According to the World Health Organization (WHO), health research encompasses five key areas: measuring the magnitude and distribution of health problems; understanding their diverse causes; developing interventions to address them; implementing these solutions through policies and programs; and evaluating their impact on health outcomes and equity [1]. The dissemination of research findings supports ongoing investigations, secures future funding, and contributes to the institution’s long-term academic mission [2].

Health professionals, as defined by World Health Organization (WHO), are individuals having expertise in the healthcare field, holding vital responsibilities in enhancing, preserving, and reinstating the health and welfare of both individuals and communities. This diverse group encompasses doctors, nurses, midwives, pharmacists, dentists, physical therapists, rehabilitative and allied health workers, public health experts, and various other healthcare practitioners [3]. Healthcare (HC) research plays a crucial role in influencing disease prevention, diagnosis, treatment, and healthcare program policies, thereby making a significant impact on overall public health [4]. Research and publication practices reinforce the development of critical thinking abilities, foster effective teamwork, enhance writing skills and build career prospects of professionals in the healthcare field [5].

Over the past two decades, publication output by Pakistan’s medical and dental faculty has surged five- to sevenfold, driven by PMDC’s publication requirements and HEC’s journal approvals [6,7]. Due to its status as a lower-middle-income country (LMIC), Pakistan's higher education institutions (HEIs) face significant deficiencies in scientific and technological aspects. As a result, their research contributions to global repositories are limited [8].

The global production of scientific publications increased by 21% in 2019 compared to 2015, indicating a general trend towards stronger publishing. Additionally, international scientific collaboration rose from 22% to 24% during the same period, with notable regional variations [9]. Literature highlights barriers, such as the absence of research training (70.1%), uncertainty regarding the capacity to accomplish a study successfully (lack of research self-efficacy) (63.8%), inadequate time (65.3%), and diminished interest in research (29.3%) [10].

Specifically, a study conducted in Saudi Arabia reported that Pakistan contributed only 0.58% to the global research output of healthcare professionals in 2019, underscoring the need to strengthen research engagement within the national context. There remains limited evidence on the research and publication practices of a broader spectrum of healthcare professionals including psychologists and paramedics [23].

Although numerous studies have explored barriers to research among medical students, there is a notable lack of evidence concerning research and publication practices among practicing healthcare professionals. To our knowledge, no prior research has investigated this population within this geographic context. The findings seek to expand the scope, to contribute valuable insights to the literature and support the development of inclusive, evidence-based strategies to promote research culture in healthcare. By identifying key obstacles, this study intends to support targeted interventions that can enhance professional development, strengthen institutional research capacity, and ultimately improve the quality of patient care in Abbottabad and similar settings. This study aims to examine the extent of engagement in research activities and the barriers faced by diverse group of healthcare professionals working in clinics and academic institutions in Abbottabad, Pakistan.

Study Settings: Medical, dental, physical therapy, pharmacy, psychology, nursing, and paramedics professionals who worked in Abbottabad's clinics and healthcare-related academic institutions located in Abbottabad, participated in this descriptive cross-sectional study.

Sampling Technique: To successfully collect responses from 377 healthcare professionals, a non-probability convenience sampling technique was employed. No participants dropped out during data collection.

Sample Size: Using the Rao Soft Online Sample size calculator, the sample size was determined with a 5% margin of error, a 95% confidence level, a potential population size of 20,000, and a 50% response distribution [11,12].

Study Duration: The study was conducted between August 2023 and May 2024.

Inclusion Criteria: All healthcare professionals with at least six months of work experience were eligible to participate. The age of professionals ranged from 25 to 70 years.

Exclusion Criteria: Certain healthcare disciplines such as occupational therapists, prosthetists, and orthotists were not included due to their unavailability during the data collection period. Additionally excluded were those on medical or unusual leave.

The questionnaire used in this study was adapted from a previously published instrument developed and tested by Ashrifi [13]. Their questionnaire was constructed based on findings from earlier research and designed to assess research engagement and barriers among healthcare professionals. The reliability of the adapted questionnaire was confirmed with a Cronbach’s alpha of 0.933, and its content was reviewed by library and information specialists. In our study, respondents answered 13 items related to barriers, categorized into organizational, individual, and social domains. These items were rated on a five-point Likert scale ranging from “strongly agree” (5) to “strongly disagree”.  The study also included questions about demographics (gender, age, qualification, department, experience, career, and work-setting), research habits (conduction, supervision, presentation, publications).

