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Epi Wit & Wisdom Letters
Epi
Research--Worth the Effort?
Dear Sir:
Our Epidemiology Center has
focused extensively on the question of how to plan research so as to
maximize its implementation potential. It has become clear to us that
considerable epidemiological research either has as the end product a
publication, usually in a journal not readily acceptable to the health
planner, or results in an internal report by a health planner that is
regarded as poor quality by the academic/research fraternity. We
believe that part of the problem lies in the poor communication
between the object of most epidemiological research (the public), the
designers and analysts (usually the research/academic
epidemiologists), and the health policy makers at local, regional, and
national level. Difficult as it may be, we have found that the chances
for successful implementation are considerably enhanced when all
members of the team are involved at the earliest stage of the design
of an epidemiological study.
Expectations
Certainly, a problem with
this approach is that undue expectation may be raised too early in the
course of what may be tentative investigations. However, by involving
all three groups early, the problems that researchers face can be
addressed openly. Once the health planners are part of a research
project, they tend to become committed to action on the results. In
many instances, particularly in health service related projects, this
in not only desirable but essential. For more complex research that
may take several years to complete, at least the involvement of these
groups helps them to understand the complexity of designing an
appropriate research project. The need to act rapidly, usually at the
pressure of politicians, can be tempered by the increased realization
that action may be taken too early and on the basis of too little
information.
Regional Group
In an attempt to increase
public involvement and interest in broad aspects of public health
research, we have recently formed a regional coordinating group for
public health research in the Western Cape region of South Africa.
This group includes representation from national and local
authorities, from universities, and research institutes such as ours.
An initial step was to assemble a comprehensive list of current public
health research being undertaken in the region. The next step has been
to plan for an exhibition of posters that summarize the results of
public health related research undertaken in the region over the past
year. The exhibition is targeted specifically at high school pupils,
the media, and informed members of the lay public. The overall
intention of the exhibition is to take the results of considerable
public health research conducted over the past years back to the
public and hopefully to stimulate discussion and debate about
priorities and future directions. In addition, the process of research
is spelled out in an uncomplicated manner. We hope that the exhibition
will attract people to undertake research in the future.
The third goal of the Public
Health Research Group is to determine what proportion of research
projects result in some form of health action. More importantly, we
hope to identify the determinants of failure of a project.
Objectives
We believe that, in much the
same way as most research protocols have extensive sections on sample
size and ethics, they need to specifically address the question of
improving their implementation potential. Certainly for many
researchers the implementation objectives may relate to a publication.
Given the scarcity of research funding, review panels would have to
determine whether that alone was a suitable criteria. In addition to
setting separate implementation objectives, the protocol should
indicate how the researchers intend to achieve these objectives which
are usually distinctively separate from the purely scientific
objectives of the study. We believe that this will be a major
challenge for researchers in the future.
Derek Yach
Published March 1990
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