Introduction to Research Methodology PDF

18/09/2023 Introduction to Research Methodology Public Health and Primary Care Unit UWI-STA 1 At end of the session Define what 'Health Research' is Outline importance of resear...

18/09/2023 Introduction to Research Methodology Public Health and Primary Care Unit UWI-STA 1 At end of the session Define what 'Health Research' is Outline importance of research Recognise the benefits to students Describe the main steps of conducting a health research. Prioritise problems for research Note distinction between Quantitative vs Qualitative Studies 2 1  18/09/2023 Research Defined A course of critical inquiry leading to the discovery of fact or information which increases our understanding of human health and disease A scientific inquiry aimed at learning new facts, testing ideas, etc. The systematic collection, analysis and interpretation of data to generate new knowledge and answer a certain question or solve a problem. 3 Importance to medicine and public health Knowledge obtained from sound research is transformed into clinical practice, leading to medical practice that is evidence-based. Cornerstone for informed and effective decision-making Integral to efforts to improve the health of the population Integral to the effectiveness of health systems 4 2  18/09/2023 Benefits to Medical Students Promoting health research in general Preparation for specialization/postgraduate research Enhances skills in Searching and critically appraising medical literature Apply evidence-base decisions to clinical situations Independent continued learning. Writing research papers – getting published 5 Prioritizing Problems 6 3  18/09/2023 Criteria for prioritizing problems for research Relevance How large/widespread is the problem? Who is affected? How severe is the problem? Avoid Duplication Has the topic been researched? If yes, are there major questions that need further investigation? Political acceptability Is it of interest to (supported by) the government/authorities? Facilitates smooth conduct of the research; increases the chance that the results of the study will be implemented. 7 prioritizing problems cont’d Applicability of possible results and recommendations Urgency of data How urgently are results needed for decision making? Prioritise research – which to be done first and which later? Ethical acceptability Will we be inflicting harm on others? 8 4  18/09/2023 Scale for Rating Research Topics Relevance Political acceptability 1 = Not relevant 1= Topic not acceptable 2 = Relevant 2 = Topic somewhat acceptable 3 = Very relevant 3 = Topic fully acceptable Avoidance of duplication Applicability 1 = Sufficient information already available 1 = No chance of recommendations being implemented 2 = Some information available but major issues not covered 2 = Some chance of recommendations being implemented 3 = No sound information available on which to base 3 = Good chance of recommendations being implemented problem-solving Urgency Feasibility 1 = Information not urgently needed 1 = Study not feasible considering available resources 2 = Information could be used but a delay of some months 2 = Study feasible considering available resources would be acceptable 3 = Study very feasible considering available resource 3 = Data very urgently needed for decision-making 9 Scale for Rating Research Topics CONT’D Ethical acceptability 1 = Major ethical problems 2 = Minor ethical problems 3= No ethical problems Rating should be based on existing data NOT on mere assumptions. 10 5  18/09/2023 The Process Outline 11 The Protocol 12 6  18/09/2023 Basics of the Protocol 1. Title 2. Abstract 3. Introduction Statement of the research problem Significance of the proposed work 4. Objective of the study (Research Questions) 5. Methods (and Materials) Type of study (study design) Study population Type of data (defining each variable to collected) 13 Basics of the protocol cont’d Methods and Material cont’d Inclusion/ exclusion criteria Sampling procedure to be used and sample size and power calculation. Data collection and management Data analysis Ethical considerations Pretest or pilot study: 14 7  18/09/2023 Basics of the protocol cont’d 6. Work plan (project management) Personnel, training Schedule (timetable)- provide actual dates for each activity - Pilot phase - Final study Onset/start, data collection, analysis, write-up Relevant facilities Cooperating organizations 7. Plan for utilization and dissemination of research results 8. Budget 9. References 10.Appendices 15 1.Title of Research A good title should be short, accurate, and concise. It should make the central objectives of the study clear to the reader. Important to specify what population will be investigated, and where it will be conducted. E.g. Face masks in the protection of healthcare workers in resource poor settings of Kouvah 16 8  18/09/2023 2. Introduction Background information and Problem Statement Convince the reader of the relevance of the study (magnitude, severity of the problem). Provide enough background data for reader to understand the different aspects of the problem and the context in which it occurs. Review of available literature and reports to further illustrate why the problem is important 17 The Problem Statement Gives basis for development of research proposal (research objectives, methodology, work plan, etc) Allows easier identification of relevant studies/reports to guide your own study design Should outline why proposed research on the problem should be undertaken and what will be achieved with the study results. 