Innovative research partnership: LJ & Allison build new way to measure clinical communication quality

Innovative research partnerships: Healthcare edition is a series of profiles about collaborations between Ph.D. communication researchers and healthcare clinicians, and is a part of the broader Innovative research partnerships series. I consider these partnerships innovative because of the creativity involved in initiating and sustaining cross-sector and multidisciplinary collaborative research. Through separate interviews of both partners in the collaboration, I share the unique stories behind such partnerships and their fruits. 

LJ’s perspective

L.J. Van Scoy, M.D., who is now a physician and associate professor of medicine, humanities, and public health sciences at Penn State Milton S. Hershey Medical Center, was frustrated after a long day in 2014 spent searching medical research databases in vain for what she needed: a way to evaluate the quality of end of life communication. In other words, how can you tell when there has been a “good” or a “bad” conversation when discussing end-of-life preferences? But none of the medical research seemed to provide a valid approach – most of it focused on behaviors rather than her concern: had a rich and substantive conversation occurred? With 5 p.m. looming after a long day, LJ abandoned the fancy search engines and turned to Google. Finally, she found something of interest: Allison’s dissertation about end-of-life communication quality. LJ printed it and took it home, finding herself reading the dissertation in the bath tub that night. “It changed my life,” LJ reflected, adding that Allison’s research was a “goldmine.”

Allison’s perspective

Allison Gordon, Ph.D., who is associate professor of communication at University of Kentucky, received a call from LJ soon afterward without knowing it would lead to four years (and counting) of collaboration. Allison studies how the quality of people’s communication with others affects their health decisions. Partnering with LJ has allowed Allison to study communication between patients and their medical providers and to more fully develop the measure of communication quality. Together, she and LJ have tested, measured, and applied multiple goals theory, which claims that people pursue various goals – often simultaneously – through their communication. These goals include relational, task, and identity goals.

About the project

Together, Allison and LJ have developed and refined the communication quality assessment (CQA), which Allison calls the “gold standard methodology for assessing clinical communication about difficult topics.” Their partnership has yielded at least five academic publications so far, and they have received an R21 grant from National Institute of Health to further develop CQA and compare alternate methods of coding communication interactions in pursuit of a more streamlined process. Given that there are few tools in medical research that are both theoretically-driven and well-attuned to communication quality, LJ believes CQA “belongs in medical culture,” adding that she wants to spread the word among clinicians about this approach to understanding and improving communication with patients.

About the partnership

The partnership between Allison and LJ has worked because they are “united by the common goal of wanting to improve clinical communication,” according to Allison. While partnerships between social scientists and physicians may be rare, Allison and LJ describe the partnership as one marked by trust and mutual respect. Both agree that their complementary areas of expertise are central to the quality of their research accomplishments. Allison acts as social scientific theorizer who provides insight and explanation about human communication, and LJ serves as the clinical expert who provides valuable insight from the clinical side and oversees application of research in context. Their work together has refined CQA by adding two new dimensions to the measure to better account for specific communication in clinical encounters. Further, LJ and Allison’s work styles seem to complement one another’s as well. LJ said that neither of them are “egocentric or arrogant,” adding that Allison had been “generous” in sharing her method and soliciting LJ’s input. Allison admires LJ’s detail-oriented “get things done” approach, adding that she is “happy to be [LJ’s] co-pilot” as LJ pursues grants and new projects.

Disclosure: I have assisted with two of Allison and LJ’s research projects, including one project currently as of October 2018, in which I serve as a paid coder.

Innovative research partnership: Lisa and Roger develop a tool to help patients make complex decisions

Innovative research partnerships: Healthcare edition is a series of profiles about collaborations between Ph.D. communication researchers and healthcare clinicians, and is a part of the broader Innovative research partnerships series. I consider these partnerships innovative because of the creativity involved in initiating and sustaining cross-sector and multidisciplinary collaborative research. Through separate interviews of both partners in the collaboration, I share the unique stories behind such partnerships and their fruits. 

