Methodological pluralism for better evaluations of complex interventions: lessons from evaluating an innovation platform in Australia

Bailie, Jodie; Cunningham, Frances; Abimbola, Seye; Laycock, Alison; Bainbridge, Roxanne; Bailie, Ross; Conte, Kathleen; Passey, Megan; Peiris, David

doi:10.1186/s12961-022-00814-5

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…The multi-dimensionality of healthcare indicated that exploring the definition of healthcare quality necessitated a pluralistic approach, which applies more than one methodology [ 21 ]. This was represented through the three approaches used to allow a more holistic perspective [ 21 , 22 ] of the definition of quality in healthcare. This study was registered with the National Medical Research Registry (NMRR-19-3522-50 030) and approved by the Medical Research and Ethics Committee (MREC), MOH Malaysia.…”

Section: Methodsmentioning

confidence: 99%

Giving meaning to quality of healthcare in Malaysia

Nair Narayanan,

Awang,

Agins

et al. 2024

International Journal for Quality in Health Care

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Background: Ensuring quality in healthcare calls for a coordinated, systematic, congruous and sustained approach. Nevertheless, it demands defining what the quality of healthcare means in the local context. Presently the Malaysian healthcare system utilises various definitions of quality of healthcare across the different initiatives and levels of healthcare which can lead to fragmented or ineffective quality improvement. The study aims to describe the process undertaken in developing an explicit definition of the quality of healthcare tailored to the Malaysian context, which is currently lacking. Methods: A pluralistic method was used to explore the different perspectives. Three distinct approaches were used to understand how quality is defined among the different stakeholder groups: 1) interactive policy-makers engagement sessions, 2) a review of local quality-related documents, and 3) an online survey engaging the public. The domains depicting quality of healthcare that emerged through these three approaches were mapped against a framework and synthesised to form the local definition of quality. A national quality-related technical working group convened on several sessions to achieve consensus and finalise the definition of quality of healthcare. Results: Quality healthcare in Malaysia is defined as providing high quality healthcare that is safe, timely, effective, equitable, efficient, people-centred, and accessible [STEEEPA] which is innovative and responsive to the needs of the people, and is delivered as a team, in a caring and professional manner in order to improve health outcomes and client experience. Conclusion: The consensus-driven local definition of healthcare quality will guide policies and ensure standardisation in measuring quality, thereby steering efforts to improve the quality of healthcare services delivered in Malaysia.

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Section: Methodsmentioning

confidence: 99%

Giving meaning to quality of healthcare in Malaysia

Nair Narayanan,

Awang,

Agins

et al. 2024

International Journal for Quality in Health Care

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“…Additionally, the inclusion of different study designs resulted in inconsistencies in the quality appraisal as three separate tools had to be used. However, not limiting by study design was justified as it facilitated methodological pluralism which is useful, not only for neutralising the limitations inherent in a single method, but also for gaining a more holistic analysis that is not achievable through the use of just one study design [79]. The narrative synthesis approach is often critiqued for lacking transparency [80] and an in-depth description of the process was beyond the scope of this review.…”

Section: Limitationsmentioning

confidence: 99%

Climate change, mental health, and reproductive decision-making: A systematic review

Dillarstone,

Brown,

Flores

2023

PLOS Clim

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The impact of climate change on reproductive decision-making is becoming a significant issue, with anecdotal evidence indicating a growing number of people factoring their concerns about climate change into their childbearing plans. Although empirical research has explored climate change and its relationship to mental health, as well as the motivations behind reproductive decision-making independently, a gap in the literature remains that bridges these topics at their nexus. This review endeavours to fill this gap by synthesising the available evidence connecting climate change-related concerns with reproductive decision-making and exploring the reasons and motivations behind this relationship. A systematic review using six databases was conducted to identify relevant literature. Included studies reported quantitative, qualitative, and mixed-methods data related to: (1) climate change, (2) mental health and wellbeing concerns, and (3) reproductive decision-making. Findings were synthesised narratively using a parallel-results convergent synthesis design and the quality of studies was appraised using three validated assessment tools. Four hundred and forty-six documents were screened using pre-defined inclusion criteria, resulting in the inclusion of thirteen studies. The studies were conducted between 2012 and 2022 primarily in Global North countries (e.g., USA, Canada, New Zealand, and European countries). Climate change concerns were typically associated with less positive attitudes towards reproduction and a desire and/or intent for fewer children or none at all. Four themes explaining this relationship were identified: uncertainty about the future of an unborn child, environmentalist views centred on overpopulation and overconsumption, meeting family subsistence needs, and environmental and political sentiments. The current evidence reveals a complex relationship between climate change concerns and reproductive decision-making, grounded in ethical, environmental, livelihood, and political considerations. Further research is required to better understand and address this issue with an intercultural approach, particularly among many highly affected Global South populations, to ensure comparability and generalisable results.

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Reflecting on the quality of a methodologically pluralist evaluation of a large-scale Indigenous health research collaboration in Australia

Bailie,

Matthews,

Laycock

et al. 2024

BMJ Glob Health

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BackgroundIndigenous communities worldwide lead calls for all evaluations of research, programmes and policies affecting their communities to reflect the values, priorities and perspectives of the Indigenous peoples and communities involved. Tools, such as the Quality Appraisal Tool (QAT), are available to assess research quality through an Indigenous cultural lens. Good evaluation requires that evaluation efforts be evaluated. We found that critical reflection on the quality of evaluations from an Indigenous perspective is largely absent from the published literature. To ensure that we strive for quality in evaluation as determined by Indigenous people with whom we work, we examined the quality of our own evaluation of an Indigenous health research collaboration by conducting a reflexive dialogue.MethodsThe QAT was used to assess our evaluation according to Indigenous health research principles. Our qualitative study used analytical coautoethnography to generate data through a series of reflexive dialogue sessions with Indigenous and non-Indigenous members of the research collaboration, using the QAT criteria as discussion prompts. Our ideas and reflections were compared and contrasted through a collaborative and iterative writing process, multiple review cycles and discussions.ResultsWe documented our findings against the QAT framework. We found examples that each QAT principle had, to some extent, been adhered to, but constantly needed to assess whether the principles were fully achieved to our satisfaction. Strengths of the evaluation included being adaptable and responsive to emerging issues for the research collaboration, while areas for improvement included more Indigenous leadership of, and involvement in, evaluation.ConclusionsAlthough reflexive evaluation practice is not always comfortable, it does provide an opportunity to generate insights for improvement. Reflecting as we did—in a partnership between Indigenous and non-Indigenous colleagues—enabled deeper insights and meaning. We anticipate that our process models how other research in Indigenous contexts might better advance ethical, quality Indigenous research through working in collaboration with Indigenous researchers and communities.

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Methodological pluralism for better evaluations of complex interventions: lessons from evaluating an innovation platform in Australia

Cited by 3 publications

References 38 publications

Giving meaning to quality of healthcare in Malaysia

Giving meaning to quality of healthcare in Malaysia

Climate change, mental health, and reproductive decision-making: A systematic review

Reflecting on the quality of a methodologically pluralist evaluation of a large-scale Indigenous health research collaboration in Australia

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