How to Make a Good Chicken Omelette: Research and Practice Working Together
Chef Jaelea Skehan, Hunter Institute of Mental Health (Program Manager)
Chef Myfanwy Maple, University of New England (Associate Professor)
Acknowledgement to Trevor Hazell for providing a core ingredient
The core ingredients
Types of research?
• Suicide prevention research has expanded since the mid 20th century and is now recognised as a discrete field – “suicidology”.
• Suicide prevention research (according to Hjelmeland & Knizek, 2011) can be broken into (1) (neuro) biological research; (2) epidemiological research; (3) intervention studies. • The question remains as to whether suicide prevention research is addressing the most pressing problems or questions;
• Many have argued that less effort is being put into intervention research.
Types of research?
• Intervention studies were rated as highest priority for future study in an Australian study; • Only 12% of suicide prevention conference abstracts examined by Huisman, Pirkis & Robinson (2010) were related to intervention studies
• By comparison, 48% related to epidemiological studies and 12% on biological or genetic risk factors. • Others have argued a need for more qualitative methods research focussed on “understanding” of suicide, with only 3% of studies in suicide prevention journals utilizing a qualitative approach). Suicide prevention practice?
• There are many ways to classify suicide prevention practice. • The LIFE Framework: (1) Universal interventions Selective interventions; (3) Indicated intervention (4) Symptom identification; (5) Early treatment; (6) Treatment; (7) Longer‐
term treatment and support; (8) Ongoing care and support.
• Other models describe Primary, Secondary and Tertiary Prevention interventions;
• Others again describe primary prevention, intervention, and postvention. Knowledge
Research
Theory
Practice
Innovation Development
Knowledge into Outcomes
Characteristics of the innovation
Characteristics of the end‐users, adopters
Dissemination
intervention
Adoption
Characteristics of the end‐user’s environment
Adapted from Ottawa Model of Research Use, Logan & Graham, 2003
Outcomes
Knowledge
Research
Theory
Practice
Innovation Redevelopment
Evaluation/Research
Characteristics of the innovation
Characteristics of the end‐users, adopters
Dissemination
intervention
Adoption
Characteristics of the end‐user’s environment
Adapted from Ottawa Model of Research Use, Logan & Graham, 2003
Outcomes
Let’s explore some case‐studies (primary prevention)
Research into practice: e.g. Mindframe
Research evidence related to media reporting and portrayal of suicide
Consultation and sector engagement to identify qualities about journalists and the media environment
Development of Australian guidelines
Evidence based strategies to enhance program dissemination
Dissemination of Australian guidelines (integration into policies, professional development, partnerships, leadership
Practice into research: e.g. Mindframe
Outcomes related to media practice: One of only two countries where the introduction of guidelines or have resulted in a change in reporting (Media Monitoring study, Pirkis et al. 2009). In terms of quality, suicide items increased from 57% to 75%
Awareness and reach: Evidence that media are aware of the resources and use the resources in their practice and the type of dissemination strategies that are effective (Skehan et al., 2006; Pirkis et al., 2006). Evaluation of novel approaches: Published outcomes indicating uptake in journalism curricula and improvements in student knowledge and skills (Skehan et al., 2009). Knowledge
Research
Theory
Practice
Innovation Redevelopment
Evaluation
Characteristics of the innovation
Characteristics of the end‐users, adopters
Dissemination
intervention
Adoption
Characteristics of the end‐user’s environment
Adapted from Ottawa Model of Research Use, Logan & Graham, 2003
Outcomes
Practice before research: e.g. Community Guidelines
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TASK: To develop community guidelines to guide the discussion of suicide, relevant to schools, workplaces, families and communities and relevant for the diversity of the NSW population.
PROBLEM: It has never been developed or evaluated before and the research evidence is limited and conflicting with many variables to be tested. CURRENT APPROACH: Generate evidence through analysis of current approaches, consultation with experts and the targeted sectors, qualitative methods to ‘understand’ community needs and possible Delphi approach to finalise resources
RESEARCH? Best practice would involve a pilot of the guidelines across settings (gold standard = RCT). Partnerships between researchers and practitioners
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• What does RCT look like in the suicide field and can this be applied on the ground?
– RCT = sample population is randomly split into intervention, non‐
intervention groups. Intervention receive something, non‐intervention do not. Change is analysed. – Imagine what this in your practice
• RCT in suicide is often difficult – there is a lot at stake
• Other models of research‐practice partnerships, e.g…
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Evaluation (often where a partnership might commence)
Analysis
Methodologies designed to suit practice
Building capacity
The problem in Australia?
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• Current funding models for “practice” do not prioritise research and generating the evidence base for interventions;
– Potentially effective activities and interventions may not be funded or supported because of the “lack of evidence”;
– Potentially harmful activities and interventions are likely to be occurring because there is little investment in evaluation and research;
– Research skill base in practice may be limited
• Much of the current research does not consider translation and dissemination of the outcomes at the design phase; – So $$$ and time is somewhat wasted (in my opinion).
– May not have the partnerships ‘on the ground’ to extend current practice
• NHMRC and ARC assisting in changing this
The way forward?
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• Funding models (for both research and practice) should reward partnerships between the two;
• We must invest in building the capacity of community based organisations to understand evidence‐base and how to apply it – and how to contribute to it
• Funded mentoring for researchers (to learn about translation and dissemination) and for practitioners (to learn about research methodologies, and how to apply them for their setting).
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