Roger’s perspective

Roger Strair, M.D., Ph.D., who is a chief of blood disorders and medical oncologist at the Cancer Institute of New Jersey, was concerned about the complex decisions his patients face. He wanted to give his patients more tools to make important and complex medical decisions. For example, he described the following hypothetical scenario: a patient faces the choice between two potential therapies. The first is relatively easy to give, and results in 40% of patients being cured. Second, the patient could choose to undergo a bone marrow or stem cell transplant, increasing their chance of being cured to 65%. Yet, a percentage of patients undergoing transplant will have a lifelong disability and some patients who go through the procedure will die sooner.

Lisa’s perspective

Lisa Mikesell, Ph.D., who is assistant professor of communication at Rutgers University, studies patient engagement including the process of complex decision-making. Roger approached her and her colleague, Mark Aakhus Ph.D., several years ago about working together. For this research, Lisa has focused on finding ways to resolve the tensions faced by doctors and patients: patients want optimism (sometimes they don’t want to know their likelihood of mortality) whereas doctors want to provide realistic information to patients without depriving patients of hope. Lisa said patients in this situation often face great uncertainty and decisional conflict. The aim of this research project is to help prevent patients from regretting their medical decision by feeling better prepared to make such a complex, life altering decision.

About the project

The research team conceptualized a multimedia tool that provides these patients who face complex medical decisions with stories of other patients who’ve made similar decisions. To develop and evaluate the tool, they gathered a team including information scientists (Sunyoung Kim, Ph.D., has since joined the team), designers, and an advisory board comprised of patients and clinicians. Their goal is to help patients to make sense of their medical situation by hearing others’ stories and developing their own coherent narrative. Lisa and her colleagues began by collecting pilot data exploring how patients and clinicians report handling the tensions of communicating about complex medical decisions. The team has also developed videos with patient stories that patients can revisit and utilize in different ways over the changing course of their illness trajectory.

About the partnership

Roger said he is generally “untrained” in communication so he appreciates Lisa and her colleagues’ expertise. Roger said they try to have fun while doing this work. He joked that you can’t trust the communications experts because they know how to manipulate words. He said, “you don’t want to play a casual game of cards with a L.A. card dealer, you know what I mean?” Lisa described members of the partnership as “malleable” in that there is openness to working with differing perspectives. Further, people are willing to balance varying priorities and show mutual respect. Roger said, “we don’t agree on everything but we do agree on the fact that there is a great unmet need and it’s a worthy area of study.”

Researchers: Four Lessons Learned About Working With Community Partners

Researchers gathered to share stories and insights about their partnerships conducting research with non-academic community partners at the 103rd annual National Communication Association convention in Dallas, Texas, this past November. Below I have summarized some of the insights they shared during our panel in the form of lessons they have learned along the way.

Panelists included, from left to right: Dr. John Parrish-Sprowl, Dr. Michelle Miller-Day, Tara Watterson (co-chair), Dr. Joann Keyton (co-chair), Dr. Jennifer Ohs, and Dr. Angela Gist-Mackey.

1. Written agreements can help protect you. Every panelist underscored the importance of formalizing the partnership and getting buy-in from decision makers in the organization with which you are partnering, usually via a written agreement. Written agreements can help protect you in case your contact at the organization leaves the position, hopefully preventing you from losing access. John Parrish-Sprowl of Indiana University encouraged researchers not to be bashful about protecting themselves through written agreements. Michelle Miller-Day of Chapman University said securing buy-in from multiple members of the organization has been crucial for the success of her research partnerships. Also, making expectations about data sharing and research outputs explicit can help ensure you are both on the same page since you and your partner are likely to have differing conceptions of research process, protocols, and outputs.

Have a handy resource, for example, a template or sample of an agreement with a community partner that you’ve used? Please join the Year of Community Research to share this resource!

2. IRB poses new challenges. Several panelists shared challenges associated with IRB. A couple of panelists agreed that although IRB and human subjects protection is important, non-academic partners are often befuddled at the need for it or turned off at the demands for signed consent forms, etc. Jennifer Ohs of St. Louis University said she ran into delays when she found she would have to secure IRB approval from both her home institution and her research partner’s healthcare institution, which added months to the timeline.