Operational Definitions: A publication or an academic article is a written piece of work which is widely accessible to the public, either in printed form or electronically. Research activities include conducting, participating in, supervising and publishing research work.

Ethical Approval: The Institutional Review Board (IRB), additionally recognized as the Women Institute of Learning and Rehabilitation Sciences' Ethical Research Committee, examined and approved the research proposal.

Consent of Participants: Informed consent was obtained from all participants prior to data collection. To ensure confidentiality, no personal identifiers were recorded on the questionnaire, and all data were securely stored with access limited to the research team

Data Collection Procedures: After seeking institutional approval and participants’ consent, subjects were screened for inclusion and exclusion criteria. Primary data was collected through distributing the self-administered standardized questionnaire to the participants.

Data Analysis Procedure: Data were analyzed using SPSS version 28.0 and MS Excel 2010. Frequencies were calculated for demographic variables and research engagement habits. Descriptive statistics including means and standard deviations were computed to determine the prevalence and intensity of perceived barriers. A one-sample t-test was applied to compare the mean scores of organizational and individual barriers against a reference point which employed a similar design and objective, while recognizing contextual differences between the populations [13,14]. Inferential comparisons were not applied for social barriers category due to insufficient degree of freedom. A 95% confidence level and p-value ≤ 0.05 was considered statistically significant. This approach does not assume identical population characteristics but offers a comparative baseline for interpreting our findings. The barrier variables were approximately normally distributed. Likert-scale responses were treated as numeric averages, not categorical labels. It allowed us to assess whether perceived barriers were statistically significant within our cross-sectional framework [24].

To explore the research practices, participants were assessed based on key demographic variables and their involvement in various research practices and barriers to research practices.

Table 1: Demographic Characteristics of Research Participants.

The demographic characteristics of the participants are displayed in percentages.

Table 1 shows that majority of participants were male (61%). Most participants were aged 25–35 years (68.41%) and predominantly held a graduate degree (62.33%). Largest representation from MBBS (43.77%). Most had 1–3 years of experience (68.70%). Majority were involved in both clinical and academic roles (57.03%). Most worked in public sector facilities (42.91%).

Funnel chart 1 shows that most participants had conducted research (89.66%). Majority had conducted 1–2 studies (56.76%). 61.54% had presented their research. 63.52% had supervised or guided research students. Slightly more than half (53.05%) had not published any research, though 32.36% had published 1–2 studies.
Funnel Chart 1: Progressively Decreasing Frequencies of Research Activities of Healthcare Professionals.

Cluster chart 2: Shows the Prevalence of Barriers to Research Activities.

Cluster chart 2 represents a majority of healthcare professionals identified several significant obstacles to research engagement: Cumbersome acceptance criteria (95.76%, mean = 4.45), Insufficient resources (94.96%, mean = 4.38), Lack of research knowledge (92.57%, mean = 4.36) and Lack of social space for research (92.57%, mean = 4.36).

Table 2: Descriptive Statistics of Likert Scale of Barriers to Research Practices.

The one-sample t-test was applied to determine whether participants' perceived barrier scores significantly deviated from an expected population mean, derived from prior study.13 The variables were approximately normally distributed. The categories represented grouped survey responses (Likert-scale averages). They were not treated as categorical labels, but rather as numeric mean values. When *p<0.05; it was deemed statistically significant.

Table 2 presents the results of the one-sample t-test applied to organizational and individual barrier scores. The analysis revealed no statistically significant deviation from the expected population mean, indicating that participants’ perceptions of these barriers were broadly aligned with previously reported norms.

The current cross-sectional study revealed that while most participants had engaged in research, less than half had published their work highlighting a gap between research activity and dissemination. The highest-rated barrier was publication regulations (mean=?4.45), followed by insufficient resources (4.38). Social barriers, including lack of research culture and limited societal recognition, also scored high (both 4.36), suggesting that structural and cultural factors continue to hinder research visibility and impact. No significant difference was found between the sample means and the population mean for organizational barriers (p = 0.454) and individual barriers (p = 0.138), which suggests that participants in our sample perceived organizational and individual barriers similarly to those reported in the reference population.

Regan A, found similar results, with 62 percent participating in the research [15]. Arshad S, reported 62.3% of individuals were aware that research is a component of their course, and 59.5% had prior research experience [19]. Ashrafi-rizi, found that the average of obstacles faced by participants in research activities were 3.89 ± 0.483 [13].

