Centers in the United States Megan A. Morris, PhD, MPH a Kenzie A. - - PowerPoint PPT Presentation

Qualitative Research Cores in Academic Medical Centers in the United States

Megan A. Morris, PhD, MPHa Kenzie A. Cameron, PhD, MPHb Rebekah Marsh, MAa Karen Kaiser, PhDb Dawn Finnie, MSc Karen Albright, PhDa,d

aAnschutz Medical Campus, University of Colorado, Aurora, CO, bNorthwestern University

Feinberg School of Medicine, Chicago, IL, cMayo Clinic, Rochester, MN, dUniversity of Denver, Denver, CO

Disclosures

ACCORDS – ADULT AND CHILD CONSORTIUM FOR HEALTH OUTCOMES RESEARCH AND DELIVERY SCIENCE

University of Colorado Denver | Anschutz Medical Campus

• None to report

Background

• Qualitative research has grown in

acceptance and use in health services and medical sciences research

• To meet the needs of investigators,

academic medical centers are beginning to develop Qualitative Research Cores (QRC)

– Similar mission to Biostatistical Cores – Provide consultation and collaboration for investigators across an institution

Potential Benefits of QRC

• Institutional recognition of:

– Value – Work required

• Formalize consultations
• Pooled resources
• Collective action
• Grantsmanship
• We aimed to describe the state of QRCs in

academic medical centers in the United States

Methods

• Reviewed the websites of all medical schools

and Clinical and Translational Services Awards (CTSA) programs in the United States from June 2017 to September 2017

– Search: “qualitative”

Methods

• Included:

– One or more individual who provides qualitative research support and consultation to investigators across an institution, not just with one department

• r program
• Excluded:

– Institutions where it was not evident that identified qualitative researchers did not provide service for institution – Institutions that only provided qualitative education (workshops or courses)

Methods: Data Analysis

• Interviews transcribed verbatim
• Three members of the research team inductively

developed codebook

• All transcripts were:
• Double coded
• Entered into Atlas.ti for data management
• Coded transcripts analyzed to identify major themes
• Preliminary themes presented to research

participants for member checking in March 2019

Results

• We identified a total of 11 QRCs

– Completed 9 interviews between October 2017 and August 2018

• Location of the 9 QRCs:

– 4 CTSA – 3 Centers within institution – 2 within a department

Function of the Core

• Participation in grant funded projects

– Small pilot grants to large, multi-year, multimillion dollar mixed-methods grants – Multiple internal and external sources (NIH, CDC, departmental funds, PCORI, foundation grants, and CTSA pilot grants)

• Varied in:

– Level demand (either steady or overwhelmed) – Integration within the institution

Ingredients for a Successful QRC

National Acceptance Supportive Leadership Skilled Methodologist and Staff Collaborations with Researchers Administrative or “Hard Money” Funding Support

National Acceptance

• Increased acceptance and value of qualitative

research within HSR

• Almost all QRCs formed 2010 - 2014

– NIH Mixed Methods Report in 2010 – PCORI in 2010 – Growth of Dissemination and Implementation Research

There's a real recognition that the kind of work that we do is important, especially the PCORI, implementation science (work). […] there's also a new emphasis countrywide on the sort of transdisciplinary research and the idea of not just one discipline or one approach being important on research teams.

Supportive Leadership

• QRCs developed either “ground up” or “bottom down”
• Identified critical need for supportive leadership and

institutional buy-in What's been really helpful is having a chair that sees the value, not just in terms of dollar signs that are coming in but also sees the value of the types of research and the ability to triangulate across methods. […] he's been able to then advocate at the level of the dean and higher for additional resources and for stable resources.

Collaboration with Researchers

• Relationship development with investigators

across institution increases use and recognition

• f QRC
• Successful products, grants, and published

papers increases value of QRC

Early on I had a couple of colleagues who had a lot of grants and basically said “this is important, let's do this.” Having collaborators who are thought leaders, it's a good thing to

• have. Demonstrating or having ready some pretty clear

evidence, like papers or funded grants, of what this kind of approach can do can be really good too.

Collaboration with Researchers

• Collaborations take time and patience

– Need to educate investigators on qualitative research, including standards for rigor – Need for both collaboration and mentorship We get plenty of people who come to us without much knowledge or understanding of qualitative research. They've got a question they need to answer that they think that qualitative approach would be the best. We'd have to teach them what it is and what we do. Often I will sit and talk with them and help them define the problem better and build up their questions to sharper questions.

Skilled Methodologists and Staff

• PhD Methodologist

– Consultations – Project Oversight – Minimal data collection – High-level analysis, writing – “Matchmaker”

• MS/BS

– Data collection (level depending

• n expertise)

– Assist with coding – Minimal (methods section) writing – Project management skills

A 1 PhD methodologist B 1 PhD methodologist C 1 PhD methodologist 3-4 MS/BS-level D 1-2 PhD methodologists, 3 PhD-level E 1 PhD methodologist 1 MS-level 2-4 Undergraduate students F 6 analysts (3 with PhDs and 3 with MS) G 1 MD in consultative role 4 MS-level 2 BS-level H 1 PhD methodologist 5 MS-level 2 BS-level I 2 PhD methodologists 3 MS-level 8-10 part time MS-level people

Skilled Methodologists and Staff

• Methodologists and staff need qualitative

skills and ability to use skills in applied, pragmatic settings

I think if you have that applied approach that's research-

• riented but also recognizes the pragmatic approach that it

takes to do this in a healthcare setting, that's important […] People who have those skill sets to be able to recognize, “yep, this is what needs to be done, this is the timeline, these are the methods, this is the methodology, and this is the goal that we want to achieve at the end.”

Administrative or “Hard Money” Funding Support

• Staff/methodologists partially or fully grant funded for all

QRC

– Most frustrating and challenging part of maintaining QRC

• All QRC received some protected time from the institution

for administration (3 – 25%); support critical to carry out Core function

The whole grant funding, grant portfolio piece is always an issue for us and making sure that we're right-sized in terms of, do we have enough time for a person's position that's funded administratively and not on grant. That's always sort of a fine balancing act that we're continuously trying to figure that out.

Conclusion

• QRC similarities:

– Types and sizes of projects – Types of activities

• QRCs differences:

– Location – Size/staffing – Demand

• Despite diversity, participants identified consistent

ingredients for success…

Ingredients for a Successful QRC

National Acceptance Supportive Leadership Skilled Methodologist and Staff Collaborations with Researchers Administrative or “Hard Money” Funding Support

Limitations

ACCORDS – ADULT AND CHILD CONSORTIUM FOR HEALTH OUTCOMES RESEARCH AND DELIVERY SCIENCE

University of Colorado Denver | Anschutz Medical Campus

• Perhaps missed QRCs
• Not include VA
• Not include QRCs that are developing or

“failed”

Conclusion

• Demand for qualitative research likely to continue to

increase in HSR

• QRCs, like biostatistical cores, are likely a way to

provide high-quality qualitative research services across institutions

• No one model or standard exists for how to develop and

sustain a QRC

• Formalization or standards for how to provide qualitative

research services through a consultative core model will further promote high-quality, rigorous qualitative research

ACCORDS – ADULT AND CHILD CONSORTIUM FOR HEALTH OUTCOMES RESEARCH AND DELIVERY SCIENCE

University of Colorado Denver | Anschutz Medical Campus

Open Faculty Positions in the Qualitative and Mixed Methods Core at University of Colorado Anschutz Medical Campus!

See Megan Morris (megan.a.morris@ucdenver.edu) for additional details

https://cu.taleo.net/careersection/2/jobdetail.ftl?job=16448&lang=en