Mary Frances Oneha, APRN, PhDAugust 22, 2013

Tools for Building Infrastructure at Health Centers for Research

Why Build Infrastructure?• It’s all about the data• Improving the health of

communities is critical

The Investment

He Alo a He Alo(Face to Face)

Burgess P. (1993) He Alo a He Alo. In He Alo a He Alo Face to Face, Hawaiian Voices on Sovereignty. The American Friends Service Committee

Stages of Research Development

• Collaborating with external entities to recruit research participants

• Establishing formal partnerships with other organizations and institutions to conduct research

• Creating a research department to generate own research proposals

Shared Commitment• Believe• Behave • Become• Belong

Building Blocks for a Research Infrastructure

• Selecting and Establishing Partnerships to gain:• A different perspective• Expertise in a particular area• Access to resources• Common vision to facilitating a healthy and sustainable future

for communities

– A MOU or MOA helps to formalize the relationship

• Policies and Procedures to Conducting Research• Overall policy to conducting research at your CHC• Detailed operating procedures

• Financial Resources• Equitable partnerships

• Human Resources• Investment of staff time (new or re-allocated)• Research Coordinator (administrative functions)

• Hard Infrastructure• Space• Equipment; Secure data storage• Software; Library databases; etc.

Building Blocks for a Research Infrastructure

Challenges and Solutions To Building a Research Infrastructure

• Infrastructure• Human Resources• Participant Recruitment• Staying Committed

Infrastructure Challenge Solution

Competing space needs Not just physical space, but consider secure data storage needs when initiating proposal.

Lack of adequate communication tools

Technological resources need to be anticipated, budgeted, and used.

Lack of analytical software Academic PI purchased quantitative software for the CHC

Transition from paper to EMR Allow time if research is in the middle of transition or wait until transition is completed.

Human ResourcesChallenge Solution

Lack of dedicated finance resources Ensure timely and dedicated finance resources for processing invoices, incentives, unanticipated adjustments to staff time, etc.

High staff turnover Developed “mobile” research orientation and project training program

Staff overload Thorough assessment of workload, training, and skill if using existing staff vs. hiring new or temporary staff.

Participant RecruitmentChallenge Solution

Sustaining engagement over multiple data collection points

More frequent contact leading up to data collection point.

Determining appropriate over-sampling numbers

Understand the social context of the population (mobile population w/ frequent address changes)

Staying CommittedChallenge Solution

Dissemination and translation State expectation when proposal is presented to CHC.

“Shovel-ready” projects Clearly state need to partner in development of idea – have the resources available to do this.

Cultural considerations and integration

Interpretation & translation is not enough; offer cultural consultation

Infrastructure to support data requests

Develop data request form that provides the limits to requesting data.

ReferencesOneha MF, Dodgson JE. Lessons learned: Refining the research

infrastructure at community health centers. Progress in Community Health Partnerships Research Education and Action. Accepted for publication January 6, 2013.

Oneha MF, Proser M, Chang Weir R. Community health centers: Why engage in research and how to get started. 2012. NACHC.

Shoultz J, Oneha MF, Magnussen L, Hla MM, Brees-Saunders Z, Dela Cruz M, & Douglas M. Finding solutions to challenges faced in community-based participatory research between academic and community organizations. Journal of Interprofessional Care. 2006; 20(2): 133-144.

Oneha MF & Beckham S. Re-examining community based research protocols. Pacific Public Health 2. Pacific Health Dialog: Journal of Community Health and Clinical Medicine for the Pacific, 2004; 11(1): 102-106.

Mahalo• National Institute of Nursing Research

(Grant #7R21 NR 010218) • Community Health Applied Research

Network (CHARN) (Grant #UB2HA20232) DHHS HRSA HIV/AIDS Bureau.