Methods Paper :

G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D

R E S E A R C H S E M I N A R

M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N

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Guidelines ..................................................................................................................... 2

Professional Seminar 6930 / Advanced Research Seminar 6717 Research Overview .. 3

Advanced Health Services Management and Research Seminar HSA 6717 Overview .... 4 Organization of the Research Proposal ......................................................................... 5

Introduction/Background .......................................................................................... 5

Statement of Problem ................................................................................................ 5

Significance of Study .................................................................................................. 6 Literature Review ....................................................................................................... 7 Research Methods ..................................................................................................... 9

CONTENTS

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A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem and/or enroll in the Administrative Residency. At some point in the program, the student may choose enrollment in research or the residency based on their interest. Typically students enroll in the Professional Seminar (HSA 6930) and the Advanced Research Seminar (HSA 6717) where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 in lieu of the HSA 6875, the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar (HSA 6717) and during the Advanced Health Services Management and Research Seminar (HSA 6977) course. Below there is a description of the Masters Program structure with either of these choices. The first objective of this guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in advance about the program research expectations. If a student decides to continue on the research project path, they have the opportunity to continue to work on the research project in their interest area. To ensure the student’s success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies depending on the type of study design that best applies. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style consult the 6th edition manual.

Guidelines

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Professional Seminar HSA 6930 // Advanced Research Seminar 6717 Overview

WEEK 1-2: Topic Selection

o Students enrolled in the Professional Seminar HSA 6930 who are interested in research, discuss a research topic with the course instructor.

o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop and annotated bibliography. o Select a feasible research topic within the first three (3) weeks.

Note: Students who do not meet the topic selection deadline, will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study

o Meet with course instructor to discuss the research progress and proposed topic. o Discuss a research proposal structure / plan o Develop a research question o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of

Research

WEEK 8-11

o Start the Literature Review: Continue to research and annotate sources o Start the methods section

WEEK 12-14

o Turn in a comprehensive research proposal including a list of references

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Advanced Health Services Management and Research Seminar HSA 6717 Overview

WEEK 1-2: Choose and/ or revise the Methods

o Choose an appropriate method and outline a design approach o Discuss the feasibility of the research methodology

Note: The Masters Research project is descriptive in nature. If the student has a preference on a specific research design, the student must consult the course instructor for approval.

WEEK 3-7

o Discuss the research data analysis plan with the course instructor o Write the research methods (i.e. participants, research design, procedures and data analysis

proposal) o Finalize your methodology

WEEK 8-11

o Data collection o Start to analyze data o Meet with your course instructor to discuss preliminary data analysis o Finalize data analysis

WEEK 12-14

o Meet with course instructor to discuss the research results and next steps o Write the results o Discussion, recommendations, conclusions and limitations o Turn in final research paper

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Organization of the Research Proposal

The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar.

When the student is writing the research proposal it is written in the future tense, since the research has not been conducted.

Example: ‘This research will explore…’ Title Page

The title page should include several sections: Project title, name, name of the institution name of the course instructor and date the proposal is submitted. Do not include a running head on the title page.

The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background

The first section must capture the reader's interest, provide a rationale for the study as a whole and inform the reader about the research content and scope.

First, explain the research background starting from a broad perspective (e.g. what is known about

the problem globally? What is the prevalence of the problem nationwide? Second, describe the problem at the local/state level.) Third, describe what is already known about the research topic.

This section includes relevant references to support the statements part of the background. The

references should be from reliable sources of information and these should be accurate. References can be found in peer reviewed literature (i.e. scholarly journals), books, and other reliable sources. Statement of Problem

The statement of problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of problem section usually starts by addressing why the student is pursuing this research topic. Is it serious enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading to the applied research. It is essential to provide compelling evidence the problem exists. This section should also be supported by evidence based references / citations. Cite relevant literature to support the topic of interest and the variables of study. Significance of the Study

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This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what is the benefit or contribution to new knowledge.

Example: “This research is important to understand barriers to access health care services for South Florida residents with cardiovascular diseases. This study is relevant to better understand what the specific barriers are so that intervention tailored to this population are implemented.”

Qualitative studies are exploratory in nature. An example of a qualitative research is: Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required.

In qualitative studies there is a guide of topics/themes. Through this design there is some flexibility to

explore the participant’s responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study

findings’ using the research participants’ direct narrative quotes that should support the study conclusions.

Qualitative research question example: “What are the relevant barriers for access to healthcare are

for South Florida residents with cardiovascular diseases.” Quantitative Research

Quantitative studies use a structured variable-specific survey questionnaire or secondary data

collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives.

In these types of studies, the student should be able to speak about the data that supports the

conclusions. In quantitative research it is not be possible to subjectively interpret any results as in the case of qualitative research.

