HPM 789-Aims, Literatrue Review, and Conceptual Model

HPM 789-Aims, Literatrue Review, and Conceptual Model -...

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Unformatted text preview: Overview to Today’s Seminar • • • Specific Aims Literature Reviews Conceptual Models Specific Aims • May be hardest part of proposal – Drives all other components of proposal – Reader must care and be excited – Tell a crisp story with logical connections – Make clear what you plan to do – Defines boundaries of your research – Iterative—will change over time – Only one page Structure of Specific Aims • • • Introductory paragraph(s) Specific aims Impact/Payoff paragraph Introductory Paragraph(s) • Opening Sentence: Capture attention • Summarize Current Knowledge: – Why should we care? Prevalence, cost, impact – What do we know? • Gap in Knowledge/Unmet Need: – Identify gap that will be addressed Specific Aims • Logical and build from introductory paragraphs • Include hypotheses with specific outcomes (if appropriate) • Judicious about number of aims (2-3) • Brief, focused, and limited in scope • Interconnected but not dependent Specific Aims Identify factors associated with disenrollment from acute/long-term managed care plans for frail older adults. Specific Aims Identify factors associated with disenrollment from acute/long-term managed care plans for frail older adults. Specific Aims • Program of All-Inclusive Care for the Elderly (PACE) is acute/long-term managed care plans for frail and vulnerable Medicare beneficiaries. • Specific Aim: Examine patterns of disenrollment in PACE across programs and time and identify enrollee and program predictors of disenrollment. Specific Aims Examine the attitudes and beliefs of key stakeholders about Medicaid expansion under the Affordable Care Act Hypotheses • • • • Declarative statement (not a question) Testable Derived from theory Posits expected relationship between variables • Specific: Define variables, setting, population • Short and to the point • Directional hypotheses are stronger Hypotheses Veterans with uncontrolled hypertension who are randomized to the titrated disease management intervention arm will have greater improvement in mean systolic blood pressure over the 18 months of followup than veterans in the control arm. Payoff Paragraph • What is expected outcome • How will findings be used in policy, practice, and/or research? • How will study improve health? Specific Aims: Suggestions • Use strong verbs: identify, determine, establish • Limit abbreviations and jargon • Think about final paper: table shells, product, audience • Start with bulleted outline Specific Aims: Suggestions • Identify first reader early possible • Seek critical feedback on drafts from your reader(s) • Set and make realistic deadlines • Write early and often • Develop thick skin Specific Aim • Diabetes is a prevalent, morbid, and costly condition in the US • The consequences of diabetes can be reduced if patients have adequate control of their blood sugar • Despite effective treatments, diabetes patients often have poor blood sugar control • Specific Aim: Identify factors that contribute to diabetes patients having uncontrolled blood sugar Theory • A set of principles, propositions, and assumptions to provide a plausible explanation for a causal relationship • Tends to be relatively broad in scope • Suggests relationships among different factors • Serves as the basis for conducting research • Is used to derive aims and hypotheses Conceptual Model • • • • • Operationalizes theory One model not inherently better than another Guides the research question Clarifies ideas Defines relationships among concepts in study • Figure often best way to present the model • Specifies critical concepts, causal order, and hypotheses • Finalizing model is iterative: literature, available data, pragmatics. Conceptual Model: Andersen and Aday • Originally to predict access to care and health services utilization – Predisposing (e.g., age, gender) – Enabling (e.g., insurance) – Need (e.g., health status) • Has been revised over time to capture additional factors that influence access and utilization Program of All-inclusive Care for the Elderly (PACE) • Acute/long-term managed care plan for frail Medicare beneficiaries • Individual- and program-level factors that explain disenrollment • Individual-level factors – Predisposing: Age, gender, education, race/ethnicity, residence, social support – Enabling: Insurance – Need: ADL, health status, diagnoses Conceptual Model • Other individual-level factors that could explain disenrollment from PACE Conceptual Model • Other individual-level factors that could explain disenrollment from PACE – – – – Satisfaction with their care Health beliefs (e.g., efficacy of program) Transportation available Presence of informal caregiver Specific Aim • Diabetes is a prevalent, morbid, and costly condition in the US • The consequences of diabetes can be reduced if patients have adequate control of their blood sugar • Despite effective treatments, diabetes patients often have poor blood sugar control • Specific Aim: Identify factors that contribute to diabetes patients having uncontrolled blood sugar Literature Reviews • Find published research to: – Establish importance of the topic – Summarize what is known and not known – Identify gaps in knowledge and direction for future research • Specific study question • How research extends current knowledge – Help identify conceptual model to guide project Conducting the Review • Peer-reviewed articles are more trusted than non-peer-reviewed sources • Read primary sources for key articles • Review reference lists of critical articles • Discussion, limitations and future directions can provide ideas about next steps • Gray literature • Be cautious when using internet sites Literature Review as a Masters Paper • Systematic literature review: Formal process that limits bias in identifying and organizing literature on a topic • Meta-analysis: Statistical synthesis of the paper Conducting the Review • Resources – Pubmed: – Electronic databases: – Literature syntheses: – Google scholar: – Mellanye Lackney librarian for SPH ...
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