Bianca E. Kavanagh PhD, Kevin P. Mc Namara PhD, Penny Bolton MPH, Carly Dennis BPH, Vincent L. Versace PhD
{"title":"Building research capacity at a rural place-based community service organisation in southwest Victoria, Australia","authors":"Bianca E. Kavanagh PhD, Kevin P. Mc Namara PhD, Penny Bolton MPH, Carly Dennis BPH, Vincent L. Versace PhD","doi":"10.1111/ajr.13170","DOIUrl":null,"url":null,"abstract":"<p>Due to their unique ability to appreciate the local context, rural place-based health and community services are central to the prevention and management of health and social issues.<span><sup>1</sup></span> Place-based approaches allow relevant evidence to be generated locally; however, at present, there is a lack of evidence generated from rurally based health services<span><sup>1</sup></span> and arguably less evidence produced from the community services sector.<span><sup>2</sup></span> This lack of evidence limits the ability for policy-makers to make evidence-informed decisions about how to improve outcomes for rural populations.<span><sup>3</sup></span> There is an increasing need to provide evidence of outcomes within the community services sector, and the need to have mechanisms in place to capture, analyse and report data has been identified.<span><sup>4</sup></span> However, the complexities of this sector—including that services are delivered within complex, dynamic and multifaceted social contexts, with multiple funding sources—have led to challenges for community services to conduct research. This impedes the opportunity to enhance service performance and outcomes.<span><sup>4</sup></span> The experiences of rural health services might inform a framework for generating evidence in the community services sector. Rural health services are reported to be motivated to build research capacity to attract and retain the rural workforce,<span><sup>5</sup></span> and parallels with the community services sector may exist.</p><p>Research capacity building is an effective approach to generating and applying new knowledge to improve outcomes.<span><sup>6</sup></span> Cooke et al.<span><sup>6</sup></span> suggested that if research questions are developed through consultation with users (i.e. service providers and policy-makers), then the research generated is relevant to fundamental health issues and concerns; this may be particularly relevant to regional, rural and remote (RRR) areas. The embedded research (ER) model may support evidence acumen by bridging the disparity between research and service delivery.<span><sup>7</sup></span> Embedded researchers (i.e. when a researcher is embedded into a ‘host’ organisation) may assist in building research capacity through their function of conducting collaborative and ‘on the ground’ research.<span><sup>7</sup></span> This model differs from the bench-to-bedside model and may be a sustainable approach to research capacity building in RRR contexts.<span><sup>1</sup></span> The ER model may circumvent the need for lower-resourced health and community services from consulting with external researchers to generate evidence. Despite being a relatively new approach to building research capacity in RRR contexts, the ER model has gained traction and demonstrated success in recent years.<span><sup>8</sup></span></p><p>An ER model was recently implemented at Brophy Family and Youth Services (Brophy) in southwest Victoria. Brophy is the primary place-based provider for family and youth services in the region. Brophy services Warrnambool (Modified Monash Model [MM]3 a large rural town), Portland, and Hamilton (MM4 medium rural towns)<span><sup>9</sup></span> and provides outreach services across the region, which are predominately small rural towns (MM5). The ER model was implemented following the recognition of the need for Brophy to be evidence-informed; establish a culture of monitoring, evaluation and learning (MEL); and provide timely data on program outcomes for relevant government/funding bodies. Despite willingness from the leadership group and practitioners, resource and knowledge limitations were cited as a barrier to achieving these objectives. Collaboration with an external research organisation was identified as facilitating increased capacity, breadth and sustainability of research capacity by utilising resources and skills from within the research organisation. Discussions were held between Brophy and Deakin Rural Health (a University Department of Rural Health), located in southwest Victoria, to establish the ER position. The aim of this position is to build research capacity and support staff to provide evidence regarding service outcomes. The embedded researcher began in late 2022 and is conjointly funded by Brophy and Deakin Rural Health via the Rural Health Multidisciplinary Training (RHMT) program. The position is guided by a steering committee (Table S1), which provides direction and oversight, and tracks progress of ER activities. The ER is located on site at Brophy, within the quality and compliance team. This article sets out the approach adopted at Brophy to support research and MEL capacity within its rural context.