Joann Keyton of NC State University expressed the need for a short video explaining the importance of human subjects protection for social scientific research purposes that is made for non-academic audiences. Know of a resource like this? Please join the Year of Community Research to share this resource!

3. Ethical concerns arise in the field. Panelists also described instances where they had to make decisions about how to handle situations in the field that they hadn’t faced previously. These situations included differing cultural expectations and diversions by the partner from agreed-upon research protocol. One panelist described pushing back when the partner wanted to change incentives for participants in the middle of the study, at which point the researcher requested not to do so and explained how that would change the research design.

Have ideas for reading material, etc. to help navigate ethical concerns that arise during community research? Please join the Year of Community Research campaign and share this resource!

4. Community research takes more time. Panelists agreed that research in the community is more rewarding, exciting, and challenging. However, panelists also agreed that this type of research takes extra resource commitment, namely, time. It requires researchers to navigate the challenges listed in this post, among others. Partnership involves seeking shared interest, but rarely does every interest overlap. Researchers sometimes make extra commitments in order to accommodate the development needs of the partner organization that didn’t fully align with the theoretical needs of the researcher. Angela Gist-Mackey of University of Kansas shared how she agreed to conduct communication training for a partner organization as part of the agreement for research access.

Have tips for managing the time demands associated with community research? Please join the Year of Community Research and share this resource!

Resource list: Philanthropy research communication

This morning at #ComNet17, about 20 social sector leaders gathered at my breakfast session to talk about partnerships between academic researchers and philanthropy/social good organizations. We concluded that it was the first time that this group of leaders — comms professionals who are primarily interested in more effectively translating and disseminating research to help drive social change — had gathered in the same room. Now we need to figure out how to keep the conversation going!

In that spirit, I have gathered a list of resources shared during our discussion. Please contact me with additional resources to add to this list and I will keep it updated.

Translation:

  • The Conversation – a news site for academic researchers to write articles about their findings
  • Greater Good – online magazine for translation of positive psychology findings

Support:

Research repositories:

  • IssueLab by Foundation Center – “Free research from social sector organizations around the world”
  • See also Foundation Center’s new campaign, Open for Good, encouraging foundations to openly share their knowledge

 

 

 

Innovative research partnership: Jeannette and Dave improve risk communication messaging training

Innovative research partnerships is a series of profiles about collaborations between Ph.D. communication researchers and working professionals in the community. I consider these partnerships innovative because of the creativity involved in initiating and sustaining cross-sector collaborative research. Through separate interviews of both partners in the collaboration, I share the unique stories behind the partnerships, the challenges they face in their collaborative efforts, and the fruits of these partnerships. The series was started in anticipation of my two conferences sessions on research partnerships at ComNet17 in September and NCA in 2017.

Today, we hear from Jeannette Sutton and Dave Cokely. Their work together addresses the improvement of communication about imminent threats, as well as quality training on this topic. Let’s start with what Dave has to say about this partnership.

Dave Cokely is an instructor at National Weather Service (NWS) Training Center in Kansas City, Missouri.

On what he has gained from the partnership: After being advised by Jeannette and several other social scientists on improving NWS risk communication messages, Jeannette led a training session for a group of NWS meteorologists who coordinate warning messages. Dave said that Jeannette designed a “brilliant” exercise, asking trainees to get their hands dirty developing messaging in various disaster scenarios. According to Dave, Jeannette’s training session received the highest rating of all sessions over the 4-day class, adding that she had “hit a grand slam.”

On his role in the partnership: Dave said he and his colleagues are frequently asking themselves how to better communicate watches, warnings, and advisories to the public to prompt action. Dave describes his role in the partnership as “start(ing) a two-way conversation” with an expert who had “absolutely critical information” to share with him and his colleagues at NWS.

On challenges the partnership faced: Dave reflected that “it takes work to get the door cracked open for these collaborations,” adding that he sees these type of partnerships happening more often. Dave said that sometimes it is hard to get meteorologists and scientists in his industry to pay attention to social sciences research because it is seen as a “soft science.”

On why the partnership works: Jeannette has a “great presence,” according to Dave, and when she presents social scientific evidence that is relevant to his colleagues, they listen. He said that she has helped him and his colleagues integrate insights from social science into an audience-centered approach to messaging, including a new training series about supporting the public’s decision-making process when preparing for disasters.

