Health Services Research Methods - Assignment Example

Health Services Research Methods

Chapter 1

Question 1: What are the main characteristics of scientific inquiry? Explain the relationship between scientific theory and scientific theory and research.

Conventionally, the main components of scientific inquiry included prognosis, treatment, diagnosis, and examination. Scientific inquiries main characteristic is called positivism that views life to be logical and with persistent patterns as opposed to being random. Scientific inquiry is, therefore, based on two main pillars of positivism, namely, Empiricism and Scientific theory (Shi 2). Scientific inquiry must be objective rather than subjective. That is, the inquiry must be testable and based on data. It is also based on verification thus reproducible. Scientific inquiry must also take consideration of the ethical standards, which include contacting the institutional review board, voluntary participation, informed consent, confidentiality, anonymity, and respect to the subjects' right to service. Empiricism is a scientific inquiry approach used to discover the life patterns. On the other hand, a scientific theory is a logical framework that guides the explanation and understanding of the life patterns. It is a set of ideas that explains particular phenomenon. Theory sets the principles and laws upon which a concept is explained. Empiricism is the development of knowledge gotten from reliable sources. It used the sources to explain the daily experiences. Empiricism uses scientific theory in determining the life patterns.

Question 2: Distinguish health services research from research in general and other forms of health care research in particular. Explain the four major characteristics of health services research.

Health services research entails examining how people access health care, the costs, and the outcomes of the services (Shi 21). Research, on the other hand, is a systematic investigation of materials and their sources with the intention of finding facts and reaches proper conclusions. Other forms of health research such as clinical trials and integration of the electronic health applications are more specific compared to health services research. However, they contribute to the health services research. Health services research has four primary characteristics. First, it is scientific with the researchers being majorly social scientists. Second, health services research is multidisciplinary since it uses distinct branches of biomedical and social sciences. Third, it is population based as it focuses on the general public as opposed to individuals (Shi 30). Lastly, health services research falls under the application sciences. In explanation, the knowledge drove from the research can be applied to a section of the population.

Chapter 2

Question 1: What are some common indicators of health status? What are some issues we may encounter when trying to measure and track these indicators? How might we try to overcome such issues?

According to Shi, some of the common indicators of health status include mortality, morbidity, and disability due to particular diseases (61). There might be some difficulties in measuring the disability and health status of a given population thus affecting the comprehensiveness of the results. The problem can be addressed through the use of the International Classification of Functioning, Disability, and Health, which is approved by the World Health Organization. There might also be problems in the accurate measuring of the patient's ability to function independently. The shortcomings can be addressed through the use of instrumental activities of daily living. Health status indicators focus only on the need for medical care and not health. Determining the health status will, therefore, entail the specific indicators such as the frequency of an individual visiting a doctor; percentage of people who have not visited a doctor in a year; length of time between visiting of doctors; and the average length of stay in a short-stay hospital.

Question 2: Discuss some of the unique characteristics of health care that distinguishes it from other products and services in the economy.

Health care is different from the other service and products in the economy. It is holistic in nature as opposed to other services and products in the economy. In explanation, health care takes consideration of the social, economic, and environmental aspects of living. Health services is also divided into three dimensions: physical, mental, and social health. The physical and mental health is at the individual level while the social health takes consideration of the whole community. Health services are affected by the cultural, political, technological, demographic, economic, and social contexts of the population (Shi 67).

Chapter 3

Question 1: Suppose you are interested in researching asthma rates among children in the South Bronx. Walk through the steps you would take in putting together and writing your research proposal.

There are several steps I would take in collecting information and writing a research proposal. First, I would conduct a preliminary study concerning asthma in the South Bronx to help determine the funding priorities and sources. After the study, I will contact the donor to determine if there is a specific guideline to be used in writing the asthma proposal. Second, I will take account of the format preferred by the organization. Third, I would seek to determine the review process of the proposal (Shi 102). Furthermore, I would aim to understand the administrative and organizational issues that might affect the research. After which, I will write the proposal as per the guideline and take consideration of all the information collected.

