research final 2

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Views on quality depend on ___________of the patients who use treatments: perspective
Qual Res gives us a variety of methods to help us 1)identify patient and provider _________, 2) identify _________to changing practice, 3) Offers ___________to the development of â€œ contextually grounded, culturally sensitiveâ€ res pr: preferences

obstacles

â€œuniqueâ€ contributions
Qualitative Historically, qual methods have been views as a way to enhance the quality of __________ Now, qual methods are seen as ends in themselves, providing info to ______________. Qual res philosophy diff than Quant (_____________)â€: Quant projects
impact treatment process
single objective reality
________philosophy is one that supports the idea that: _________meaning and interpretations are what decisions are based upon It is generative⬦meant to offer __________and explanation: Qual res
subjective
description
Indications for Qual Research *The level of knowledge uncovered in your lit search often establish ________for your study design *____________for the background of your study may be indicative of the need for qual res *Qual methods are oft: rationale
Lack of literature
first steps
exper design
augment or enhance study
Qual Research Techniques Three data collection techniques: Observation
Interviews
Document Review
Qualitative Res Techniques Observation is central to _____________ Observe what they do⬦describe and interpret what has been observed Often ____________ responses are diff than what people actually do⬦: understanding behavior

questionnaire or interview
Observational Methods Vary in distinct ways 1) __________- Participant Observer 2) based on the ____________the researcher is involved 3) conducted with or w/o subj awareness/permission..________ 4) may be limited to specific area of: Classic Fieldwork

length of time

hawthorne eff

inquiry
Interview Different interview strategies are avail __________- Highly structured and directed vs unstructured and non directed __________, probes for content, recall strategy will effect quality and quantity of information received. U: Indiv

Active listening

exploratory

Focus groups

variables
Qual Research Techniques _________ Involves organizing and evaluation of a body of existing information for combination with other data; or as a stand alone data source. ____________can range from formal to informal _________- object: Document Review
Documents
Formal
Informal
Qualitative Research _____________ Qual Research requires constant __________..Field notes and trigger notes are used, Recording on subjective experiences during data collection also impt ___________means to capture interview or obser: Data Management
recording
Electronic
Nonverbal and verbal
Transcription
Qualitative Research ____________ Do not have to have all data collection completed prior to beginning ___________..coding for initial categories and themes Develop concepts/categories Sort and re categorize, will have themes ev: Data Analysis
Segment data
Contextualizing process
Inductive theory
Qualitative Research _________is subject of debate in qual research Strategies: ___________is a safeguard- Multistrategy approach (Ex. Open ended interviewing WITH observation) Need to work out issues of logistics and resources<: Validity

Triangulation

Validity Check

Researchersâ€™ critical appraisal skills

colleagues

Qualitative
Community Based Participatory Research (CBPR) An approach to RESEARCH designed to â€œ___________â€. How? Through the establishment (*and ________) of community partnerships Not the â€œ___________â€ clinician researcher coming into the c: promote community

maintenance

all knowing
Why does this WORK? The __________approach creates a well needed â€œ________â€ between communities and researchers Incorporates local knowledge and local theory Culturally relevant measurement design and instrumentation Partnerships: partnership
BRIDGE
quality of data
VALIDITY
CBPR CBPR is Designed to be -____________ -emphasize co-learning/reciprocal transfer of ___________, and ownership of process and product -ensure and structure ___________ by those being affected -increase the _______ of: collaborative
expertise
participation
value
community
methods

SHARE
PHASES
CBPR PHASES *Identifying ________ *Assessing _________ strengths, assets and challenges *Defining __________ *Developing research and _________ *______________data *______________findings (Disseminating of findings: research questions
community
priorities
data collection methodologies
Collecting and analyzing
Interpreting
community concerns

