MEDI362 NOTES
WEEK 1:
• Appreciate the importance of asking and answering questions for research
• Understand a range of research paradigms which inform society on human nutrition WHAT IS RESEARCH:
Research is:
• ‘a systematic investigation of a specific question to establish new facts and draw new conclusions’
• ‘it involves discovery of new knowledge and interpretation and revision of current knowledge’
• Results in construction of new knowledge which can be used to provide answers to health problems What does research involve?
• asking a research question
• gathering and interpreting current knowledge on the topic
• designing a method to collect information to inform the answer to the research question
• interpreting results considering previous studies and developing new conclusions NHMRC code for responsible conduct of research
• honesty, fairness, accountability, rigour, respect, promotion, transparency, recognition Research has many requirements
• Gaining ethics approval
• Meeting deadlines
• Sticking to word limits
• Meetings with supervisors/research teams
• Progress reports
• Presenting at seminars
• Avoidance of plagiarism
• An examination process Research Design
• Refers to the type of research enquiry
• Refers to outline of the study: formalised plan prepared before conducting the research
• Aims to find evidence that we can use for our evidence based approach
• Three major research designs: quantitative, qualitative and mixed method research
• Qualitative approach: the design details the planned approach that researchers use for gathering data, data collection, data analysis à beliefs about the nature of knowledge to be generated
• Quantitative approach: describes how participants will be selected and put into groups
• Need to carefully address the nature of research questions à pick appropriate research design
• Research design must serve the purpose of the study Stages in Research
1. Planning 2. Implementation 3. Analysis 4. Reporting
5. Communicating: Conferences, Manuscripts, Media, Newsletters The research process
• Planned activity that researchers used to construct their research project
• Cyclical process
1. Commences with determining a research problem by identifying a gap in knowledge about health 2. Literature is reviewed to ascertain key knowledge about the issue and establish relevant evidence 3. Research design, nature of question, and aim is determined
4. Sampling strategy- recruitment and number of participants 5. Ethical issues must be addressed before data collection
6. Data are then collected and analysed using the most appropriate collection methods and analytical techniques
7. Findings are disseminated to the appropriate audience 8. Findings are used to enhance practice
Research Cycle:
• Literature review of problem à design of study (proposal) à ethics approval à data collection à data compilation / preparation à data analysis à develop results à discuss results à integration with literature Disciplines in nutrition research
• Nutritional epidemiology: health relationships - clinical effectiveness studies (RCTs) - cross sectional surveys
- dietary survey methodology
• Social research: how society works
• Systems research: how health systems operate and their effectiveness - clinical audits
- service evaluation
• Evidence based practice research: the current evidence base The Concept of Research
1. Nutritional epidemiology
• Study designs:
- Cross sectional surveys vs cohort studies vs randomised controlled trials
§ quantitative research–involves precise measurement
§ aims to verify hypotheses
§ emphasises one or more well – defined aspects of a whole experience
• Considerations:
- Sampling and power
- Inclusion and exclusion criteria - Statistical analyses
• confounding variables and outcome variables
• Examples: dietary interventions, surveys, dietary methodology Useful terms (“research jargon”)
• Quantitative research: research that places emphasis on numbers in the process of data collection and analysis.
• Cross sectional surveys: give a profile of a sample at one point in time. Cannot make inferences about past or future.
• Cohort studies: follows a group of people over time, often a group who have been ‘exposed’ and another who have not. Enables relationships between exposed and outcomes to be assessed
• Clinical trial: a trial conducted to determine if an intervention has been effective
• Randomised controlled trials: a clinical trial where participants are randomly assigned to groups
• Sampling: the process of selecting elements of a population for inclusion
• Power: the probability that the outcomes will reject the null hypothesis
• Confounding: a factor that distorts the true effect of an intervention 2. Social research
• Study designs: focus groups, key informant interviews, in depth interviews
• Research using methodology from sociological disciplines
• Addresses social and cultural problems in a nutritional context
• Naturalistic (qualitative) research considerations - importance of the whole experience
- patterns or themes emerge in participant’s descriptions of events or processes - researcher has no preconceived views
Useful terms (“qualitative jargon”)
• Qualitative research: research with emphasis on words rather than numbers in the process of data collection and analysis
• Focus group: a data collection method based on a group discussion typically with a moderator.