Question 2: Now suppose you work for a foundation that funds health services research, and you are charged with reviewing the proposal about childhood asthma mentioned above. How would you go about deciding whether this proposal is worthy of your financial support? What are some of the things you would be looking for? What are some of the questions you would ask?

If I am reviewing the childhood asthma proposal, factors that I would determine if the study is worth funding or not will include: first, it should be relevant to at least the objective of the organization. Second, the research must be logical and with adequate literature to support the background. Third, I would ask for the researcher’s experience in childhood asthma and research. Furthermore, I will determine if the hypotheses used are appropriate, testable, and relevant to the procedure and aims of the study. I will also take consideration of the reliability and validity of research instruments and the adequacy of the data to be used (Shi 102). I would be looking for the sample size and if can represent the total population of South Bronx. I will also consider the analytical methods proposed and the significance, creativity, and feasibility of the study. Under feasibility, I will ask if the time and budget allocated are justified and adequate. I will also look for the limitations stated and how the researcher plans to mitigate them.

Chapter 4

Question 1: Explain the strengths and weaknesses of the research review portion of the overall research process.

Research reviews have got strengths and weaknesses. The first strength is that it contributes to the advancement of scientific knowledge. Second, research reviews are efficient since they are based on already existing materials (Shi 125). However, research review is limited to the available materials for review. In explanation, research review focuses on the already existing publications and documents. Furthermore, the abnormalities or mistakes in data collected can affect the literature review process.

Question 2: What are the four types of research reviews that we identified? Explain and give a potential example of each.

Research reviews can be categorized into four groups. First, the integrative review which is the most used type of research review. It is a summary of the past research work that relates to the area of interest, for example, the analysis of peer-reviewed journals concerning asthma among children. Second is the theoretical review which is a summary of all the relevant theories used in a given area of study (Shi 108). It provides a comprehensive summary of theories and findings. For example, the theoretical review can be the reviewing the nursing theories in a detailed context. Third, the methodological review is the summary of different research designs with an aim of identifying their strengths and weaknesses. For example, analyses of the qualitative and quantitative research methodologies in health care. Lastly, policy-oriented review entails summarizing the knowledge as per the impact of policy. For instance, a review of how the health policy in the United States affects health care.

Chapter 5

Question 1: Explain how using secondary analysis could help you and be incorporated into your asthma project from Chapter 3.

The secondary analysis could be of assistance in my asthma project if I were to reanalyze data that already exists. For instance, it might be of importance if the study wants to analyze data already existing in the peer-reviewed journals. It can also be used for the analysis of quantitative data relating to the asthma project (Shi 130). Secondary analysis would make the work easer and enable efficiency in the asthma project to be conducted in South Bronx. In explanation, it would conserve time among other resources as opposed to collecting data and conducting a fresh analysis.

Question 2: Why is secondary analysis especially important in times of limited resource availability for research? In other words, how can using secondary analysis help you to conserve resources and still see your project through to completion?

Secondary analysis relieves from the burden associated with data collection. It entails the use of already existing resources as it omits the process of data collection and analysis which is so expensive. It is, therefore, economical to use secondary as opposed to primary analysis methods. In fact, secondary analysis saves money, personnel, and time (Shi 138). However, a number of resources will vary depending on the format compatibility, accessibility, and proper documentation of the set of data.

Chapter 6

Question 1: Discuss an example where qualitative research might compliment, rather than replace, more quantitative methods. How might the two approaches work together?

Qualitative research can complement the quantitative approaches when little is known about the subject. It is often conducted before the quantitative research to allow for exploration. In such situations, both the quantitative and qualitative approaches can be triangulated to ensure a comprehensive research (Shi 143). Qualitative research plays the elucidating and confirmatory roles to which the quantitative research is based. The former acts meaning, substance, and depth to the results of the latter. Triangulation of the two approaches, therefore, leads to a comprehensive research.