The existing literature by Iloh, highlighted that publishing fee (100%), acceptance rate (97%) and publication time (95%) were the most often considered factors for publication practices [16]. The study of Motealehi A, showed that individual, organizational and social dimensions were all rated as less than average (12.8%), more than average (57%) and moderate (21.9%) by the participants, respectively [17]. Findings of Taher TM, documented shortage of allocated time (70.3%); and the lack of skills and knowledge in medical research (56.9%) [18]. While Abusamak M, reported insufficient training in medical research (84.4%), a lack of support and stimulation (71.1%) and a lack of adequate research facilities and resources (68.4%) as the most significant research barriers [22].

In another study by Alamri Y, highest mean value (3.6±1.0) was associated with perceived barrier of lack of prominent and prosperous "physician-scientist" role models followed by institutional hurdles (inadequate salaries, small laboratory space, little financing, etc.) with mean value of 3.5±0.6 [21]. AlEnazi A, found that medical residents faced significant institutional challenges in conducting research due to the study approval process (p = 0.02). Most specialties reported that faculty disinterest hindered research efforts (p < 0.004), and financial support for residents was also a crucial barrier (p < 0.02) [20].

Khan ZA, conducted a study with participants averaging 29.3 years; 58% were female. Lack of training was cited by 62.6% as the main barrier to research [2]. Saunders, review reported that healthcare professionals had moderate to high research knowledge, skills, and attitudes [4]. Meo SA and Jawaid SA report that Pakistan published 193,928 research articles till 2020. Web of Science records show a sharp rise: 641 papers in 2000, and 28,802 by 2020 [5]. Faculty from various disciplines, ages, and academic rankings were included by Fahim A, 95% of the respondents had published publications. 36.7% had ten or fewer publications [6].

60.4 percent of the participants had accurate and comprehensive understanding of research practices, according to Pundhirl, Bilal M, reported male students exhibited a better attitude than female students (72.97 ± 20.54 vs. 67.09 ± 21.56; p = 0.010) [7]. The overall mean scores of students on attitude, knowledge, and barriers were 69.27 ± 13.44, 70.39 ± 15.67, and 72.46 ± 13.46, respectively [8]. 44.9% females participated to a study, according to Muhandiramge J, Just 20.5% of respondents cited an interest in academia as a motive for pursuing research, with the main reason (51.9%) being the increased employability for specialization training programs [10].

Limitations and Future Recommendations: First, the use of a convenience sampling technique restricted participant diversity, as only healthcare professionals available in Abbottabad during the data collection period were included. Second, the study did not encompass occupational and speech therapy disciplines, which may limit the generalizability of the findings across the broader healthcare sector. Third, the effect of participant demographics such as age, gender, designation, and years of experience on research practices was not explored. Fourth, the perspectives of publication bodies and editorial institutions; key stakeholders in the research activities were not explored, leaving a gap in understanding systemic barriers.

Future research should aim to incorporate a wider geographic and disciplinary scope and adopt sampling strategies that allow for demographic analysis to uncover patterns in research engagement. Engaging with publication bodies, journal editors, and institutional review boards could provide a more holistic view of the structural and procedural challenges faced by healthcare professionals. Additionally, longitudinal studies may help assess the impact of institutional policies and support systems over time.

The study provided a clear depiction of the research landscape among the surveyed population, revealing that majority were actively engaged in research endeavours. The study unveiled several significant barriers encountered by study professionals encompassing heavy regulatory criteria, time constraints, limited financial incentives, and a notable deficiency of research culture in society. Additionally, the findings underscored that less than half of the participants had successfully contributed to academic publications, highlighting the need for increased support and capacity-building efforts to enhance research productivity within this demographic.

Every author contributed to the conception of study project, its data gathering and analysing, writing a manuscript; and approving the final version for publication. The authors attest that it is original, unpublished, and not presently under consideration for publication anywhere. Every author committed to taking responsibility for every facet of the work, making sure that any concerns about its integrity are duly addressed.

Acknowledgement

UF: Supervisor of research team as well.

AJ: Co-supervised the research project as well.

KS: Collaborated with institutional tasks as well.

Source of Funding: This study is not supported by any funding sources.

Conflict of Interest: There is no conflict of interests in this study.

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