SAMPLE #1: USe of research evidence Proposal Abstract
Practice/Policy Question:How do research–practice partnerships promote the use of research evidence in school districts?
Background:The current policy environment encourages evidence-based decision making as a key strategy for improving the effectiveness and efficiency of schools. Research–practice partnerships—long-term structured collaborations—are a promising strategy for improving the use of research evidence in school districts. These partnerships vary in how they define and tackle problems, how they formalize knowledge and develop tools, and how they work with districts to use what is learned. This revised proposal will consider two partnership types: a research alliance and a design-research partnership. In research alliances,school district officials collaborate with university researchers to define an agenda focused on studying local problems of policy and practice. In design-research partnerships, researchers and school leaders develop tools and processes to support educational improvement. The proposed study will examine these models of partnering to learn how differences in their design and strategy shape school districts’ capacity to interpret and use research.
Research Aims or Questions:What organizational structures are necessary for school districts to access, interpret, and use research evidence? Do differences in the design and strategies of research–practice partnerships shape school districts’ capacity to interpret and use research? If so, how do they build capacity to create and use research to improve student outcomes?
Setting and Participants:The first case study will focus on a design-research partnership among the Strategic Education Research Partnership (SERP), the University of Pennsylvania, and the Baltimore City Schools. This partnership will enact a program of research to measure and improve the grit and perseverance of middle school students. The second partnership involves the Research Alliance for New York City Schools at New York University and the New York City Department of Education, which traditionally has studied reform efforts, high school achievement, and college readiness.
Research Methods:The PI will use a longitudinal, qualitative case study design to explore how variation in the two partnerships bears on the development of each district’s capacity to interpret and use research. They will observe dialogue and social exchanges during meetings among partners and with district staff during 12–14 visits over 2.5 years of data collection. These observations will provide insights about how district staff value, interpret, and use research. The team will also conduct 10–15 semi-structured interviews with partnership members during each visit to probe how members make sense of research based on their own experiences, their colleagues, their position in the organization, and other factors. The investigators will also review documents and artifacts, produced by the partnerships’ leadership and district staff to assess how they value, interpret, and use research. The team will analyze the information gathered to look at organizational structures associated with research use and the partnership’s role (if any) in advancing these structures and processes.
SAMPLE #2: USe of research evidence Proposal Abstract
Practice/Policy Question:Will communicating research through narratives have a greater impact on clinicians’ prescribing behaviors than evidence-based guidelines?
Background:Clinicians are prescribing antipsychotic medications at alarming rates to children enrolled in Medicaid. The PI and colleagues posit that, consistent with the theory of planned behavior, clinicians’ prescribing behaviorsare influenced by their attitudes, the norms of their peers, and how easy they think it is to perform the recommended behaviors. The investigators suggestthat these factors are amenable to change, but that standard evidence-based guidelines are static and unlikely to affect clinicians’ behavior. In contrast, narratives—coherent stories with an identifiable beginning, middle and end, which provide information about characters, scenes, and conflicts—have been recognized as a persuasive tool to promote patients’ health behavior change. Narratives have not been tried with experts or practitioners, but there is reason to believe they have promise. The PI hypothesizes that pairing guidelines with narratives that engage clinicians in concerns related to the misuse of antipsychotics among Medicaid-enrolled youth will enhance physicians’ recall of guidelines, and help shift attitudes, norms, control, and, ultimately, prescribing behaviors. The investigator proposes to test an approach that may promote the use of research todecrease over-prescribing behaviors by clinicians.
Research Aims or Questions:Are guidelines accompanied by narratives about patient care and professional experiences more impactful in shifting prescribing behaviors than standard evidence-based guidelines alone?
Setting and Participants:The sample for phase one will include at least 30 clinicians serving youth. The sample will be balanced across clinical specialties (pediatrics, family practice, and psychiatry) and regions of Pennsylvania. The sample for the second phase will include 3,000–4,000 clinicians in Pennsylvania who treat Medicaid-enrolled youth ages 5–18 with behavioral conditions.
Intervention:For six months, providers will receive an email every three months with the standard evidence-based recommendations or the narrative-enhanced recommendations. The narratives will seek to maximize clinicians’ identification with characters, imagery of the events, perceived realism, normative values, and reinforcement of the desired behaviors.
Research Methods:The study will unfold in two phases. In phase one, the research team will interview clinicians to ascertain the factors motivating their decision-making and prescribing behaviors. The interviews will probe clinicians’ attitudes, norms, and control related to guidelines, use of evidence, and prescribing behaviors. The interviews will also elicit patient care narratives and professional experiences. The researchers will then use focus groups to optimize the narratives for insertion in the intervention implemented in phase two. Phase two will involve a randomized controlled trial to test the effectiveness of these narratives in both written and video form, as compared to standard evidence-based guidelines presented in newsletter form. Effectiveness of the interventions will be measured using administrative Medicaid claims data from pharmacy and personal summary files of provider counts of monthly antipsychotic prescriptions.