Community Research T ools Stepping Out..

1. Community Research ToolsStepping Out.. Thuy Bui, MD January 26, 2012

2. Why community? • Social accountability of medical schools/academic health centers • Physicians’ public roles • Social determinants of health Health disparities research Translational research Implementation science Health services research

3. What are some of the approaches and tools that we use? • Community based participatory research (PAR) • Community needs assessment • Implementation, feasibility study, quality improvement • Project/program development and evaluation • Evaluation of health education and promotion initiatives • Literature review and case studies *Overlaps among classification common

4. Research Tools • Project evaluation methods • Participatory/community • Process evaluation • Logic models • SWOT analysis • Observation, survey, interview, focus groups • Data mining • Systematic literature review • Quantitative/statistical analysis • Qualitative analysis • Thematic analysis using computer software • GIS

5. Key Informant Interviews • When qualitative, descriptive information is sufficient for decision-making • When there is a need to understand motivation, behavior, and perspectives of consumers and partners • When a main purpose is to generate recommendations • When quantitative data collected through other methods need to be interpreted • When preliminary information is needed to design a comprehensive quantitative study

6. Conducting Key Informant Interviews • Formulate study questions • Prepare a short interview guide • Select key informants: first-hand specialized knowledge and unique perspectives • Establish rapport; sequence questions, phrase questions carefully, use probing techniques; maintain a neutral attitude • Take adequate notes

7. Focus Groups • When to use: • In conjunction with a satisfaction survey • At the start of a project, when making changes to your service or when identifying a problem • Preparing a strategy • When you want to improve relationships with consumers/partners

8. Inappropriate Use of Focus Groups • Avoid focus groups when they imply commitments you cannot keep or raise expectations • If participants are not comfortable with each other • When the topic is not appropriate for the participants • When a project require statistical or objective data

9. Four Steps to Effective Focus Groups • Planning • Recruitment: compatibility, 6-10 participants • Moderation: setting up the session, preparing questions, recording the data • Analyzing and reporting NEED PROPER TRAINING TO CONDUCT FOCUS GROUPS!

10. Survey Design • Establish the goals of the project • Determine your sample • Choose interviewing methodology • Create your questionnaire • Pre-test questionnaire, if practical • Conduct interviews and enter data • Analyze the data; produce the reports Better to use validated instruments! Dr. Galen Switzer

11. Survey Methods • Personal Interviews • Telephone surveys • Mail surveys • Computer direct interviews • Email surveys Cost Speed Health Literacy Sensitive questions Multiple choice Numeric open end Text open end Rating scale Agreement Scale

12. Literature Review =Summary and Synthesis • Enlarging your knowledge • Information seeking • Critical appraisal • Synthesize results into a summary of what is and is not known • Identify areas of controversy in the literature • Formulate questions that need further research

13. The Case Study • A problem or how a person or institution dealt with a problem • Propose a solution; recommend a course of action; or assess the success of previous attempts to solve the problem • Bring in theories to show how it relates to the case at hand

14. SWOT Analysis • Strengths • Weaknesses • Opportunities • Threats

15. Logic Model http://www.uwex.edu/ces/pdande/evaluation/evallogicmodel.html

16. Logic Model http://www.uwex.edu/ces/pdande/evaluation/evallogicmodel.html

18. Principles of participatory evaluation • Focuses on learning, success and action • Useful to the people who are doing the work that is being evaluated • Ongoing and continual feedback • Knowledge, attitudes, skills and behavior change is built into the evaluation • Define specific project evaluation questions, the indicators of success and realistic timeframes • Recognize shared interests among funders, stakeholders, consumers, and staff.

19. 5 key evaluation questions • What? Did we do what we said we would do? • Why? What did we learn about what worked and what didn’t work? • So what? What difference did it make that we did this work? • Now what? What could we do differently? • Then what? How do we plan to use evaluation findings for continuous learning?

20. 5 evaluation process steps • Define the project work. What are the measurable project goals and objectives? • Develop success indicators and their measures • Collect the evaluation data • Written questionnaire, telephone survey, interview, focus group, observation, project diary, program records, before and after questionnaires • Analyze and interpret the data • Use the evaluation results

21. GIS in RTI research

22. THIS WEEK IN GLOBAL HEALTH Global Women's Health Lecture Series"Intimate Partner Violence: A Community Engaged Approach to Intervention Development"Speaker: Jessie Burke, MHS, PhDWednesday, January 11, 7:30-9 p.m. Magee-Womens Hospital, Auditorium, 0 Level Dr. Burke is an assistant professor at the University of Pittsburgh Graduate School of Public Health. She has an undergraduate degree in cultural anthropology from New York University, a masters of health sciences in international health, and a PhD in social and behavioral sciences from Johns Hopkins Bloomberg School of Public Health. Dr. Burke is a public health social scientist with a focus on the interpersonal and neighborhood contexts of urban health disparities, and much of her work addresses low-income women and children. Her research adopts an ecological perspective and a community engaged approach in addressing health promotion. She employs ethnographic and social epidemiologic techniques to explore the multiple levels of influencing factors associated with health problems such as intimate partner violence, youth violence, low birth weight, and preterm delivery. She is also interested in the design, implementation, and evaluation of comprehensive interventions that address important women's health problems. Her work has been used to help develop a clinic-based, peer-advocate, intimate-partner, violence-intervention for women. Now in a position to expand her domestic urban health research into a global setting, Dr. Burke recently developed a women's health research agenda in Hyderabad, India.

23. http://www.bchs.pitt.edu/

24. Health disparities research http://www.cherp.research.va.gov/leadershipfaculty.asp

25. Vaccine effectiveness research Teen pregnancy prevention community project Environment and contextual factors impacting asthma Childhood obesity prevention in community Biomarker signaling techniques Contact: Dr. John Maier

26. FOCUS GROUP COURSE AT GSPH

27. CLRES2400 Spring Course in Qualitative Research • Tuesdays 1-3pm Parkvale Building (1/10-2/28) • Receive project-specific training in conducting and analyzing qualitative data. • Course Objectives: • Design a qualitative research study. • Write an interview or focus group script. • Develop a qualitative codebook and code textual data. • Learn to use the qualitative software program Atlas.ti. • Apply intercoder reliability approaches to qualitative data. • Questions? Contact: Susan Zickmund, PhD, Director, Qualitative Research Core, susan.zickmund@va.gov; 412-954-5259

28. http://www.ucsur.pitt.edu/survey_design.php

29. Student SP examples: • Jaime Moore: “Documenting Financial Burden and Identifying Barriers to Obtaining Financial Assistance Among Adult, English-Speaking Uninsured Patients at the Birmingham Free Clinic” • Thematic analysis of patient interviews using ATLAS.ti • Will Bemben: “Translation of a Model Street Medicine Program for the Homeless in a Unique Setting: a Three Phased Approach” • Literature review and interviews of key informants • Jane S. Tschang: “Effectiveness of Adolescent Anti-Smoking Health Education through Computerized Media Literacy Program” • implementation and evaluation of the pilot program using pre- and post 18-item validated smoking media literacy scale

30. Area of Concentrations • Underserved Populations • Global Health • Public Health

31. February 2nd 12-1Dr. Michael Yonas Introduction to community based participatory research And the use of photovoice