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Berihun Megabiaw (MD,MPH) April, 2012 Epid & Biostat Dep`t, UoG
Learning Objectives
At the end of this session the student will be able to: Define health research, research design, and research methods Understand the differences between research and audit Understand the different types of research Develop research objectives of different
forms
Research?
The systematic collection, analysis, and interpretation of data to answer a certain question or solve a problem
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Health Research?
Health research is the process of obtaining systematic knowledge and technology which can be used for the improvement of the health of individual groups. It provides the basic information on the state of health and diseases of the population; it aims to develop tools to prevent and cure illness and mitigate its effects and it attempts to devise better approaches to health care for the individual and community (Davies 1991)
Types of research
Level of Analysis
Conditions
Object of Analysis
Responses Clinical Research (Efficacy of preventive, diagnostic, and therapeutic procedures, natural history of diseases) Health Systems research (Effectiveness, quality, and costs of services: development and distribution of resources for care )
Biomedical Research (Basic biological processes, structure and function of the human body, pathological mechanisms) Epidemiologic Research (Frequency, distribution, and determinants of health)
Epidemiological Research Example: Prevalence and risk factors of cigarette smoking and khat chewing
Research Methods
Refers to: The practices and techniques used to collect, process and analyze the data (e.g What type of experiment or survey); The sample size and methods of sampling In the case of experiments and analytical studies, of assignment to experimental and control groups The research proposal will need to present and justify the appropriateness of the chosen research methods
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Because what Yes, we you told us is are. How absolutely did you correct but it is know? completely useless.
Because you dont know where you are, you dont know where youre going, and now youre You must blaming me for be policyanswering your makers. question precisely.
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What is A Problem?
What is
Ideal Exist
Situation: In District X (pop. 145,000) sanitary conditions are poor (5% of households have latrines) and diseases connected with poor sanitation, such as hepatitis, gastroenteritis and worms, are very common. The Ministry of Health has therefore initiated a sanitation project which aims at increasing the percentage of households with latrines by 15% each year. The project provides materials, and the population should provide labour. Two years later, less than half of the target has been reached.
Discrepancy:
35% of the households should have latrines, but only 15% do have them.
Possible answers????
Problem situation: District A: 125 HIV-positive adults were coming to the hospital every day as part of a DOTS programme to take medication for TB; last month for one entire week, none of the 125 patients received any medication Discrepancy? Problem question? What are the factors responsible for 125 patients failing to receive any treatment? Possible answer: During the week a very heavy rainstorm caused flooding that washed out several roads a resupply truck could not reach the hospital for one week
? ? ?
1. Relevance How large or widespread is the problem? Who is affected? How severe is the problem?
2. Avoidance of duplication find out whether the suggested topic has been investigated before either within the proposed study area or in another area with similar conditions
3. Urgency of data needed (timeliness) How urgently are the results needed for making a decision or developing interventions at various levels (from community to policy)? Consider which research should be done first and which can be done later 4. Political acceptability research a topic which has the interest and support of the local/national authorities
5. Feasibility Think about the resources required to conduct the study manpower, time, equipment and money that are locally available possibility of obtaining technical and financial assistance from external sources 6. Applicability of possible results/recommendations Is it likely that the recommendations from the study will be applied?
7. Ethical acceptability the possibility that we may inflict harm on others while carrying out research
Problem Analysis
Identify factors that may have contributed to the problem Clarify the relationship between problem and the contributory factors
X Ray or smear microscopy is inadequate for use in D &T Delay in diagnosis Attempts to develop rapid diagnosis procedure
Self medication
Delay in treatment
Growing resistance of Mycobacterium species to anti TB drugs Failure of anti TB drugs to control TB in recent years
Poor compliance of patients Not providing HE
Problem statement
Constitutes the scientific justification for the study; Gives an empirical basis to describe the situation Clearly specifies the gaps (in existing knowledge and/or controversy and inconclusive evidence) Defines the objective of study and conveys the questions or broader issues
A logical sequence for presenting the statement Magnitude, frequency and distribution: Affected geographical areas & population groups affected by the problem Probable causes of the problem: What is the current knowledge of the problem and its causes? Is there consensus? controversy? conclusive evidence? Possible solutions: In what ways have solutions to the problem been attempted? What has been proposed? What are the results? Unanswered questions: What remains to be answered? What areas have not been possible to understand, determine, verify, or test?
NATURE OF PROBLEM
ANALYSI S
SOLUTION TRIED & JUSTIFICATI ON
Growing resistance of Mycobacterium species to anti TB drugs Failure of anti TB drugs to control TB in recent years Prolonged In adequate X Ray or duration for C smear microscopy &S Unsuccessful attempts to develop rapid diagnosis procedure
EXPECTED RESULT
RESEARC H QUESTION
What will be the ways and means to develop rapid culture technique for tubercle bacilli ? Sample for INTRODUCTION
4/25/2012
Berihun M.
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A Research Question
Uncertainty about something in the hospital/treatment procedure/population that the investigator wants to resolve by making measurements on his/her study subjects
Medical Articles
Research Question
Observations
Conference s
Research questions:
- Formulated when insight into the problem being studied is not sufficient.
E Ethical : Autonomy, Benefits and Risks, Justice R Relevant : To scientific knowledge, clinical & health policy
future research directions
Formulating Objectives
Example: Imagine you are a member of National Cigarette Smoking Cessation Group. One issue that the group considers is nicotine replacement therapy for people who want to stop smoking. The other group says advising people to stop smoking will suffice. The debate continued but they couldnt agree. Formulate a research question for the above problem
To focus the study (Narrow the scope) To avoid collection of unnecessary data
Facilitate the development of research methodology Help to orient the collection, analysis, interpretation and utilization of data.
certain of where you are going, you may well end up somewhere else (and not even know it!).
WHERE ARE YOU GOING?
Set objective
Evaluate performance
General Objective
Specific Objectives
Breaking down the general objective into smaller, logically connected parts
Should address various aspect of problem and factors influencing/associated with/determining the problems. The first specific objective usually focuses on quantifying or specifying the problem Should specify What will do in the study Where For what purposes
1. Determine the level of utilization of ANC in District X over the years 1998 and 1999. 2. Identify whether there are variations in utilization of ANC service, related to the season and type of clinic.
3. Identify socioeconomic & cultural factors that may influence the mothers' utilization of ANC services
Cover the different aspects of problem and its contributing factors in a coherent way and logical sequence
Clearly phrased in operational terms by specifying what you are going to do, where and for what purpose
Considering local conditions to be realistic Use action verbs
To compare: the level of utilization of ANC services among various S.E groups. To establish: the pattern of utilization of ANC services in various seasons of the year.
To the dev`t of all other components of a research design, subsequent data collection, analysis, reporting & utilization of data.
1. Formulate research questions (03) 2. Write general and specific objectives for them
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