Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration

Abstract

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.Electronic supplementary materialThe online version of this article (10.1186/s13012-019-0853-y) contains supplementary material, which is available to authorized users.

Adapting rapid assessment procedures for implementation research using a team-based approach to analysis: a case example of patient quality and safety interventions in the ICU

“…There have been a variety of attempts to improve the speed at which rigorous qualitative analysis can be undertaken. Such approaches include creating an a priori structured codebook for summarizing data by interview question [39], coding audio only [20], condensing data down through a series of tables [40], or allocating researchers to code for specific themes [17]. Such rapid analysis approaches have been shown to produce valid findings compared to traditional in-depth, line-byline transcript analysis and may be added to the applied qualitative health services researcher toolkit [39].…”

The rise of rapid implementation: a worked example of solving an existing problem with a new method by combining concept analysis with a systematic integrative review

“…Attributes Attributes are characteristics of the concept that make it possible to identify situations that can be characterised under the concept and constitute the essential definition of a concept [27,49]. The defining attributes of the term rapid implementation include rapid [37,39,44,50], responsive [10,39,51], relevant [37,42,52], efficient [36,37,44], and speedy [4,37,39] research findings that are produced because of more flexible designs (methods [10,44,53], approaches [42], procedures [37,50], and implementation science frameworks [40,50,54]. Other attributes include calls to re-define research rigour [11,37,41,52] which entails promoting research that is both thorough, relevant and that disseminates well into practice to increase the timeliness and applicability of research.…”

“…Peek et al [52] suggest current conceptions of rigour do not allow for this and limit the range of real-world situations where intervention implementation is feasible. Striking a balance between rigour, rapidity and flexibility of methods and procedures [55] is difficult however to achieve [37,50].…”

Promoting community health collaboration between CTSA programs and Cooperative Extension to advance rural health equity: Insights from a national Un-Meeting

“…The purpose of these sessions was to obtain information from stakeholders and disseminate the results to inform practice, research, and policy; therefore, the sessions were not audio-recorded, nor transcribed verbatim, but instead analyzed with a time-intensive qualitative approach. Rapid qualitative analyses, such as the approach taken by our Un-Meeting team, have been shown to be a reliable method compared to results from in-depth analyses provided by stakeholders [9].…”

“…The HERO was able to assist the researcher by introducing her to school leaders and parents, as well as explain the relevance of her role in conducting a study that was aimed at reducing obesity in young adults residing in their county. Additionally, a HERO was called to work alongside the department of psychiatry at UNMHSC to prepare training sessions in Mental Health First Aid for "first responders" to help relieve barriers in accessing counseling or therapy [9].These examples illustrate how a similar model could be undertaken to address the health-specific topics from the Un-Meeting sessions, such as chronic disease, substance use, gun use, health literacy, and intergenerational and aging issues.…”