18 9  18/09/2023 Literature Review Become acquainted with the relevant literature Prevents duplication; allows refinement of ‘problem statement’ Increases familiarity with different research methods Sources PubMed, Medline, Cochrane Books, journals Institutions, experts, Annual reports, guidelines Conferences 19 4. Objectives (of the Study) Should be closely related to ‘problem statement’ A general objective can be split/broken smaller and connected specific objectives. General objectives : aim of the study in general terms E.g. To assess low EPI coverage in Kouvah Specific objectives: measurable statements related to the research problem situation. E.g. To establish the reasons for the lack of immunization among children at the health services in Kouvah. 20 10  18/09/2023 SMART Objectives Research objectives must be: S-M-A-R-T Specific Measurable Attainable Relevant Time-bound 21 Purpose of Objectives To focus the study To avoid collection of unnecessary data To organize the study in clearly defined parts or phases Properly formulated, specific and SMART objectives facilitates development of the research methodology and will help to orient the collection, analysis, interpretation and utilization of data. Action terms for Objectives To determine; to compare; - to verify To calculate; to describe; to establish 22 11  18/09/2023 Research Question Problem researchable if 1. There should be a perceived difference or discrepancy between what it is and what it should be; 2. The reason(s) for this difference should be unclear (so that it makes sense to develop a research question); 3. There should be more than one possible and plausible answer to the question (or solution to the problem). 23 Research Question e.g. Situation: Kouvah has 2 health centers, 1 hospital all of which functions smoothly. However, at the end of the 2016 it was detected that the immunization coverage was only 40%. Research question: What factors influence the low vaccination coverage among children in Kouvah? Possible answers: Mothers might have problems attending EPI sessions; MCH, MOE and EPI programmes might not be integrated resulting on children having missed opportunities for immunization; Follow up of defaulting children might not be effective and other reasons. The above problem situation is researchable 24 12  18/09/2023 FEASIBLE INTERESTING Criteria for Developing NOVEL Research Question ETHICAL RELEVANT Nothing FINER than a good research question 25 Good research question? Feasible Ethical Subjects Social or scientific value Resources Safe Manageable Data available? Relevant Advance scientific knowledge? Interesting Influence clinical practice? Novel Impact health policy? In relation to previous findings Guide future research? Confirm or refute? New setting, new population 26 26 13  18/09/2023 A Research Question Must Identify 1. The variables under study 2. The population being studied 27 5. Research Methods 28 14  18/09/2023 Study Design The guide researchers use to collect, analyze and interpret observations; a logical model Observational (non-intervention) studies researcher observes and analyses situations but does not intervene Intervention studies researcher manipulates the situation and measure the outcome of the manipulations Two primary arms: Descriptive and Analytical 29 Types of Studies Descriptive studies describe occurrence of outcome Analytic studies describe association between exposure and outcome 30 15  18/09/2023 Descriptive Analytic Case report Cohort study RCT Case series Case-Control study Descriptive Epidemiology Case-Crossover study Cross-sectional study Before-After study Ecologic study 31 Descriptive Studies Develop hypothesis Investigate it’s Case-control Studies relationship to outcomes Define it’s Cohort Studies meaning with exposures Test the link Clinical trials experimentally 33 16  18/09/2023 Analytical Studies 38 Analytical Studies Experimental Studies Observational Studies Randomized controlled Group data clinical trials Ecologic Community trials Individual data Cross-sectional Cohort Case-control Case-crossover 39 17  18/09/2023 Study Population and sample The study population should be clearly identified Study sample must be representative large enough size to ensure sufficient power Variables Identify the variables that will be involved Four types of variable are important in research: Independent (predisposing/risk factors), Dependent (outcome/condition/disease), Confounding, and Background variables. Specify whether variables are: Numerical (continuous/discrete), or Categorical (ordinal/nominal). 44 Study Population and sample Inclusion criteria Those characteristics that subjects being recruited must have to be included in the study Exclusion criteria Those characteristics that should disqualify subjects from being included in the study. 45 18  18/09/2023 7. Dissemination Plan for research results Outline how research findings will be disseminated Consider Progress reports Final report Publications Seminars, workshops, and conferences Discussion with policymakers and program managers 46 9. References References in your text should be numbered in the sequence in which they appear I Different referencing styles exist e.g. Vancouver system 47 19  18/09/2023 10. Annexes These may include: Interview schedule/ questionnaires (and/or other data collection tools) Informed consent form Institutional/Ethical approval for the study 48 Tips for your Protocol 49 20  18/09/2023 The Protocol Write out introduction and methodology in detail Give it to people to read to check for major flaws Get help at this stage 50 The study Assign roles Projected time to completion Get ethical approval Get all equipment before start Accurate testing and measurements Stick to your protocol Stick to your sample size and sampling plan 51 21  18/09/2023 Authorship Should be directly involved at the every stage Idea stage Protocol development Actual performance of the study Interpretation of results Writing up All authors must take full responsibility for the study 52 Research Questions Examples 59 22