Lisa DiMartino, Allison J Carroll, Jennifer L Ridgeway, Anna Revette, Joan M Griffin, Bryan J Weiner, Sandra A Mitchell, Wynne E Norton, Christine Cronin, Andrea L Cheville, Ann Marie Flores, Justin D Smith
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引用次数: 0
摘要
背景:与整合定量数据的方法相比,整合不同研究和多地点研究联合体中定性数据的方法尚不成熟。鉴于数据共享和开放科学日益受到重视,开发此类方法对于支持跨研究定性调查所需的数据交换至关重要。我们介绍了美国国家癌症研究所(National Cancer Institute's Improving the Management of symPtoms During And Following Cancer Treatment, IMPACT)联合体(由癌症登月计划(Cancer MoonshotSM)资助)的定性数据整合方法。数据收集和分析以实施研究综合框架 (CFIR) 为指导。我们的案例研究强调了在研究联盟中整合多种环境下的定性数据时所面临的独特挑战的潜在解决方案:IMPACT 联合体由三个研究中心 (RC) 组成,每个中心都在开展实用性试验,研究常规症状管理对以患者为中心的治疗效果的影响。在就使用 CFIR 作为共同的实施决定因素框架达成共识后,研究中心制定了半结构化访谈指南,并根据其医疗环境和症状管理干预措施的特点进行了调整。区域协调中心与医疗保健系统合作伙伴进行了访谈/焦点小组讨论,以研究影响实施的背景因素。区域协调员交换了 1-2 份笔录(共 5 份),以便对方法进行试点测试:结果:鉴于研究环境和背景的异质性,同时在领域和结构层面分配代码具有挑战性,而且这一过程需要大量资源。我们提出的建议包括:从一开始就为数据收集和分析采用一个共同的框架;首先在领域层面进行编码,然后纳入建构代码;通过一个协调中心(或类似实体)集中处理流程,并使用定性软件合并已编码的记录誊本。我们还生成了一个经过反复改进的编码手册,该手册采用了 CFIR 模式,并纳入了 CFIR 2.0,为进行跨研究定性调查的编码人员提供了详细指导:关于如何支持跨多个研究的定性数据整合、数据交换和共享的指导非常有限。本文介绍了一种采用实施决定因素框架指导方法来促进数据整合的系统方法。其他研究联盟可以采用这种方法来支持定性数据整合、跨研究机构定性调查,并加深对循证干预实施的理解。
Development of a method for qualitative data integration to advance implementation science within research consortia.
Background: Methods of integrating qualitative data across diverse studies and within multi-site research consortia are less developed than those for integrating quantitative data. The development ofsuchmethods is essential to support the data exchange needed for cross-study qualitative inquiry and given the increasing emphasis on data sharing and open science. We describe methods for qualitative data integration within the National Cancer Institute's Improving the Management of symPtoms During And following Cancer Treatment (IMPACT) Consortium funded by the Cancer MoonshotSM. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Our case study highlights potential solutions for unique challenges faced when integrating qualitative data across multiple settings in a research consortium.
Methods: The IMPACT consortium is comprised of three research centers (RCs) each conducting pragmatic trials examining the effectiveness of routine symptom management on patient-centered outcomes. After reaching consensus on use of CFIR as the common implementation determinant framework, RCs developed a semi-structured interview guide and tailored it to features of their healthcare setting and symptom management interventions. RCs conducted interviews/focus groups with healthcare system partners to examine contextual factors impacting implementation. RCs exchanged 1-2 transcripts (n = 5 total) for purposes of pilot testing the methodology.
Results: Given the heterogeneity of study settings and contexts, it was challenging to simultaneously assign codes at both domain and construct levels and the process was resource intensive. Recommendations include employing a common framework for data collection and analyses from the outset, coding at domain level first and then incorporating construct codes, and centralizing processes via a coordinating center (or similar entity) and combining coded transcripts using qualitative software. We also generated an iteratively refined codebook that employed the CFIR schema and incorporated CFIR 2.0 to provide detailed guidance for coders conducting cross-study qualitative inquiry.
Conclusions: Limited guidance exists on how to support qualitative data integration, data exchange, and sharing across multiple studies. This paper describes a systematic method for employing an implementation determinant framework-guided approach to foster data integration. This methodology can be adopted by other research consortia to support qualitative data integration, cross-site qualitative inquiry, and generate improved understanding of evidence-based intervention implementation.