Question 2: Focus groups are one specific type of qualitative research. What are some examples of information that you can get out of a focus group approach that would be difficult to get using other methods? How can a focus group meet these needs?

Focus group discussions help in the exploration of issues (Shi 148). The exploratory and definitive information might be difficult to get through other methods since focus group discussions have a variety of views. Focus group discussion can give the exploratory information when it has more than one investigator. One of the investigators will play the moderator role while the other while the other will be recording the information for the content analysis process. The individuals in the group are supposed to be given the opportunity to respond to the views of the moderator and their colleagues.

Chapter 7

Question 1: In class I said that the gold standard in experimental design is a study that is randomized, double-blind, and placebo-controlled. Explain what each of those terms mean, and why they are important in experimental design.

Randomize is a process through which the sample subjects are located to the control or experimental groups regardless of their individual preference or characteristics (Shi 166).The process ensures internal validity of the research study since self-selection is eliminated. Placebo-control is the issuance of a dormant substance administered to the subjects as an imitation of therapy but does not have the therapeutic value (Shi 167). The process can be used in the medical research to determine the effectiveness of a particular medicine. Double-blind experiments, on the other hand, is an experiment that the subject, experimenter, or the researcher is not aware of the control group (Shi 168). The process helps reduce the prejudice that might occur in the study.

Question 2: Explain the difference between internal and external validity of experiments.

External validity is the degree to which the research can be generalized to the treatment, measurement, setting, and population variables. It can be divided into ecological and population validity (Shi 173). Internal validity is the degree to which the independent variable determines the outcome of the study as opposed to the extraneous variables (Shi 174). External validity, therefore, focuses on the extent to which the study determines what is on the ground. On the other hand, internal validity focuses on the relevance of the independent variables in the study.

Chapter 8

Question 1: What is the difference between a cross-sectional survey and a longitudinal survey? What are some of the strengths and weaknesses of each approach?

The cross-sectional survey is a study that has a single survey for each of the samples. Data is collected through self-administered questionnaires or interviews. The cross-sectional survey might be used to ask retrospective, contemporaneous, and prospective questions (Shi 192). However, the amount and accuracy of data that the respondents can give are limited due to recall and memory capability. The survey does not allow for a causal relationship or do not recognize the conflicting views. On the other hand, the longitudinal survey is when a sample has multiple surveys over a period. The survey can be designed to serve multiple purposes. It can also accommodate the non-core questions beside the core questions to help determine latest interests and developments. The surveys can be predetermined at the biannually, annually, and quarterly intervals. They might also be conducted on a continuous basis. Longitudinal surveys can help describe or explain the tools that cross-sectional surveys cannot. It can also determine causal relationships and give accurate studies in the change process. However, it covers only the since it is costly. It also entails a follow-up which might be hectic. Furthermore, the longitudinal survey needs a long-term commitment to funding and security on organizational base. Trace the subjects might be difficult and costly at some moments. Even though the instruments and methods used in the longitudinal survey might change over time, the information received might not be comparable to the initial ones due to factors such as age difference. Furthermore, the survey does not have a comprehensive and established methodologies and theoretical framework.

Question 2:  Why is it so important to train the interviewers who are conducting surveys? In other words, how could poorly-trained interviewers harm your survey’s results?

Training the interviewers’ helps them become motivated as they will understand what the research is about (Shi 199). It also makes them familiar with the specifications and instructions on the questionnaire. Furthermore, training enables the interviewers to be able to record responses during data collection process. They are also taught the basic interviewing techniques such as creating rapport and probing. Failure to train the interviewers might, therefore, lead to the recording of inappropriate answers. It will also cause an increase in the "Don't Know" as the response.

