Qualitative methods in implementation science: where do we need to - - PowerPoint PPT Presentation

Qualitative methods in implementation science: where do we need to go?

December 3, 2018 Suzanne Heurtin-Roberts Ph.D., M.S.W. Implementation Science Team Division of Cancer Control and Population Sciences

On behalf of the QUALRIS Group

10th Annual Conference on the Science of Dissemination and Implementation Washington, DC

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• What is the QUALRIS project?
• Why did we do this?
• About qualitative methods in implementation

science

• What needs to happen beyond the white

paper?

Outline

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Qualitative research in implementation science (QUALRIS)

• Origins: Implementation Science Team, NCI
• Team of experts in implementation science,

qualitative methods, or both

• To examine the use of qualitative research

methods as used in Implementation Science and give guidance on their use

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Deborah Cohen, PhD

Department of Family Medicine Oregon Health and Science University

Benjamin F. Crabtree, PhD

Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School

Laura Damschroder, MS, MPH

VA Ann Arbor Center for Clinical Management

Research (PrOVE) QUERI, Ann Arbor, Michigan

Alison B. Hamilton, PhD, MPH

VA Greater Los Angeles Healthcare System and Department of Psychiatry and Biobehavioral Sciences, UCLA

Suzanne Heurtin-Roberts PhD,MSW

Implementation Science Team, Division of Cancer Control and Population Sciences

The QUALRIS Group

Jennifer Leeman, DrPH, MDIV

School of Nursing University of North Carolina, Chapel Hill

Deborah K. Padgett PhD, MPH

Silver School of Social Work New York University

Lawrence Palinkas, PhD

School of Social Work University of Southern California

Borsika Rabin, PhD, MPH, PharmD

VA San Diego and School of Medicine, UC San Diego and Triple Aim QUERI, Eastern Colorado Healthcare System, Denver, Colorado

Heather Schacht Reisinger, PhD

Iowa City VA Health Care System and Carver College of Medicine, University of Iowa Healthcare System

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Ross Brownson, PhD

Brown School School of Medicine Washington University in St. Louis

Cam Escoffery, PhD, MPH

Rollins School of Public Health Emory University

Russell E. Glasgow, PhD

School of Medicine University of Colorado

QUALRIS Advisors

Bryan J. Weiner, PhD

Department of Global Health Department of Health Services University of Washington

Anne Sales, PhD, RN, MSN

University of Michigan Medical School VA Ann Arbor Healthcare System

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Purpose:

1) to call attention to key features and requirements for using qualitative methods in implementation science 2) to provide general guidance for the appropriate and rigorous use of qualitative approaches in implementation science

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• Conversations starting in 2015 among a few persons
• Noted:
• importance and extensive use of qualitative

methods in implementation science

• variation in expertise with qualitative methods
• little discussion of the specific challenges for using

qualitative methods in implementation research.

• need for guidance

Background

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• The group was expanded
• Worked via email, conference calls, webinars and

in person

• Problems observed, challenges discussed
• Consulted literature on qualitative methods
• drew upon members’ own extensive

experience in using these methods for implementation science

• Drafted, revised many versions
• Produced the QUALRIS white paper

More background (methods)

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October 2018: QUALRIS white paper was posted on NCI’s Implementation Team website.

Direct link:

https://cancercontrol.cancer.gov/IS/docs/NCI-DCCPS- ImplementationScience-WhitePaper.pdf

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• “Traditional” qualitative methods vs. qualitative

methods in implementation science

• Use and value of qualitative methods in

implementation science

• Methodological considerations for rigor in data

collection and analysis

• Need for methodological innovation in the use of

qualitative methods in implementation science

What’s in the QUALRIS white paper ?

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• 1. Qualitative methods in implementation science tend to

be more positivist and deductive in nature.

• 2. Qualitative methods in implementation science tend to

be practical and targeted.

• 3. It’s inherently multidisciplinary rather than discipline-

specific.

• 4. Qualitative and quantitative methods mixed methods
• 5. Implementation science usually involves qualitative

research teams rather than solo researchers

Key Considerations # 1-4 (p. 4)

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5. Data collection often time limited, rapid with single or punctuated time points 6. Engagement tends to be with targeted stakeholders 7. Targeted to specific a priori research questions 8. Published in grey literature as much as “academic” scientific publications

Key Considerations #5-9 (p. 4)

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Some problems observed in literature

• Little variation in methodological approaches

(focus groups, semi-structured interviews)

• Inductive vs deductive approaches sometimes

muddled

• Lose sight of meaning and purpose
• Misunderstanding of key concepts
• Atheoretical or unclear methodological theory
• “Grounded theory” is used as default

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• Be clear about your research question.
• Data collection, sampling, analysis must be

appropriate to answer research question.

• Consider validity and reliability if in line with your
• approach. Some may consider trustworthiness.
• p. 14
• Strategies to enhance rigor, p. 15
• Leave an audit trail.
• Document analytic process (rationales,

meetings, decisions).

• Transparency and documentation throughout,

always.

Some good practices

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• Use existing methods in innovative ways or developing

entirely new methods.

• Strengthen tools and techniques for conducting rapid

qualitative assessment and analysis.

• Explore methods of qualitative data collection and

analysis not commonly used in implementation science.

• Development of a common language
• Develop meaningful and feasible approaches for cross-

context comparison and synthesis of qualitative data.

• Methodological discussion and debate
• Methodological research and development.

And now what?

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Many thanks to the QUALRIS group,

• ur advisors, and

you!

sheurtin@mail.nih.gov