What is Research?
Health services research is popular, relevant to the community, and constantly in the news. This is of course important for many reasons:
- We are concerned about our health and want to be well informed.
- We want to know about the latest breakthroughs and discoveries.
- Considerable amount of health research is funded by public agencies meaning that we - the public are paying for the research we read about, and thus have an additional personal stake in it!
The questions asked and methods that are used in any study will have a very significant impact on the nature of the study, the findings that arise from it, and what they might mean for people.
The Research Question
- What is the specific question that is being asked?
- Tension between the wish to ask - and try to answer big and important questions about health issues and the necessity to be focused and specific in any individual study.
- The bigger the issue the more challenging it can be for researchers to study it.
- When a question is very focused about a specific aspect of a specific condition, even the best and most credible findings are likely to be applicable only to a sub-group of the whole population.
- When reading or listening to or reading an account about research it is important to be clear what questions were being asked, in order to decide whether that study and those findings are applicable to ourselves or our patients.
- While the topic may be relevant and of interest this specific study might not apply to the issues important to us.
How is the Study Designed?
In addition to the specificity of the questions being addressed in any research, the way in which studies are designed is very important. A brief outline of some of the commonest designs may help to illustrate this point:
- Randomized clinical trails (RCTs): Involves assigning people, at random, to receive one or another intervention and to look at the effect of that particular intervention over time.
- Cross-sectional: Number of issues at the same time, and try to identify and then understand the relationship or association between "this" and "that". Classic example: Frequent observation of an association between childhood autism and parental distress and uncertainty about how to parent an apparently disturbed child.
- Retrospective: We have looked back in time at the reports in the medical charts, or at other information, and have tried to extract the information in which we are now interested.
- Prospective Study: We look forward in time, knowing specifically what we want to look at, and then collect those data systematically. Example: Want to explore the nature of the journey of parents who have recently found out that their child has a developmental disability. For such a study we would want to assemble a cohort of parents just starting that journey, and travel with them over time to learn from them about the nature, challenges and joys of the journey.
How can clients (youth, parents & knowledge users) become involved in research?
- It is important for clients to recognize that research takes time and can be a lengthy process.
- It is essential for clients to become actively involved in research by engaging with researchers early in the development of the research question. This is an ideal opportunity for clients to voice their needs, concerns and opinions before the research takes place in order to increase the relevance, applicability and uptake of research results.
This is the starting place for any research project. Anyone can have an idea for research; it does not have to be complicated.
All studies begins with a structured research question that includes a description of the group you are interested in, what you are going to do to the group (the intervention), what you are comparing the intervention with (control) and what you want to achieve/hope will happen.
Many research questions can arise from a particular idea however researchers need to prioritize their research questions according to relevance and feasibility. Key stakeholders can be engaged in assisting researchers to decide which questions are the most important and feasible to answer.
There are lots of different ways of designing research, depending on what the question is e.g. collecting people's opinions and views about something, or comparing groups of people (for example, people who are having a treatment compared with people who are not). We also need to think about things like the timescale of our research, how many people we need to take part and how we are going to find them. The outcome of this stage is a 'research protocol'
In order to carry out a research project we have to apply for funding. Lots of organizations fund research such as the Canadian Institutes of Health Research, Partnerships for Health System Improvement, Ontario Innovation Fund and many others.
All research has to be passed by an ethics committee before it starts. The committee will think about issues such as confidentiality, benefits, and potential harm that might be associated with participation in a study.
Carrying out the stages described in the research protocol for collecting the information (data) will assist in answering the research question.
Data analysis involves synthesis of the collected data to answer the research question. The type of analysis will depend on the design of the study, the way we collect the data and the question being asked.
Interpreting Results and Drawing Conclusions
Interpretation of the research findings involves thinking about what the results mean and how it relates back to the research question, as well as what is most relevant to convey to the target audience.
Telling People The Findings
To have a positive impact on your research findings, it is important to properly communicate your research to all relevant people. There are numerous methods that researchers communicate their findings such as giving talks at conferences, writing articles, posting information on websites and creating engaging videos.
Research findings can lead to a change in practice if the research is considered reliable and relevant to key stakeholders. This can simply mean whether a new treatment is routinely recommended by doctors based off evidence from research findings.
Answering one research question often leads to more questions, which can lead to further research.