Quantitative research question example: “What are the most prevalent barriers to access health

care services identified by South Florida residents with cardiovascular diseases?”

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Literature Review

The purpose of the literature review is to describe the related and existent evidence about the topic of

interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted.

The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining and summarizing related studies.

The reader should be able to find a roadmap and a narrative describing many aspects of the literature

on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature.

Provide a logical structure to the reader guiding them through previous research studies and theories

supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and

current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews, described below:

1) Integrate research / evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field

Example of a research question for the example below: “What are the barriers to access

health care services identified by South Florida residents with cardiovascular diseases?”

Literature Example: “Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones-Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population in South Florida identifying significant transportation barriers to access preventive care services.”

According to Creswell (2014) (in quantitative research) the literature review starts with an (1)

introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent

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variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47).

The literature review for a qualitative and quantitative study is written as part of the research

proposal.

Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step

Creswell (2014) suggests several different ways to work on a literature review:

1) Identify key words to locate different materials in a library. The key words may emerge from

the literature and it may allow for the identification of a topic. 2) Search journals, books, databases (e.g. FIU computer databases: ProQuest, EBSCO,

PubMed, etc.). 3) Gather as many reports as possible that are related to the research topic. 4) Skim though the articles. Creswell (2014) suggests that throughout this process, it is

important to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature.

5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the

study will contribute to the literature. b. Position the study within the larger body of research.

6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods.

7) Assemble the literature review. Structure the literature thematically (use headings).

The literature review conclusion should suggest how the proposed research may contribute to the current literature and could address gaps in the current literature.

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Research Methods

This section provides a description about participant selection, the data collection the research

procedures and data analysis. This section starts with a description of the study design (i.e. qualitative and/or quantitative

design). The methods section includes the following:

1. Introduction. This section includes a reiteration of the statement of problem and research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g. males and/or females, age range, ethnicity, or other demographical characteristics). Describe how the participants will be chosen (qualitative), recruitment procedures, the estimated number of participants, and reimbursement or monetary compensations are given to participants (if any) should be specified.

3. Procedures for data collection. This section includes detailed descriptions of procedures (quantitative or qualitative) used/to be used to collect the data. Anticipate how data will be collected. Explain why each procedure was chosen. It is also important to describe how the procedure will address the research questions. 4. Data Collection. In this course, data collection will be done mainly through secondary data (data collected by others, not the principal investigator). Provide a rationale for the procedures, using arguments based on its strengths and weaknesses, costs, data availability and/or convenience.

Qualitative Research

When conducting qualitative research, the aim is to address people’s experiences, needs, and different perspectives. Qualitative research aims at understanding and observing attitudes, life circumstances, beliefs, opinions, behaviors and a processes in depth.

Data is collected by interviewing people and recording the responses as well as observing and documenting participant body language. The common approaches for facilitating interviews are:

a. In-depth interviews: These are one on one interviews. Researchers are interested in

understanding individual experiences or opinions. b. Focus groups interviews: The researcher attempts to discuss or explore participants’

opinions in a group setting. c. Telephone mediated interviews: The researcher interviews participants by phone. d. Online mediated interviews: These are one on one interviews conducted online. e. Observation: This is an approach often used as a supplement to recording participant’s

responses.

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Quantitative Research When conducting quantitative research, data is often gathered using surveys either in person or

through the Internet. If the information is collected through a survey questionnaire it usually has three sections: (a) inclusion/exclusion criteria, (b) demographic information and (c) the questions assessing the study variable (s) of interest.

Sample and Population Qualitative Research

In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). He/she should have in mind the research problem and which population (s) are affected by the problem.

This section of the paper describes the selection of study participants, explains the characteristics

of the participants and describes the proposed number of participants. It also includes the inclusion and the exclusion criteria for including the research population.

Quantitative Research

As is the case with qualitative research designs, this section describes the selection of participants (e.g. data), explaining the demographic characteristics and describing the proposed number in the sample being studied. It also includes the inclusion and the exclusion criteria for selecting the research sample. Sample sizes may vary based upon the research aim/question (s). Large sample sizes (e.g. ≥ 100), often leads to increased accuracy in estimates about the population.

Note: Students are encouraged to ask their course instructor for recommendations on sample sizes.

Data Collection Qualitative Research

It is common to develop structured and semi structured questions and record each participant’s responses. The interview research question should map to the main research question.

When conducting qualitative research, an interview/discussion guide is developed to conduct the interviews. These questions address the main research problem. Other data collected during the interviews could include participant demographics (e.g. age, sex, race/ethnicity, income for descriptive statistics).