</p><p>To the authors' knowledge, there are no frameworks for ER within the community services sector. As such, the activities of the ER role are guided by the development of an agency-wide place-based MEL framework, designed to steer MEL and research at Brophy (Table 1). This framework was developed by the embedded researcher and steering committee, and sought input from consumer and diversity working groups, managers and the wider staff cohort. It also drew on elements of a place-based evaluation framework.<span><sup>10</sup></span> Consultation from the Starlight Foundation—a larger Australian non-profit organisation with a more established culture of MEL and research—was also sought in the initial stages of this role. This consultation provided valuable insight into the current work and approach. As such, key MEL and research activities are undertaken in a phased approach, with an initial focus on understanding readiness, and enabling change in capacity, decisions and collaboration. This phased approach recognises that affecting outcomes within a specific geographic area entails a long-term and collaborative effort.</p><p>To date, activities of the embedded researcher have focused on establishing an agency-wide approach to MEL and research, providing select programs with support and piloting the monitoring of outcomes in specific programs (Table S2). These activities have provided an avenue to increase research literacy—this is important as, in general, the community services sector may be considered a research emergent profession, and initiatives to increase evidence informed practice should assist in building research literacy.<span><sup>11</sup></span> Although these activities are in the preliminary stages, the buy-in and interest from staff and support from the leadership team are high (as reported during staff interviews by the ER, regarding Brophy's initial research and evaluation needs). This suggests that community service staff are motivated to participate in and produce research, despite the challenges in doing so. The initial success of this ER position is a result of strong collaboration between Brophy and Deakin Rural Health, including through existing local relationships between organisations. Further, Deakin Rural Health is also a place-based organisation, with a mandate and resources for capacity building in allied health. These factors have supported a shared vision based on mutual trust, common goals and a long-term commitment to partnership and have resulted in the co-funded ER role. The results of this work will allow evidence to be published, and aid in improving the health and social outcomes of the southwest population.</p><p><b>Bianca E. Kavanagh:</b> Conceptualization; investigation; project administration; resources; writing – original draft; writing – review and editing. <b>Kevin P. Mc Namara:</b> Project administration; resources; supervision; writing – original draft; writing – review and editing. <b>Penny Bolton:</b> Project administration; resources; supervision; writing – review and editing. <b>Carly Dennis:</b> Project administration; writing – review and editing; supervision; resources. <b>Vincent L. Versace:</b> Project administration; resources; supervision; writing – review and editing.</p><p>BEK is funded by Brophy Family and Youth Services and the Australian Government's Rural Health Multidisciplinary Training program (RHMT). VLV is also funded by the RHMT.</p><p>None declared.</p><p>None.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13170","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Journal of Rural Health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajr.13170","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Due to their unique ability to appreciate the local context, rural place-based health and community services are central to the prevention and management of health and social issues.1 Place-based approaches allow relevant evidence to be generated locally; however, at present, there is a lack of evidence generated from rurally based health services1 and arguably less evidence produced from the community services sector.2 This lack of evidence limits the ability for policy-makers to make evidence-informed decisions about how to improve outcomes for rural populations.3 There is an increasing need to provide evidence of outcomes within the community services sector, and the need to have mechanisms in place to capture, analyse and report data has been identified.4 However, the complexities of this sector—including that services are delivered within complex, dynamic and multifaceted social contexts, with multiple funding sources—have led to challenges for community services to conduct research. This impedes the opportunity to enhance service performance and outcomes.4 The experiences of rural health services might inform a framework for generating evidence in the community services sector. Rural health services are reported to be motivated to build research capacity to attract and retain the rural workforce,5 and parallels with the community services sector may exist.