Chapter 9

Question 1: What is evaluation research? Explain the four types of evaluation research discussed in the text.

Evaluation research is the use of a single or several research methods in determining the various features of a policy or program. There are four types of evaluation research. First, needs assessment helps to determine the deficiency and weaknesses of a project. Second is the process evaluation. It deals with the operation of a particular program. Third, outcome evaluation deals with the assessment of the impacts of a program, service, or a policy and its effectiveness in attaining its goals before implementation (Shi 217). Lastly, policy analysis helps in the setting the goals, identifying the alternatives that can be used to meet the goals and assists in the identification of the appropriate option of meeting the goal.

Question 2: Individuals and organizations often resist being the subject of evaluation research. Why do you think that is?

Organizations and individuals often resist being the subject of evaluation research since it will indicate their flaws (Shi 211). In explanation, it will determine their weaknesses and how much the objective has been met. Evaluation research helps determine the weaknesses and strength of an organization or particular individuals or situation. Even though organizations and people might not have issues with the strengths, identification of the weaknesses and their causes is not a friendly attribute. People and organizations fear that the evaluation process will reveal the malpractices that led to the shortcomings.

Chapter 10

Question 1: Explain some of the considerations that need to be taken into account when designing a study.

There are some considerations that need to be considered when designing a study. First, the research population and the sampling strategy must be determined. Second, the appropriate research method or methods should be identified. Third, the data collection identified should be able to determine features of the study population. Measures should also be put in place that will see the sample represent the total population. Furthermore, the appropriate research strategy should be identified that will ensure that validity is upheld. The statistical methods to be used in testing the research hypotheses also need to be determined (Shi 249). Ethical issues and administrative concerns should also be taken into account. Lastly, the timeline and milestones of the study should be taken into account.

Question 2: What is the difference between exploratory, descriptive, and causal research? Give an example of each.

Exploratory research is the study conducted when there is little known concerning the subject matter, for example, a study determining why asthma is common among children. Descriptive research gives a detailed account of the features of the issue of study. This account is seen, for example, in the study of the characteristics of asthma among children in South Bronx (Shi 254). Causal research is a study aiming to determine the relationship between the features. An example of causal research is the link between age and asthma.

Chapter 11

Question 1: A survey firm plans to fill its survey sample by dialing randomly selected home phone numbers during weekday business hours. Identify at least three potential sources of bias that this plan might introduce into the sample.

Random dialing of the home phone numbers might lead to potential sources of bias. The first source of error would be excluding the population without the home phone numbers, more so, those of low socio-economic status. Second, those who are not in their homes during weekdays will be excluded in the study. Third, not all the people selected will be respond to the questions or return the filled questionnaires (Shi 270). Furthermore, the working class is more likely to be excluded in the study since it is conducted on weekdays.

Question 2: What are the different types of probability sampling methods? Explain when each approach is best used.

The four types of probability sampling methods are simple random, systematic, cluster, and stratified sampling. Simple random sampling is suitable when the researcher has little information concerning the population (Shi 272). Systematic sampling is suitable when the researcher has little knowledge of the population and sampling frame is not required. Cluster sampling is suitable when low field costs are needed and the details of the subjects are not available. Lastly, stratified sampling is suitable when there is additional information needed in the study, and there are strata to consider. Furthermore, it is suitable when highest precision possible is needed.

Chapter 12

Question 1: Explain the differences between nominal, ordinal, interval, and ratio measures. Give an example of each.

The nominal measure is a classification of variables using their attributes or characteristics. For instance, classifying gender into male and female (Shi 292). Ordinal measures are indicators whose characteristics can be ranked in a given order. For example, ranking the health services as; very satisfying, satisfying, somewhat satisfying, dissatisfying, and very dissatisfying. Interval measures are variables that can be ranked in a particular order and they are separated using equal distances. A good example is ranking temperature in an interval of 5 degrees Celsius such as 0, 5, 10, 15, and 20. Lastly, the ratio measures are variables with order and interval. However, it also has a true zero. For example height and weight in which zero mean no value.