Note: The student interviewer informs the research participant the location, day and time of the interview. The interviewer ensures the participants have the interviewer contact information in case they get lost, are delayed, or have other problems prior to the interview.

During and prior to the interview:

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a) Provide an informed consent form indicating the research is voluntary b) Remind the research participants that they will be recorded c) Remind the research participants that there are no right or wrong answers during the

interview session (promote open and honest communication) d) State name and the goal of meeting with the participants e) Ask each participant to introduce themselves, state their names or initials so that you can

later distinguish each participant responses f) Do not redirect or interpret the respondent answers, or judge g) Know the interview guide and questions h) Do not bring any knowledge to the table i) Be comfortable with silence Note: Use probes as needed. For example – be silent, repeat the statement they said and then continue neutrally (“I see, uh…”), direct (“Tell me more”), and clarify (what, where, when, what).

Quantitative Research

This section describes how many questions are going to be used (even if it is secondary data

collection) and how the survey that led to the data collection was developed.

Example: “The data used in this research is from the cardiovascular diseases questionnaire used in research conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a national cross-sectional research study representative of the U.S. population. The interviewers were elderly persons and minorities to provide a full representation of the U.S population.

Note: If the student plans to use a survey or other form of data collection, consult the course instructor for guidance.

Procedures

Qualitative Research

This section describes the participant’s recruitment process as well as the methods used while

conducting the interviews (e.g., notes, audio tape recording, and video tape recording). Discuss how the group (if a focus group) will have a discussion in a quiet, comfortable place to ensure everyone speaks/participate. Describe the development of a topic guide. A topic guide is used in the interview process to guide and discuss key questions the interviewer would like to cover, including useful prompts to encourage discussion.

Include an explanation about transcribing the interview once the participant’s interviews/discussions

have ended. After transcribing, the student reads the interviews (i.e. the data) and start coding it.

Note: Coding is an approach used to organize the data by grouping pieces (categorizing the data) and writing a word representing a category (Rossman & Rallis, 2012; Creswell, 2014, p. 198). In qualitative research, data is primarily in the form of words derived from the participant’s expressions on a subject matter.

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The data should be organized into categories of themes. Describe how the validity occurs in the research process to validate the findings of the proposed study.

Describe one or more strategies for establishing the accurateness of the findings. Some of the commonly used strategies are described below:

a) Triangulation: Search for different data sources and use these to build the justification of

themes (Creswell, 2014). If the researcher finds that the themes are established based on converging several sources of data or participant perspectives, then this would add to the validity of the study.

b) Member checking: Taking the emergent themes back to the participants and asking them if

they feel the themes are correct.

Note: To check the reliability, researchers may cross-check the results with an independent person who can check the codes used by the researcher. Consult the course instructor for more information on this methods.

Quantitative Research

In this section the student documents the participant’s recruitment process (e.g. consecutively, using a

snowball approach, randomly, or other procedure that is free from bias). The student must always provide informed consent and specify the research is voluntary to all participants prior to starting the data collection process. Therefore, the student must describe the informed consent process in the methods section (if administering a survey).

This section describes the processes used while collecting the research data. It documents all the

processes for gathering data, selecting participants (or sites), providing copies of the consent form (if applicable).

Describe the study variables, the parameters established for the variable (s) of study (e.g. optimal

health risk scores are defined as ≥10”) and how these data collected was collected.

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Data Analysis Qualitative Research

This section explains how the data analysis section would be organized. It also describes the data analysis plan, how to code (assign numbers to the verbal answers obtained from the participant). Describe the study variables and the specific statistics that will be used (e.g. counts, percentages, means) as applicable.

Tips: Propose to use a software for data organization and management:

a) Microsoft Excel can be used to organize the narrative data collected. b) For the demographical data (organize it in Microsoft Excel). c) If using Microsoft Excel, create headings in each column with the themes (type the

questions you asked in your interviews) for classifying themes and units of analysis. d) Quantify your themes and report its frequencies e) Always refer back to the research question, asking “Was the research question

answered?” Quantitative Research

This section explains how the data analysis section is organized. Present the data analysis plan in

sequential order. The analysis plan should include: (1) Descriptive statistics of the data (e.g. frequencies and percentages, the reporting average and counts).

After discussing the descriptive statistics, describe how the variables will be measured on the survey

instrument. How the data will be handled (e.g. continuously or categorically)? Discuss which of the questions in the survey instrument answer the research question (s).

Describe other statistical data plans on how to handle the data (e.g. missing variables, outliers,

normality of the data).

Explain that the results will be shown using tables, graphs, figures, or other form. This section ends with a discussion of the implications for practice of the study. Typically discusses

theoretical and practical consequences once the study is completed.