05.001

Zhou B, Wu J, Guo S, Hu M, Wang J (2020) Environmental regulation and financial performance of Chinese listed companies. PLoS ONE. https://doi.org/10.1371/journal.pone.0244083

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Acknowledgements

The authors want to thank our editor and reviewers for their valuable comments and advice. The authors also want to acknowledge China Scholarship Council and the contribution of Professor Boris I. Sokolov to this paper.

This research was funded by the China Scholarship Council (Grant Nos. 202008090357, 202210280044, 202210280022, 202008090178).

Author information

Y. Zhang and Y. Fu have contributed to the work equally and should be regarded as co-second authors.

Authors and Affiliations

Faculty of Economics, RUDN University, Miklukho-Maklaya Street, 6, Moscow, Russia, 117198

Institute of Management, Economics and Finance, Kazan Federal University, Butlerova Street, 4, Kazan, Russia, 420010

Y. Zhang & Y. Fu

Institute of Economics and Management, Belgorod State Technological University, Ulitsa Kostyukova, 46, Belgorod, Russia, 308012

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Contributions

Xiaowei Ding: conceptualization, investigation, methodology, formal analysis, data curation, writing—original draft, and writing—review and editing and corresponding author. Yaqiong Zhang and Yongguang Fu contributed equally to this work: supervision, visualization, validation, and writing—review and editing. Zhenpeng Xu: conceptualization, supervision, and writing—review and editing. All the authors provided critical feedback and helped shape the research, analysis, and manuscript.

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Correspondence to X. Ding .

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Conflict of interest.

The authors declare no competing interests.

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Editorial responsibility: Maryam Shabani.

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Ding, X., Zhang, Y., Fu, Y. et al. R&D investment and corporate total factor productivity under the heterogeneous environmental regulations: evidence from Chinese micro firms. Int. J. Environ. Sci. Technol. (2024). https://doi.org/10.1007/s13762-024-05710-9

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Received : 09 September 2023

Revised : 05 February 2024

Accepted : 05 May 2024

Published : 19 May 2024

DOI : https://doi.org/10.1007/s13762-024-05710-9

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• Environmental regulation constraints
• Research and development investment
• Corporate total factor productivity
• Impact mechanism
• Moderated mediating effect
• Threshold effect

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