Transformation of findings into action
community members
RESEARCH PARADIGMS ____________- Set of basic beliefs about the nature of reality which can be studied and understood. ______________- A single reality on how things work exists to be studied and understood _______________- single reality: Paradigm
Positivist and Postpositivist
Positivist
Postpositivist
Objective detachment
Research Paradogms CBPR is aligned with ______________(multiple realities, intangible construction and rooted in everyday experience) _______________â€“ indiv constructions of reality â€œinformed rather than trueâ€ and are alterableâ€¦ Re: constructivist research paradigms

Consensus construction

linked
Common Research Methods There are basic partnership principles and values that CBPR rely on *Form and informal __________and structures *Build and maintain _______ *Agree on values, ________and obj of research *Balancing _______a: partnership networks
trust
goals
power
credit
Clinician is armed with ___________but canâ€™t forget that community members and reps from CBOâ€™s have perspectives that are also useful for inclusion during the research process CBPR can be infused into any __________. Your text demonstrates its: intellectual resources

research methodology
Common Research Methods AOCD- ____________ Itâ€™s purpose-To understand the health status, dynamics and relationships with the community. To understand the interaction between community members and â€œ_____________â€ which impede or prom: Action Oriented Community Diagnosis

broader structures

needs assessment

strengths-based
CBPR within AOCD Like ALL methods that adhere to CBPR, AOCD begins with a working collaborative relationship with _________ *Community data review and windshield tour of community *After tour (and throughout AOCD), researchers document exp: community members
field notes
fish bowl scenario
action or intervention
CBPR with in AOCD More about AOCD AOCD will rely on a community forum to present to â€œ_________â€ the findings of a research process *__________is meant to encourage dialogue Often emic and etic perspectives are explored and done s: influential advocates
Forum
qualitative methods

Focus Group
ethnograph
CBPR How to get started? To be able to establish partnerships, values and principals⬦you must ____________first Networking is essential. Identify _________, investigate issues from various perspectives, build trust Stakeholders are: NETWORK
stakeholders
gatekeepers
entry
How do start a CBPR? Build _______ They have been â€œ________â€ before as living laboratories You, the researcher, may want to put in some volunteer time Serving on local health coalitions are good ideas too You build community: Trust
burnt
association

Relationships

Partnerships
Things you need to know about Data Analysis You must make decisions about data analysis ________to data collection Data analysis planning is part of ____________ Pay careful attention to the type of research being conducted and the type of: PRIOR
research methodology
understanding data analysis
Objectives when evaluating data analysis of a research study Be familiar with the ___________ in the study Be familiar with the most common __________ Understand the rationale behind the selection of _________ Understand how specific: types of data produced
statistics
statistical analyses
What test do I use The first step in deciding on the type of statistical analysis is determining the ___________ The higher the level of measurement, the ________info that can be ascertained from the data See figure 9-1 page 121 AND see ha: level of measurement
more

Nominal
Ordinal
Interval/ratio
What test do I use? The second step- Is your data _______________? * parametric(normal) and non parametric describe the distribution of the ________ or variables. _________ data are always considered to have a normal distribution. Th: parametric or non parametric
subjects
Continuous

relationship

number

Relationship
Statistics ___________- measures of central tendency, measures of variability (range, std dev and std error of the mean) _____________-Start with the basic, â€œWhat is the hypothesis? 1) A relationship or 2) a difference between variables: Descriptive

Inferential statistics
What do we remember about Inferential statistics? Tools we use to draw ________ about the results (the test of hypothesis) It is based on the testing of a _____________ ___________ testing is key All the steps of hyp testing are impor: inferences
null hypothesis
Hypothesis

(est hyp, alpha, test, conclusion, p values)