Dr. Jeannette Sutton is an assistant professor in the Department of Communication and director of the Risk and Disaster Communication Center in the College of Communication at University of Kentucky. 

On how the partnership got started: Dave contacted Jeannette after he heard her speak at a NWS-hosted hazard simplification conference in 2015, eventually asking her to lead a training on risk communication for NWS. Jeannette was asked to conduct this training again this fall by another contact. Jeannette said she works to build relationships with partners such as Dave so that they can collaborate in the future if an opportunity presents itself.

On why this research matters: Jeannette said she “has the privilege of working with people who are putting out life-saving messages” about disasters. Although Dave wasn’t involved in writing it up, Jeannette is publishing the training exercise she developed in a forthcoming journal article. She added that working with professionals like Dave ensures her research is responsive to the needs of people in the risk communication field.

On challenges the partnership faced: Jeannette said that it takes time and effort, on top of a busy teaching schedule and research agenda, to develop and maintain relationships with practitioners in the field of disaster communication. However, she frequently travels to present at and attend conferences such as the American Meteorological Society and Society for Risk Analysis to share her research and maintain relationships.

On why this partnership works: Jeannette said that she has seen the NWS grow increasingly interested in incorporating social science into their operations. Dave and his colleagues at NWS are interested in some of the same questions she is asking about how people perceive messages and the factors that influence how people interpret them.

See more about Jeannette’s research from University of Kentucky’s People Behind Our Research series:

Innovative research partnership: Chris and Lynsey explore recovery communication strategies

Innovative research partnerships is a series of profiles about collaborations between Ph.D. communication researchers and working professionals in the community. I consider these partnerships innovative because of the creativity involved in initiating and sustaining cross-sector collaborative research. Through separate interviews of both partners in the collaboration, I share the unique stories behind the partnerships, the challenges they face in their collaborative efforts, and the fruits of these partnerships. The series was started in anticipation of my two conferences sessions on research partnerships at ComNet17 in September and NCA in 2017.

Today, I highlight the partnership between Lynsey Romo and Chris Campau, who have worked together on research for a year and a half. Their research explores how students in recovery from drug and alcohol abuse talk to others about their recovery status (or not) given the stigma and negative reactions the students may face. First, we hear from Chris.

Chris Campau is the collegiate recovery program coordinator at Addiction Professionals of North Carolina.

On what he has gained from the partnership: Chris said that he learned from this research that some students in recovery simply “wouldn’t talk about it at all on campus.” This has informed his work in his current position coordinating support for students in recovery. Further, he noticed the empowerment and positivity he saw in students who possessed more communication strategies to manage disclosure of their recovery status. He said this has refreshed his commitment to conducting more recovery message training programs for people in recovery.

On his role in the partnership: Chris started working with Lynsey while he was a non-traditional student at NC State University. As a person in recovery himself, Chris was paid to conduct interviews asking participants who were in recovery about their experiences disclosing their recovery status or not. He asked about how they disclose their status and how disclosures changed based on whether participants were talking with drinking peers, non-drinking peers, or with professors. Chris has also been involved with analyzing data and writing up the research report.

On challenges the partnership faced: When he began his new job, Chris said the project had to be put on hold for several months and lost some steam. He said he felt he has been able to readjust and rejoin work on the research now that he has settled into his new job.

On why the partnership works: Chris said that Lynsey is “an extraordinary human being.” He said that what made the partnership successful is that both parties were equally willing to learn about the other’s work and expertise.

Dr. Lynsey Romo is an assistant professor in the Department of Communication at North Carolina State University.

On how the partnership got started: According to Lynsey, the partnership began when an addiction treatment professional in Raleigh who had read a previous research article of hers about communication among nondrinkers set up a meeting to introduce Chris and Lynsey.

On why this research matters: This research expands on some of Lynsey’s previous research about the difficulty faced by former problem drinkers in social situations. Studying the social experiences of people in recovery and gathering communication strategies they use can help in developing support for this population in managing their new-found sobriety and identity.

