Table 3

Methods for Generating the Needed New Knowledge

1. Current challenges
There is not a common lexicon among stakeholders
Contextual factors are dynamic, fluid, interrelated, and vary according to perspective
Because contextual factors interact in dynamic ways, it is important to measure them from conceptualization to completion of the research study, and to have analytic techniques that do not rely on assumptions of linearity
To be relevant, methods may need to be combined, modified, or developed
There is tension between gathering data and burden to participants
2. Suggestions for relevant knowledge generation
Research studies involving MCC should always consider contextual factors
Contextualized MCC research requires methods that are:
 Participatory (engage multiple perspectives and relevant partners)
 Flexible (data collection, intervention delivery, outcomes ascertainment)
 Both quantitative and qualitative (mixed methods)
 Multilevel (from person to place to policy)
 Sufficiently granular to address what works for whom in what situation
 Conducive to ongoing measurement from diverse data sources
 Generative of ongoing learning
In all aspects of research from conceptualization to dissemination and implementation:
 Persons with MCC and their family and friend caregivers should participate
 Researchers should effectively engage communities
 Researchers should ensure that shared language is developed and used among stakeholders
 Research funders and publishers’ policies should require inclusion of contextual factors in all research, unless exclusion is justified
 Context should be measured and analyzed at multiple levels
To reduce participant burden (eg, health care system, individuals, providers of health care), existing data (eg, EHR, marketing research, and public health data) should be mined when possible and commensurate compensation provided
Methods that are most appropriate to the research question should be selected, rather than having the methods drive the question. Exploration of methods from multiple disciplines (eg, occupational therapy, engineering, systems science, modeling) is encouraged
Development and adaptation of methods that are sensitive to the emergent properties of complex systems is warranted
  • EHR = electronic health record; MCC = multiple chronic conditions.