Chi Square
Epidemiological
Measures of Association Can only be used to determine relationship between two continuous (interval or ratio) variables __________, interpret it and test of significance ____________ techniques also allow for relationships among variables: Pearson R
Multivariate Regression
prediction
What do you do next? After selecting design and data analysis method⬦you run the test Then you need to report and interpret your results Results of a study are presented in the _______ of the text, tables, figures and charts Extensi: body
graphical
Tables
Results One of the more impt parts of the research report.The â€œ_______â€ of the report Key ________ must be presented clearly in logical fashion Author indicates whether the _________ was supported or rejected Previous sections of: meat
findings
hypothesis
Facts
Interpretations and conclusions need to go elsewhere Opinions need to go elsewhere- Discussion section _______ section should be neutral in every aspect, free from conclusions The use of _________ is advised The ______ part of the res: Results
Graphs and Charts
shortest
past
present
Results For ethical purposes, all _________ should be reported, not just those supporting the hypothesis Information or description of what was done go in Materials and Methods section and NOT in the Results Section Do not make the mistak: key findings
raw
meaning
Results How do you start Begins with description or profile of subjects..include _________ Use #s % and central tendency measures to describe the study sample After you describe the sample used in study, you need to report the results: demographics
detail
Descriptive
Experimental (or Quasi)
Results Be careful using the word _________. Significant can mean statistically significant or clinically significant Only significant if statistics support that judgment Include ________ for why you chose the statistical procedure,: significant
rationale
methodology
discussion
Results Tables and figures as essential for ________ and brevity..exp when numerical data needs to be presented. Software programs are great, excel and spss Donâ€™t start off with topic sentence â€œTables 1 presentsâ€¦â€ Tables usefu: clarity
correlations
tables and figures
Results Variety of choices, line graphs, scatter graphs, histograms, pie charts _______graphs to show relationships (between to quan variables) _______and histograms, used to plot freq distributions Remember the difference in bar grap: Line
Freq polygons
Discussion This is where you state your: __________ You can have subsections in the discussion paper for _______, conclusions, implications, interpretations, _________ and a closing: interpretations,
Conclusions and
Opinions

summary
recommendations
The discussion should center on the importance of the results AND their _________ to patient care, as well as society, education or the profession The _________ discussion section of a research report covers the following area: Implications, __: APPLICATION

TRADITIONAL
limitations
bias considerations
Discussion __________ This is where you explore the meaning of research results Think critically about the research results and draw/make ____________ Remember, even with out statistical significant findings, there is still meaning to: Implications
inferences
Discussion Implications in a study may point out the ________ values of a finding or the need for replication of the study or ________ Your arguments should be ________ if you are contradicting accepted dogma or theory Be __________in list: potential
modifications
rational
conservative
practice and clinical
Discussion _____________ Impt bec it gives a picture of the studyâ€™s defects or weaknesses Limitations should be considered in light of the overall ________of the study. ________ in the methodology..such as the sample size limited by: Limitations
worth
Flaws
Discussion Limitations⬦other things to discuss Discuss the _________ if the sample selection Can the data be generalized to the entire population Discussion of errors in data _______ The level of data quality Any interveni: randomness
entry
hawthorne effect
Discussion ___________ To avoid bias, make sure you write out your hyp before hand Maintain your ___________ Concentrate on the process and methodology of the study If the process is sound, results will be sound Be careful: Bias Consideration
objectivity
attention
double blind
Discussion _________ States your ideas on what future research is needed based on the outcomes of the current study New data collection technique? New instrument, larger sample, etc Purpose is to alert the reader that more?s need to b: Recommendations
obscure
****
1.relevance,
2.clarity and
3.brevity
__________ Last section of the paper It is brief Begins with brief restatement of the aim of the study and major res ?s Then state the major ________ of the study (bullets or numbers to separate each) Point out same findings as o: Conclusions
findings
closing abstract
Bibli and Ref Most places have a technical style manual requirement for papers Publishers require manuscripts that follow a style, found under â€œ________â€ APA, MLA and CHI (Chicago Manual of Style) Differences between these styles: information for authors
AMA
APA
MLA
Chicago
Bibli and Ref Buy the manual or an abridged handbook The ______ Handbook The ______ Writers Handbook Adv are compact and handy Disadv limited _____ and amount of info limited There are lots of different writing style manual: Brief Holt
Thesis
scope
Documenting Sources Using Ref and Bibli Since much of the info gleaned in a lit search uses backgrd materials representing other peopleâ€™s work, you must ________ Whether direct quote or paraphrased, you must ______ If it is not ________: cite it and give credit.
document
general
footnote or endnotes
end
________ End notes and footnotes seem to be giving way to the bibliographic format in many scientific writings All works used as ________ material in the construction of the paper need to be properly documented The bibliography (also refer: Bibliographies
reference
alphabetically
Text mentions two variations of bibli 1) _______(authors comments to be appended to any of the entries in the list) and 2_ ______entries by source, primary, secondary, published and unpublished .. Remember, ________ sources are those which are origi: Annotated
Grouping
Primary
critical
article,case studies or books
General bibliographies are available, such as ________- can be a starting place to locate other sources of info. Not a good tool for graduate work and above (too generic written for layman) _________ direct reader to more in-depth sources in particu: Books in Print and the Bibliographic Index

