What Is Research And How Can Research Benefit Your .

What is Research andHow Can ResearchBenefit YourOrganization?Shao-Chee Sim, PhDDirector of Research and EvaluationCharles B. Wang Community Health Center

What is research to you?When you hear“Research,”what comes to mind?

We define “research” as Research entails systematic collection ofinformation about the activities, characteristics,and outcomes of programs, services,organizations and communities served bynonprofit organizations.Research activities, which may include needsassessment, quality improvement, monitoring,and evaluation, are undertaken to informorganizational direction, develop programs andrefine services.

Common reactions to the term “research”

Common Sentiments about Research I don’t speak the research languageI am not a numbers personIt can only be carried out by PhDs and socialscientistsIt costs a lot of monies and timeIt means reading lengthy reportsIt will distract from real workThe research findings will be ignored

Barriers to Conducting Research Limited resources (time, money and/or expertise)Misunderstanding and anxiety over the researchprocess and terms like hypothesis, methodology,outcomesPast research efforts that have been burdensome,critical and problem-centeredPast research efforts that have been “imposed” onorganizations from the outside (i.e. funders)Delay in producing research reportsExisting tension between producing useful knowledgevs. scientific knowledge (findings may not be timely)

Overcoming Organizational Barriers Senior staff and the board should agree on thepurpose of the research, the public sharing of thesepurposes and adherence to the purposes and scopeof the researchInvest energy in building buy-in for the value of theresearchDefine roles and tasks early in the processLeaders should implement mechanisms for regularreporting, sharing of findings, updates and airing ofconcerns

The Role Research Typically Plays in ATypical Nonprofit Organization Fundraising Financial management Facility planningStrategic Planning Organizational assessment Needs assessment Organizational planning Program planning Marketing & communication Human resource development Program development Management Governance/leadership LegalResearch?Program implementation

The Role Research Should Play in ANonprofit Organization Fundraising Financial management Facility planningStrategic Planning Organizational assessment Needs assessment Organizational planning Program planning Marketing & communicationProgram implementation Human resource development Program development Management Governance/leadership LegalProvides the necessarydata for assessing howtrue an organization isstaying to its missionand visionProvides data onhow the abovecapacities affectthe quality of theprogramResearchProvides the necessary data for understanding the quality of the program inrelation to achieving the desired outcomes

Benefits of Having Timely andMeaningful Research Data Better understand evolving community needsInform program development and refinementMeasure the outcomes of programs and account foruse of resourcesPromote organizational learningCreate new understanding about what works and whatdoes notStrengthen the case for program fundingArticulate context, rationale and benefits of programsto communicate with stakeholders, boards, funders,audiences

Building Infrastructure to Carry outResearch Projects Secure support and commitmentfrom organizational leadersDevelop policies and proceduresSelect and establish partnershipswith universities and/or hospitalsObtain external fundingDetermine research capacity How research evolved at CBWCHC: Develop or recruit researchersUse research to inform day-to-dayperformanceObtain access to scientificliterature and qualitative andquantitative software programsSupport from Chief Medical Officerand Chief Executive OfficerFunding from hospitals, government,foundations and other agencies tocarry out research projects relevant tothe Chinese American population Chinese American Elderly DepressionStudy (1999-2003)Breast and Prostate Cancer Preventionand Screening Study (2000-2001)Partnership with CSAAHCollaboration with AAPCHOBuilt on early successesResearch staff had the necessaryacademic credentials and CBW staffwere familiar with the community

Common Steps In Planning AnyResearch Effort1. Determine research objective, key questions and audiences2. Identify information sources to address key researchquestions3. Decide on data collection approaches, including researchdesign, methodology and tools4. Develop a data analysis plan5. Develop a dissemination plan to share the research findings6. Determine staff resources (internal vs. external) toundertake the research activities within a concretetimeframe.

Key Considerations for EmployingExternal Resources to UndertakeResearch ActivitiesExamples of external researchers are consultants, universitystaff, graduate students or volunteers. Expertise Impartiality Cost Time

Tradeoffs between using internalresources vs. external resources (1)Advantages:Disadvantages:Internal Team MemberInternal Team Member Timely – Immediately the program/projecthas information that begins informingprogram/policy decisions. Buy-In – Those involved have theopportunity to have their voices heard, andmay want to contribute to the research. “Insider” perspective – An “in-house”researcher may be more familiar with thestaff, community issues, and resourcesassociated with the project/program. Time consuming – Internalresources involve staff time thatmay draw on limited personnelresources. Bias – There may be aperception of bias if the internalstaff is “too close” to the subjectmatter; this may result in riskingthe credibility of the researchfindings and hindering its use.

