Cohort profile: The nurses and midwives e-cohort study: A novel electronic longitudinal study

Hegney, DG ORCiD: 0000-0003-1267-1760Nurses and midwives comprise the largest professional group in most national health systems, so shortfalls in numbers can have a substantial impact on health care delivery. A scarcity of human resources in health has been internationally recognized and has led the International Council of Nurses to launch the Global Workforce Project in 2004, and the World Health Organization to announce the Health Workforce Decade 2006–15 in 2006.1,2 Efforts to address workforce needs through coherent workforce planning and policy setting are hampered by the complexity of predicting the supply of and demand for nurses and midwives, and the challenges associated with understanding drivers of workforce retention.3 Available workforce descriptors among regulatory authorities vary considerably; and collections are mostly cross-sectional, frequently incomplete and typically limited to administrative databases. In Australia and New Zealand, workforce issues include the migration of staff between states and countries, and critical personnel shortages in rural and remote communities; although data limitations preclude clear delineation.3,4 One response to the problem of insufficient available information on which to base workforce planning, the Nurses and Midwives e-cohort study, was conceived by its director and developed by a team of researchers at The University of Queensland, Brisbane, Australia. In the first instance the study focused on an investigation of the Queensland workforce. Pilot data and other findings,5–7 suggested a desirable initial aim was to conduct a longitudinal examination of recruitment and retention in the Queensland nursing and midwifery workforce to better understand time-related patterns affecting retention and loss. Encouraged by the planned move of professional registrations to an on-line format, we attempted to maximize efficiency by adapting traditional longitudinal research methods to a novel electronic cohort (e-cohort) design. We envisioned that participants would primarily engage with and respond to the study using email and the Internet; a strategy which has not yet entered mainstream epidemiology.8 From the project's inception, professional associations and industry partners committed funds and other support and helped establish credibility and relevance to stakeholders and potential participants. As the Queensland component was being developed, the value of expanding the cohort to increase sample size and to cover a variety of settings was apparent so academic colleagues elsewhere in Australia and in New Zealand were invited to join the research team. All nursing and midwifery councils in Australia and the Nursing Council of New Zealand were then approached to seek their collaboration to enable this expansion