Index Medicus
Material in _______ domain can be used without permission, but should be acknowledged as a source..PD- Material that has not been copyrighted or for which the copy right has expired. Public Domain works are those â€œCreative works that are _________: public

not protected by copyright and may be freely used by anyone

fair use
The __________ Act is a comprehensive law that deals with the legalities of using copyrighted material. Material may be used without permission of the holder for certain specific uses. These uses are referred to collectively as fair use. ⬦ $______: 1976 Copyright
$150,000
Evaluating Sources Remember, its not quantity but _______ Is your source authorative? Credible author Current trends or theories? Donâ€™t forget _________ Where and when was article published? Peer reviewed? Prestigious Journals?: quality
classic works
original
________â€“ a discipline which seeks to understand the moral duties and obligations that associate with any action Ethics in medicine a factor- _____ medical experiments Do no Harm Respect Human Rights Have you thought about what it m: Ethics
WW II
affective dimension
intellectual rigor
moral
The values that surface as impt to researchers are: ________, ________, ________, altruism, respect, prudence, justice, equality, and fidelity⬦intra or interpersonal aspects of personal functioning.. Other good values that shape good practice, pag: Honesty
beneficence
intergrity

Affective
Research Ethics Ultimately, the goal of ethics in research is to ensure that no one is _________ from research activities. As research is designed, several ethical considerations must be balanced: Protect the ______ of the participant or: harmed or suffers adverse consequences

