Maximizing research study effectiveness in malaria elimination settings: a mixed methods study to capture the experiences of field-based staff

Malaria Journal

Research

Cesia E. Quintero¹  Jack S. Richards²  Sara E. Canavati³  Maxine Anne Whittaker⁴  Sovann Yok⁵  Dysoley Lek⁶  Britt Haller⁷ 

[1] Centre for Biomedical Research, Burnet Institute, Melbourne, Australia;Centre for Biomedical Research, Burnet Institute, Melbourne, Australia;Department of Medicine, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia;Department of Infectious Diseases, Monash University, Melbourne, Australia;Centre for Biomedical Research, Burnet Institute, Melbourne, Australia;Vysnova Partners Inc., Washington, DC, USA;College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Australia;Provincial Health Department, Pailin City, Pailin Province, Cambodia;The National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia;The Northern Hospital, Epping, Australia;

关键词: Malaria;    Mobile and migrant population;    Clinical trials;    Therapeutic efficacy studies;    Artemisinin resistance;    Study design;    Multidrug resistant malaria;    Malaria elimination;    Cambodia;    Malaria research;    Operational research;   

DOI  :  10.1186/s12936-017-2016-4

 received in 2017-01-24, accepted in 2017-09-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn a drug-resistant, malaria elimination setting like Western Cambodia, field research is essential for the development of novel anti-malarial regimens and the public health solutions necessary to monitor the spread of resistance and eliminate infection. Such field studies often face a variety of similar implementation challenges, but these are rarely captured in a systematic way or used to optimize future study designs that might overcome similar challenges. Field-based research staff often have extensive experience and can provide valuable insight regarding these issues, but their perspectives and experiences are rarely documented and seldom integrated into future research protocols. This mixed-methods analysis sought to gain an understanding of the daily challenges encountered by research field staff in the artemisinin-resistant, malaria elimination setting of Western Cambodia. In doing so, this study seeks to understand how the experiences and opinions of field staff can be captured, and used to inform future study designs.MethodsTwenty-two reports from six field-based malaria studies conducted in Western Cambodia were reviewed using content analysis to identify challenges to conducting the research. Informal Interviews, Focus Group Discussions and In-depth Interviews were also conducted among field research staff. Thematic analysis of the data was undertaken using Nvivo 9® software. Triangulation and critical case analysis was also used.ResultsThere was a lack of formalized avenues through which field workers could report challenges experienced when conducting the malaria studies. Field research staff faced significant logistical barriers to participant recruitment and data collection, including a lack of available transportation to cover long distances, and the fact that mobile and migrant populations (MMPs) are usually excluded from studies because of challenges in follow-up. Cultural barriers to communication also hindered participant recruitment and created unexpected delays. Field staff often paid a physical, emotional and financial cost, going beyond their duty in order to keep the study running.ConclusionsFormal monthly reports filled out by field study staff could be a key tool for capturing field study staff experiences effectively, but require specific report fields to encourage staff to outline their challenges and to propose potential solutions. Forging strong bonds with communities and their leaders may improve communication, and decrease barriers to participant recruitment. Study designs that make it feasible for MMPs to participate should be pursued; in addition to increasing the potential participant pool, this will ensure that the most malaria-endemic demographic is taken into account in research studies. Overlaps between clinical care and research create ethical dilemmas for study staff, a fact that warrants careful consideration. Lessons learned from study field staff should be used to create a set of locally-relevant recommendations to inform future study designs.

【 授权许可】

CC BY   
© The Author(s) 2017