Using Mixed-Method Survey Data to Enrich Participatory Action Research

The appropriate approach for operational research is by using problem solving cycle model, comprising (i) measuring the magnitude of the problem, (ii) identifying the causes of the problem, (iii) developing the solution, (iv) implementing program/ intervention, and (v) evaluating the program. Within a scientific perspective, in every phase of problem solving cycle, it needs research, including the fourth phase i.e. implementing program/ intervention. Research that provide scientific evidence for better implementation is labeled as Implementation Research. As a methodological approach, Implementation Research belongs to critical realism paradigm that is possible to use mixed method (combination of qualitative and quantitative), or stand alone of qualitative method, or quantitative method. The role of Implementation Research is very crucial for better implementation or for better scale-up of the program by understanding the implementation process as well as the impact of the program under concern. Participatory action research, as one of the Implementation Research approach, can be used as an appropriate methodology for better implementation in the real context of the new policy (new program) by tailoring the implementation process (management process) with the real world situation in terms of policy actors, organizational situation, human resources variable, community variable, as well as, resources variable. Abstrak Pendekatan yang tepat untuk riset operasioanl adalah melalui siklus pemecahan masalah terdiri dari (i) mengukur besaran masalah, (ii) mencari penyebab masalah, (iii) mengembangkan solusi, (iv) implementasi intervensi/ program, dan (v) evaluasi program. Dalam perspektif ilmiah, maka dalam setiap tahapan siklus pemecahan masalah memerlukan penelitian, termasuk tahap keempat yakni tahapan implementasi program. Penelitian yang menyediakan bukti ilmiah untuk implementasi program disebut dengan Riset Implementasi (Implementation Research). Sebagai pendekatan metodologi, Riset Implementasi termasuk dalam paradigma realisme kritis (critical realism), yang memungkinkan untuk menggunakan metoda campuran (mixed method) (kombinasi kuantitatif dan kualitatif), atau secara senidri hanya menggunakan kuantitatif, atau kualitatif saja. Peran Riset Implementasi menjadi sangat penting untuk mendapatkan cara-cara implementasi yang lebih baik, atau dalam rangka memperluas jangkauan progam, guna mempelajari proses implementasi dan melihat dampak program sebagaimana diinginkan. Riset tindak partisipatif (Participatory action research), dapat dipergunakan sebagai metodologi yang tepat untuk mendapatkan cara-cara implementasi yang lebih baik dalam konteks penerapan kebijakan/ progam baru, dengan menyesuaikan proses implementasi (proses manajemen) disesuaikan dengan situasi dunia nyata di lapangan, berkaitan dengan aktor kebijakan, situasi organisasi, variasi sumber daya manusia, variasi masyarakat, maupun variasi sumber daya lainnya.

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Participatory action research for global antibiotic stewardship network in CPLP: mixed-method study

European Journal of Public Health ◽

10.1093/eurpub/ckz186.506 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M R Maia ◽

L V Lapão

Keyword(s):

Information System ◽

Decision Support ◽

Action Research ◽

Participatory Action Research ◽

Mixed Method ◽

Antibiotic Stewardship ◽

Educational Program ◽

Mixed Method Study ◽

Participatory Action ◽

Support Information

Abstract Background Antibiotic stewardship services (ABS) contribute to antibiotic resistance (AR) global monitoring. Aiming at co-implement an ABS network within the Portuguese-speaking setting (CPLP), by enabling the evidence translation and second opinion between the countries, we surveyed Cape Verdean (CV) health professionals (HP) perceptions about AR prevention and control, assessing ABS opportunities. Methods A Design Science with Participatory Action Research establishes a contextualized ABS process. This mixed-method study addressed the first 2 stages, the problem and objectives. Quantitative study considered the HP’s answers (56 HP; 2 hospitals) to a questionnaire, about their perception on AR and ABS. Qualitative study set-up 10 open-ended structured interviews, clinical shift observation in 2 pilot-services (1 hospital), and meetings with key-elements for ABS, including leadership. Results Key-stakeholders for ABS multidisciplinary teamwork were identified. Preliminary results are: 1. HP reveal some knowledge but lack of awareness on AR and ABS (eg. 34% don’t recognize the AR local threat); 2. The absence of guidelines and lack of access to key-information affect prescribing confidence (eg. only 46% HP consider microbiology results in deciding antibiotherapy); 3. Priorities for a pilot service are the lack of qualified HP, the need to optimize material resources management and stock procurement, and the need for better access to patient’s clinical and prescription information; 4. Digital resources and telemedicine system can be facilitators. Top-down communication and support are essential for the ABS process sustainability. Conclusions A Global ABS network can be important in promoting prevention and effective control of AR, reducing differences between the CPLP countries. In CV, an educational program to support the co-design of ABS service and a decision-support information system are identified priorities. Digital health, like telemedicine, can be ABS facilitators. Key messages The implementation of a Global Antibiotic Stewardship network, aiming at reducing Portuguese-speaking Countries differences, could be leveraged by a Participatory Action Research process. An educational program, a decision-support information system and the telemedicine are key for the Global Antibiotic Stewardship network implementation success.

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