Precarious Times, Professional Tensions: The Ethics of Migration Research and the Drive for Scientific Accountability

How should migration scholars navigate tensions between our ethical responsibilities to research participants and growing “open science” calls for data transparency, replication, and accountability? We elaborate a three-step process to navigate these tensions. First, researchers must understand core principles behind open-science initiatives and the mandates of research ethics boards, especially those related to privacy, confidentiality, and protection from harm, and take them seriously. Second, migration researchers must think beyond routinized or mandated procedures to carefully consider the unique vulnerabilities of migrants in their study, which depend on socio-political context. Third, if vulnerabilities are significant, migration researchers should modify (or challenge) procedures elaborated in the name of open science or routinized research ethic board mandates, if inappropriate for their study. We, thus, encourage migration scholars to engage with open-science advocates but also to educate colleagues on migrants’ vulnerabilities and to double-down on data security, including vis-à-vis government authorities, as evolving technologies continue to change research practices.

Protocol for a mixed-method analysis of implementation of case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs

IntroductionCase management (CM) in a primary care setting is a promising approach to integrating and improving healthcare services and outcomes for patients with chronic conditions and complex care needs who frequently use healthcare services. Despite evidence supporting CM and interest in implementing it in Canada, little is known about how to do this. This research aims to identify the barriers and facilitators to the implementation of a CM intervention in different primary care contexts (objective 1) and to explain the influence of the clinical context on the degree of implementation (objective 2) and on the outcomes of the intervention (objective 3).Methods and analysisA multiple-case embedded mixed-methods study will be conducted on CM implemented in ten primary care clinics across five Canadian provinces. Each clinic will represent a subunit of analysis, detailed through a case history. Cases will be compared and contrasted using multiple analytical approaches. Qualitative data (objectives 1 and 2) from individual semistructured interviews (n=130), focus group discussions (n=20) and participant observation of each clinic (36 hours) will be compared and integrated with quantitative (objective 3) clinical data on services use (n=300) and patient questionnaires (n=300). An evaluation of intervention fidelity will be integrated into the data analysis.Ethics and disseminationThis project received approval from the CIUSSS de l'Estrie – CHUS Research Ethic Board (project number MP-31-2019-2830). Results will provide the opportunity to refine the CM intervention and to facilitate effective evaluation, replication and scale-up. This research provides knowledge on how to resp ond to the needs of individuals with chronic conditions and complex care needs in a cost-effective way that improves patient-reported outcomes and healthcare use, while ensuring care team well-being. Dissemination of results is planned and executed based on the needs of various stakeholders involved in the research.