Building research capacity at a rural place-based community service organisation in southwest Victoria, Australia

IF 1.9 4区 医学 Q2 NURSING Australian Journal of Rural Health Pub Date : 2024-07-23 DOI:10.1111/ajr.13170
Bianca E. Kavanagh PhD, Kevin P. Mc Namara PhD, Penny Bolton MPH, Carly Dennis BPH, Vincent L. Versace PhD
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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. 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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.

None declared.

None.

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澳大利亚维多利亚州西南部一个以地方为基础的农村社区服务组织的研究能力建设。
星光基金会是澳大利亚规模较大的非营利性组织,在多边环境协定和研究方面拥有较为成熟的文化。这次咨询为当前的工作和方法提供了宝贵的见解。因此,主要的 MEL 和研究活动是分阶段进行的,最初的重点是了解准备情况,并促成能力、决策和合作方面的变革。迄今为止,嵌入式研究员的活动主要集中在建立全机构范围的 MEL 和研究方法、为选定的计划提供支持以及对特定计划的成果进行试点监测(表 S2)。这些活动为提高研究素养提供了一个途径--这一点很重要,因为一般而言,社区服务部门可被视为一个研究新兴行业,而提高循证实践的举措应有助于提高研究素养。11 尽管这些活动还处于初步阶段,但员工的认同和兴趣以及领导团队的支持都很高(正如应急专家在与员工访谈时就 Brophy 的初步研究和评估需求所报告的那样)。这表明,社区服务人员参与和开展研究的积极性很高,尽管在这样做的过程中会遇到各种挑战。该急诊室职位的初步成功得益于布罗菲与迪肯农村医疗机构之间的紧密合作,包括通过各组织之间现有的地方关系。此外,迪肯农村医疗机构也是一个以地方为基础的组织,拥有联合医疗能力建设的授权和资源。这些因素支持了基于相互信任、共同目标和长期合作承诺的共同愿景,并促成了共同出资的 ER 角色。这项工作的成果将使证据得以公布,并有助于改善西南部人口的健康和社会成果:构思;调查;项目管理;资源;写作--原稿;写作--审阅和编辑。Kevin P. Mc Namara:项目管理;资源;监督;写作--原稿;写作--审阅和编辑。彭妮-博尔顿项目管理;资源;监督;写作--审阅和编辑。Carly Dennis:项目管理;写作--审阅和编辑;监督;资源。文森特-L-范思哲BEK 由 Brophy 家庭与青少年服务机构和澳大利亚政府的农村卫生多学科培训计划 (RHMT) 资助。VLV 也得到了 RHMT 的资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Australian Journal of Rural Health
Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.30
自引率
16.70%
发文量
122
审稿时长
12 months
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.
期刊最新文献
How First Nations peoples living in the Torres Strait and Northern Peninsula Area describe and discuss social and emotional well-being. Growing the peer workforce in rural mental health and social and emotional well-being services: A scoping review of the literature. Understanding the professional factors that impact the retention of pathology workers in regional, rural and remote Australia. Issue Information Evaluation of nurse practitioners' extended scope of practice in a regional hospital emergency department in tropical Australia.
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