Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration
Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration
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DOI：
10.1186/s13012-019-0853-y
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发表时间：
2019-02-01
影响因子：
7.2
通讯作者：
Midboe, Amanda M.
中科院分区：
文献类型：
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作者：
Gale, Randall C.;Wu, Justina;Midboe, Amanda M.
开展和迅速传播深入定性分析的结果具有挑战性，由于其方法耗时，可能妨碍及时实施干预措施。为了更好地理解对可操作结果的需求和科学严谨性之间的权衡，我们提出了我们的方法来进行框架指导的快速分析（RA），并将这些发现与采访记录的深入分析进行比较。方法在评估退伍军人健康管理局成功的阿片类药物处方学术详细（AD）项目的背景下，我们根据实施研究综合框架（CFIR）制定了访谈指南，并采访了10名学术详细（临床药剂师）和20名初级保健提供者，以获得该项目成功特征的细节。对于RA，使用结构化模板（基于CFIR）对逐字转录本进行汇总；随后，根据参与者类型将摘要合并为矩阵，以确定项目中工作良好的方面以及促进其他地方实施的方法。为了进行比较，我们随后对成绩单进行了深入的分析。我们描述了我们的RA方法，并在主题和资源强度的一致性方面对RA和演绎深入分析进行了定性比较。结果在整个RA和深入分析中整合CFIR有助于在两种分析之间提供结构和一致性。两项分析的结果是一致的。来自深度分析的最常见的编码结构与RA的主题很好地结合在一起，后一种方法对于处理主要的评估目标是足够和适当的。与深入分析相比，我们的RA方法的资源密集程度较低，可以及时将发现传播给我们的业务合作伙伴，这些合作伙伴可以整合到正在进行的实施中。结论深度分析可能占用大量资源。如果与项目需求一致（例如，快速生成信息以通知正在进行的实现或遵守政策命令），考虑使用RA是合理的，特别是在面临资源限制时。我们的RA在短时间内提供了有效的调查结果，使我们的运营合作伙伴能够确定可操作的建议。
BackgroundIt is challenging to conduct and quickly disseminate findings from in-depth qualitative analyses, which can impede timely implementation of interventions because of its time-consuming methods. To better understand tradeoffs between the need for actionable results and scientific rigor, we present our method for conducting a framework-guided rapid analysis (RA) and a comparison of these findings to an in-depth analysis of interview transcripts.MethodsSet within the context of an evaluation of a successful academic detailing (AD) program for opioid prescribing in the Veterans Health Administration, we developed interview guides informed by the Consolidated Framework for Implementation Research (CFIR) and interviewed 10 academic detailers (clinical pharmacists) and 20 primary care providers to elicit detail about successful features of the program. For the RA, verbatim transcripts were summarized using a structured template (based on CFIR); summaries were subsequently consolidated into matrices by participant type to identify aspects of the program that worked well and ways to facilitate implementation elsewhere. For comparison purposes, we later conducted an in-depth analysis of the transcripts. We described our RA approach and qualitatively compared the RA and deductive in-depth analysis with respect to consistency of themes and resource intensity.ResultsIntegrating the CFIR throughout the RA and in-depth analysis was helpful for providing structure and consistency across both analyses. Findings from the two analyses were consistent. The most frequently coded constructs from the in-depth analysis aligned well with themes from the RA, and the latter methods were sufficient and appropriate for addressing the primary evaluation goals. Our approach to RA was less resource-intensive than the in-depth analysis, allowing for timely dissemination of findings to our operations partner that could be integrated into ongoing implementation.ConclusionsIn-depth analyses can be resource-intensive. If consistent with project needs (e.g., to quickly produce information to inform ongoing implementation or to comply with a policy mandate), it is reasonable to consider using RA, especially when faced with resource constraints. Our RA provided valid findings in a short timeframe, enabling identification of actionable suggestions for our operations partner.