• Key informant: an individual who is able to provide in depth information
• In depth interview: an interview that does not use fixed questions though can be guided by a set of questions. It aims to engage interviewees.
• Grounded theory: an approach aimed to generate theory from data. Theories are grounded in empirical data and built up inductively
• Thematic analysis: searching through data to inductively identify interconnections and patterns. Patterns are then analysed as themes to later build a theory
• Ethnography: a focus on the lived culture of groups of people used to discover and describe social or cultural groups
3. Health systems (evaluations/audits)
• Often apply a mixed method approach
• Study designs: Medical records audit, observations, interviews
- Disease audit, dietetic activity analysis, customer (patients/staff) views of service (materials)
• Research on patient care - oriented towards standards
• Dietary, nutritional assessments
• Ongoing evaluation + documentation against standards
• May change current practice Useful terms (more jargon!)
• Mixed methods: combining both qualitative and quantitative research approaches
• Audit: systematic and independent examination of records, or documents
• Observation: The process of collecting data for looking and listening
• Evaluative research: research that attempts to identify an initiative's consequences as well as opportunities for modification/improvement
4. Evidence-based practice research
• A process that includes finding empirical evidence regarding the effectiveness and/ or efficiency of various treatment options and determining the relevance of those options to specific clients
• Needs to be clear about what is known and not known about any health problem or health practice
• Systematic review of the literature
• Based on key research questions
• Search terms
• Types of studies
• Limitations of food based research
• EBR does not apply to many health issues in certain populations e.g. ethnic, refugees, rural communities Evidence:
• Evidence: information that can be used to support and guide practices, programs and policies in health to enhance the health of individuals
• Example: depression and risk for suicide and prevention à evidence may include perceptions and experiences of depression and suicide among young people
Evaluating evidence within the evidence based research model
• Hierarchical ranking system: evidence is evaluated according to the research design e.g. the highest standard à systematic review of multiple randomised controlled trials
• Limitation: ignores limitations of RCTs and neglects observational studies; qualitative evidence is undervalued
Useful terms (“review jargon”)
• Systematic review: a comprehensive identification and synthesis of the available literature on a specified topic
• Quality assessment: An evaluation of the methodological quality of a study or studies to guide interpretation of the review findings and help determine the strength of the inferences.
• Search strategy: The process by which potential literature to be included in a systematic review is included.
Problem oriented research – using a mixed methodology Mixed Methods:
• A research design that combines methods from quantitative and qualitative research approaches within a single study
• Example: using a focus group and questionnaires
• Three ways to implement:
- Triangulation: use of qualitative research to confirm the findings from quantitative research - Facilitation: one research approach is used to facilitate research using the other approach - Complementarity: two approaches are used
WEEK 2:
RESEARCH ETHICS: SOCIAL SCIENCES What is research ethics
• How we treat people in a research setting
• How we treat their information
• How we conduct research with a mind to protecting participants and researchers
• Risks to participants and researchers
• Benefits to participants and society Risks
• Additional risks the person is being exposed to by taking part in the study
• Participants:
- Physical - Psychological
- Spiritual or cultural harm - Emotional, distress or harm.
- Financial
- Unwanted consequences which may arise
• Information:
- Infringement of privacy - Confidentiality
- Ownership
• Researchers - Physical - Psychological
- Emotional, distress or harm - Financial
- support to ensure they are remaining healthy whilst dealing with sensitive information
• Instances of breaching confidentiality for participants: putting people through unhealthy situations, may trigger conditions (possibly irreversible); for researchers: could trigger bad childhood memories e.g. abuse