Tradeoffs between using internalresources vs. external resources (2)Advantages:Disadvantages:External Researcher Perspective – An external researchermay provide a view of the programthat is considered more objective bythe intended users. Credible – An external research maybe perceived as having credibility forpeople outside of the program/project(funding partners, stakeholders, etc.) Expertise – An external researcher orteam may possess certain evaluationresearch skills and knowledge that theinternal staff may not. S/he may alsohave exposure to a wider range ofissues, methods and practices thatwould be useful to incorporate.External Researcher Cost – External research can be morecostly than internal evaluations. Time – It maybe difficult to manage aproject conducted by an externalresearcher. Expertise – It may be difficult to find aresearcher who understands theregion or programming area.

Case studies from CBWCHCStrategic Planning Needs Assessment GeriatricService Grant Chinatown JUMP Physical Activity GrantQuality Improvement Evaluation CommunityGenetics Education Network Project Front-line Health Worker Training

Strategic Planning Issue: There is a growing and shifting Chinese American and Asian Americanpopulation in New York City. These residents still receive varying levels of care.Objective: To identify areas of New York City with a large population of ChineseAmericans and to provide an overview of the Asian American population data toinform strategic planning discussionsData collection approach: Extract Census and American Community Survey(ACS) data from Factfinder.census.gov and Infoshare.org pertaining to theChinese American and Asian American population in New York City. Types ofdata collected include total population, foreign-born population, number ofpeople with Limited English Proficiency (LEP), poverty levelData analysis: Analyzed data at the city, neighborhood and borough level;analyze by age categories and by genderFindings: As of 2008, approximately 75% of the Asian population in New YorkCity is under the age of 50. However, from 2000-2008, Chinatown-Lower EastSide experienced a 19% decrease in the Asian 17 years old and underpopulation. The borough of Queens had an overall increase of 176% for Asianindividuals over 65 years old and the borough of Brooklyn had a 63% increasein the 65 year and older Asian population.

Needs Assessment to informdevelopment of Geriatric Services Issue: There is a growing Chinese American elderly population in New YorkCity. Many Chinese American seniors have difficulty understanding andnavigating New York City’s complex health care delivery system.Funding Source: United Hospital Fund, Fan Fox and Leslie Samuels FoundationObjective: To identify gaps in health services for Chinese American elderly inNew York CityData collection approach: Conducted literature review, secondary data analysis(Census data and chart review), interviews with service providers, focus groups,convened an advisory committee to guide the needs assessmentFindings: Needs assessment activities helped to identify service gaps, including:a need for linguistically and culturally appropriate services; a need for patienteducation and case management services; a need for mental health services;and a need for affordable services for uninsured and underinsured patients. Apatient-centered medical home model was implemented at CBWCHC as a resultof the needs assessment.

Needs Assessment to Inform Developmentof Physical Activities for Youth Issue: There is an alarming trend of childhood obesity amongst Asian Americanchildren and youth. A 2004 chart review from CBWCHC found that the combinedoverweight and obesity prevalence rate of Pediatrics patients of Chinese descent was25% (Au et al., 2009). The prevalence rate among U.S. born boys aged 6-12 yearswas as high as 40%.Funding Source: New York State Department of HealthObjective: To identify barriers to participation in physical activities in order to informprogramming targeted towards youth and families living in Manhattan ChinatownData collection approach: Administered surveys in the Pediatrics waiting room,conduct focus groups with youth and parentsFindings: Awareness of physical activity is high, however major barriers exist toengage in routine physical activity. Barriers include lack of knowledge on accessingresources, costs of specific activities, parental concerns over neighborhood safety,and competing activities at school and on the computer. Needs assessment findingswere used to inform program development. Currently, the Pediatrics department hasimplemented several intergenerational programs, including a walking group, yogaclasses for children and elders and basketball clinics for youth.

Quality Improvement Issue: Providing high quality to our patient population is always a toppriority.Objective: To understand patients’ levels of satisfaction with thehealth center’s services and identify areas for improvement withinCBWCHCData collection approach: Implemented a patient satisfaction surveyto measure 4 key domains: ease of getting care, health centerfacilities, waiting time, and staff (Patient Service Representatives,nurses/medical assistants and providers). The survey wasadministered to patients in the waiting room prior to their doctor’svisit.Findings: Data from the patient satisfaction surveys suggest thatpatients are generally highly satisfied with their experiences atCBWCHC and that CBWCHC continues to make improvements onall measures. Although waiting time has improved, almost half of thepatients who responded to the survey would like to see moreimprovement to the waiting time.