Question 2: What is the difference between systematic and nonsystematic errors in research? Which one should you be more concerned about? Why?

Systematic errors are biases that consistently affect the research process. On the other hand, the non-systematic errors are those that measurement process in an unpredictable way (Shi 294). Researchers should be more concerned about the systematic errors because they affect the reliability and validity of the study. Reliability focuses on the accurateness of the instruments used in the study. On the other hand, validity is about the extent to which the study measures what is happening on the ground. Both reliability and validity are, therefore, crucial in a study.

Chapter 13

Question 1: What are the advantages and disadvantages of using published versus unpublished sources of data?

Published sources have a number of advantages. First, they are relatively easy to access. Second, using them saves money and time. However, the published sources they are mere summaries thus making it difficult to conduct secondary analysis. Unpublished source, on the other hand, are of much assistance to the researcher as they avail raw data and are available in large sample sizes (Shi 328). However, they might be impossible or had to access more so when the data is confidential or is considered sensitive.

Question 2: You’ve sent out a questionnaire for a research project you’ve been working on, but have been very disappointed by the response rate. What are some actions you might take to improve the response rate going forward?

Some of the actions that I will take to improve the questionnaire response rate will be follow-ups. Furthermore, I would increase my appeal to the sponsor and also reduce the length of the questionnaires (Shi 340). The questionnaire should also be accompanied with an introductory letter explaining the purpose and nature of the research. I would also change the type of questions to suit the respondents’ preference and introduce inducements. Furthermore, I would identify the appropriate population and assure the respondents of anonymity and confidentiality. Furthermore, I might change the contact time and adjust the method through which the questionnaires are returned.

Chapter 14

Question 1: What are dummy statistical tables, and how might they be useful in your research process?

Dummy statistical tables are tables that the values and frequencies of the collected data are recorded (Shi 356). They can be used for research analysis. Dummy statistical tables can also be used in contrasting the measure between control groups and the interventions. They can also be used as statistical plan. The table allows a proactive approach to the evaluation and appraisal.

Question 2: What is the difference between univariate, bivariate, and multivariate analysis? Give an example of each.

Univariate analysis entails an examination of a single variable at a time. It, therefore, produces descriptive statistics in most cases, for example, the number of children affected by asthma. Bivariate analysis is the examination of the relationship occurring between two variables at a given time, for example, how age affects asthma prevalence (Shi 357). The multivariate analysis examines the relationship between three or more variables at a particular time. An example of multivariate analysis is analyzing the relationship between age, economic status, climate, and asthma prevalence.

Chapter 15

Question 1: Explain the different audiences for health services research. Which of these do you think is most difficult to communicate to, and why?

The different audiences of health research services are the public, the stakeholders, and the research community. The public is neither the funders nor the researchers in a project (Shi 392). The stakeholders are those who have a critical role to play in the research and include the funders. The research interest includes the potential scientists and the scientists. The one more difficult to is the public because they have no idea concerning the project and would not be able to understand some of the technical terms used in the study. Some of them are also illiterate or might not have an interest in the study.

Question 2: What are three reasons that a researcher might not see her findings implemented in the real world? What are some things she might do to try to overcome those obstacles?

The research findings might not be implemented in a real world setting if they are not relevant to the policies. The hindrance can be addressed through conducting another study that is more relevant to the health policy. The study type and its predicted impacts might influence its implementation (Shi 400). The solution can be corrected if it is based on tangible evidence. Lastly, research findings can fail to be implemented due to the conflict between research and policy priorities. The hindrance can be solved through the researchers studying the areas that the decision makers consider to be of concern and conduct research on them.

Work Cited

Shi, Leiyu. Health Services Research Methods. Clifton Park, NY: Thomson/Delmar Learning, 2008. Print.