rights

sponsor
Ethical Principles Three Ethical Principles Guide Research with Human Participants There are MORE we will discuss, p 177: 1) Respect for Persons
2) Beneficence
3) Justice
Respect for Persons Requires investigators to obtain _________ from research participants, to protect participants with impaired decision making capacity, and to maintain confidentiality Research participants are not passive sources of data, bu: informed consent
___________ Requires that the research design be scientifically sound and that the risks of research be acceptable in relation to the likely benefits Risks to participants include (not only physical harm from tests or treatments) but also _____: Beneficence
psychosocial
confidentiality
____________ Requires that the benefits and burdens of research be distributed fairly Requires equitable access to the benefits of research _________ populations, such as people with poor access to health care, those with impaired decision: Justice
Vulnerable
So what is the problem? Historically, Clinical Research has been thought of as ________and potential subjects have been thought of as â€œ_________â€ needing protectionâ€¦ Now, it is regarded as providing access to potentially life saving new t: risky
guniea pigs
PROTECTION
Obligations of the Client Protect rights of ____________ of the subjects Follow medical ethics in their relationship with the researcher Provide full information to the researcher about the objectives or problems to be studied Encour: confidentiality
truth
misrepresent
Affect vs Cognition Science demands affect and cognition from its ________⬦often in equal measures. Examples of situations that may involve value conflicts are endless. Lets go over some of the scenarios we MIGHT encounter⬦.Page 176: practioners
Federal Regulations for Research on Human Subjects _________ regulations are intended to ensure that clinical research is conducted in an ethically acceptable manner Federal regulations provide 2 main protections for human subjects, _________an: Federal
IRB approval
informed consent
Federal guidelines distinguish ________(that to contribute to generalizable knowledge) from unproven clinical care that is directed toward benefiting the individual patient and not toward publication Research is also distinguished from ______ that w: research
program evaluation
IRB Fed regulations require that research on _______subjects be approved by an IRB. IRB systems are decentralized The IRB mission is to â€œensure that the research is _________ and that the welfare and rights of research participants are ______: human
ethically acceptable
protected
Ok, but what does the IRB actually Do? It has the authority to approve (or deny) research study and the IRB must determine the following for EACH study 1) ______ to participants are minimized 2) Risks are reasonable in relation to anticipa: Risks
benefits
participants
Informed consent
Confidentiality
The Cons of IRB Some criticize them for focusing too much on ________, like consent forms rather tha research design A common criticism is that the fail to scrutinize the research design and review of scientific merit is usually beyond the expe: procedure
funding agency
research participants
Character? Does it have its place in Medicine? Many feel that it is ultimately about the judgment and character of the _________(researchers) which is the most essential element for ensuring that the research is ethically acceptable. WHAT DO Y: investigator
Exceptions to the IRB Review What Research is EXEMPT from IRB Review (See pg 191) What is __________? There is a list of types of research that are eligible for expedited review (review by a ________ rather then the full committee) p: expedited review
single reviewer
Obligations of the Researcher Protect the ___________of the subjects and client Provide subjects informed choice to participate (________) Follow medical ________ in their relationship with the client Do not appropriate ideas from oth: rights of confidentiality
INFORMED CONSENT
ethics
Scientific Misconduct- Other Responsibilities of the Researcher There are many levels of __________ and many behaviors considered worthy of this labels (ie. Enrolling ineligible patients in clinical trials, making up research data, altering research: misconduct
fabrication, falsification
SCIENTIFIC MISCONDUCT __________- MAKING UP RESULTS AND RECORDING OR REPORTING THEM _________- MANIPULATING RESSEARCH MATERIALS, EQUIPMENT OR PROCEDURES OR CHANING OR OMITTING DATA OR RESULTS SO THAT THE RESEARCH RECORD MISREPRESENTS THE ACTUAL: FABRICATION
FALSIFICATION
PLAGIARISM
Conflicts of interest RESEARCHERS MAY HAVE CONFLICTING INTERESTS THAT MIGHT IMPAIR THEIR ___________ Some potential types of conflict of interest are: 1) ________for clinician-investigators 2) ________conflicts of interest Resear: OBJECTIVITY AND UNDERMINE PUBLIC TRUST IN RESEARCH

Dual roles
Financial
Deception is sometimes used in research. It is allowed if the information is critical, and there is no other way to gather the necessary data. If deception is used, 1. The researcher must ensure that _________will result from the deception, an: no physical danger or psychological harm

concealment or deception
Informed Consent Researchers must disclose information that will be relevant to the potential participantâ€™s decision about whether or not to participate Some crucial questions are? Why is the research being done? What will participa: minimal risk
Minimal risk? Plays a key role in _________ Minimal Risk is defined as that â€œ__________â€ encountered in daily life or during the performance of routine physical or psychological tests. The ________ and probability of risk must be consi: federal regulations
ordinarily
magnitude
Informed Consent You must address these areas with potential participants 1) The _______ of the research project 2) The ________ of the study 3) The _______and potential benefits of the study⬦and the alternatives to participating in: nature
procedures
risks
confidentiality
voluntary
Vulnerable Populations The following should be subjected to additional scrutiny 1) ________ 2) Prisoners 3) _________, fetuses and embryos 4) People with impaired decision making capacity: Children
Pregnant women
Obligation of the Respondent: Honesty

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