Research capacity building is an effective approach to generating and applying new knowledge to improve outcomes.6 Cooke et al.6 suggested that if research questions are developed through consultation with users (i.e. service providers and policy-makers), then the research generated is relevant to fundamental health issues and concerns; this may be particularly relevant to regional, rural and remote (RRR) areas. The embedded research (ER) model may support evidence acumen by bridging the disparity between research and service delivery.7 Embedded researchers (i.e. when a researcher is embedded into a ‘host’ organisation) may assist in building research capacity through their function of conducting collaborative and ‘on the ground’ research.7 This model differs from the bench-to-bedside model and may be a sustainable approach to research capacity building in RRR contexts.1 The ER model may circumvent the need for lower-resourced health and community services from consulting with external researchers to generate evidence. Despite being a relatively new approach to building research capacity in RRR contexts, the ER model has gained traction and demonstrated success in recent years.8
An ER model was recently implemented at Brophy Family and Youth Services (Brophy) in southwest Victoria. Brophy is the primary place-based provider for family and youth services in the region. Brophy services Warrnambool (Modified Monash Model [MM]3 a large rural town), Portland, and Hamilton (MM4 medium rural towns)9 and provides outreach services across the region, which are predominately small rural towns (MM5). The ER model was implemented following the recognition of the need for Brophy to be evidence-informed; establish a culture of monitoring, evaluation and learning (MEL); and provide timely data on program outcomes for relevant government/funding bodies. Despite willingness from the leadership group and practitioners, resource and knowledge limitations were cited as a barrier to achieving these objectives. Collaboration with an external research organisation was identified as facilitating increased capacity, breadth and sustainability of research capacity by utilising resources and skills from within the research organisation. Discussions were held between Brophy and Deakin Rural Health (a University Department of Rural Health), located in southwest Victoria, to establish the ER position. The aim of this position is to build research capacity and support staff to provide evidence regarding service outcomes. The embedded researcher began in late 2022 and is conjointly funded by Brophy and Deakin Rural Health via the Rural Health Multidisciplinary Training (RHMT) program. The position is guided by a steering committee (Table S1), which provides direction and oversight, and tracks progress of ER activities. The ER is located on site at Brophy, within the quality and compliance team. This article sets out the approach adopted at Brophy to support research and MEL capacity within its rural context.
To the authors' knowledge, there are no frameworks for ER within the community services sector. As such, the activities of the ER role are guided by the development of an agency-wide place-based MEL framework, designed to steer MEL and research at Brophy (Table 1). This framework was developed by the embedded researcher and steering committee, and sought input from consumer and diversity working groups, managers and the wider staff cohort. It also drew on elements of a place-based evaluation framework.10 Consultation from the Starlight Foundation—a larger Australian non-profit organisation with a more established culture of MEL and research—was also sought in the initial stages of this role. This consultation provided valuable insight into the current work and approach. As such, key MEL and research activities are undertaken in a phased approach, with an initial focus on understanding readiness, and enabling change in capacity, decisions and collaboration. This phased approach recognises that affecting outcomes within a specific geographic area entails a long-term and collaborative effort.
To date, activities of the embedded researcher have focused on establishing an agency-wide approach to MEL and research, providing select programs with support and piloting the monitoring of outcomes in specific programs (Table S2). These activities have provided an avenue to increase research literacy—this is important as, in general, the community services sector may be considered a research emergent profession, and initiatives to increase evidence informed practice should assist in building research literacy.11 Although these activities are in the preliminary stages, the buy-in and interest from staff and support from the leadership team are high (as reported during staff interviews by the ER, regarding Brophy's initial research and evaluation needs). This suggests that community service staff are motivated to participate in and produce research, despite the challenges in doing so. The initial success of this ER position is a result of strong collaboration between Brophy and Deakin Rural Health, including through existing local relationships between organisations. Further, Deakin Rural Health is also a place-based organisation, with a mandate and resources for capacity building in allied health. These factors have supported a shared vision based on mutual trust, common goals and a long-term commitment to partnership and have resulted in the co-funded ER role. The results of this work will allow evidence to be published, and aid in improving the health and social outcomes of the southwest population.
Bianca E. Kavanagh: Conceptualization; investigation; project administration; resources; writing – original draft; writing – review and editing. Kevin P. Mc Namara: Project administration; resources; supervision; writing – original draft; writing – review and editing. Penny Bolton: Project administration; resources; supervision; writing – review and editing. Carly Dennis: Project administration; writing – review and editing; supervision; resources. Vincent L. Versace: Project administration; resources; supervision; writing – review and editing.
BEK is funded by Brophy Family and Youth Services and the Australian Government's Rural Health Multidisciplinary Training program (RHMT). VLV is also funded by the RHMT.
期刊介绍:
The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.