On challenges the partnership faced: Lynsey said that, generally, doing applied research with community partners can sometimes take longer since you “lose some control of the process.” This can be a challenge since she is under pressure as a faculty member seeking tenure to publish her research in a timely manner. However, she said this project has been a win-win that is valuable to the community and to the academic research community.

On why this partnership works: Lynsey said that having funds to pay Chris for some of his early work interviewing participants while he was still a non-traditional student helped get the project off to a strong start. Lynsey said she and Chris have a great rapport. She added that he brings a lot to the table because “he is so passionate and has first-hand knowledge” about the research topic.

Disclosure: I have previously worked with Lynsey on research an am a co-author on the paper cited in the interview. Further, I have previously met Chris and his colleagues through research with Lynsey. I was not, however, involved in the research project discussed in this profile.

How research will drive the next stage of strategic storytelling for social good: #ComNet16 takeaways

 

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Between soaking in views of the Detroit river and DIA’s Diego Rivera mural, conference goers at ComNet16, a gathering of social sector communication leaders, found that many sessions emphasized a crucial communication challenge: good storytelling.

We know that being able to tell the story of our social issues is crucial to engaging and moving audiences. But what exactly makes for good story? What can we expect to achieve with a good story? How do we move beyond the trite, sometimes exploitative, and all-too-familiar trope: “organization x saves person y from circumstance z?”

As a researcher, I am trained to look to the data and the existing research to answer these questions. While I think there is room for more research on strategic storytelling and more translational work to make this research accessible, I was delighted to see that speakers at the conference provided some excellent case studies of how it looks to do strategic storytelling.

The first keynote with Aaron Belkin of the Palm Center kicked things off with the journey (marathon?) to repeal Don’t Ask Don’t Tell, including how research informed the campaign and messaging (read more here). Doug Hattaway later recalled how achieving marriage equality demanded shifting of the story from “lgbtq people deserve equal civil rights” to “marriage is between two committed individuals.”

John Trybus of Georgetown University’s Center for Social Impact Communication introduced us to the emerging megatrends of storytelling (think virtual reality, etc.).


In an electrifying Q&A with Jesse Salazar, NY Times columnist Charles Blow reminded us that if our storytelling does not ultimately create change, we have fallen short. Storytelling has to do more than entertain or delight. Our strategic communication should be in service of changing hearts and minds, which in turn, drives social and policy change. And it can — here’s a brief review of the science behind how stories can create change.

Nat Kendall-Taylor of Frameworks Institute and Shaun Adamec reminded us of the importance of how we frame social issues. For example, do we talk about addiction in terms of empathy (“we need to identify with addicts and treat them with compassion”) or interdependence (“everyone has a stake in solving this problem”)? Though many communicators are prone to tell stories about addiction that are meant to inspire empathy, the Institutes’s research results from a sample in Canada suggested the empathy frame may be counter productive, actually decreasing support for policies that addressed disparities in the access to and delivery of addiction services. We can’t trust that our well-intended story will have the effect that we intend on our audiences. Our storytelling must utilize strategic framing.


Finally, Doug Hattaway and Alfred Ironside presented their ambitious attempt to answer some of these questions about how to frame strategic stories and messages: a research initiative called American Aspirations, based on a nationwide survey of 2,000 people about their values. There is much still to be reported about the methods used for this study and its results (I’m studying for my PhD–I had to say it).


However, I am happy to see this proactive effort meant to find common ground for persuasive communication. The crucial question, once we’ve identified common values, is how people with certain values actually respond to the messages targeting these values. Unfortunately, we can’t always assume our communication meant to target those values are indeed perceived as in line with those values.

We must commit to the task of rigorous strategic storytelling that drives change by developing stories based on the data and by evaluating our stories for impact.

Communicating global change

Poster design by Matt Abele

Poster design by Matt Abele

For my graduate Communication Campaigns course at NC State this past spring, a group of us developed a communication campaign proposal for the Southeast Climate Science Center‘s (SE CSC) inaugural Global Change Symposium. Recently, we checked in to find that the good folks at SE CSC were able to implement many of our tactics.

This Global Change Symposium, which will be held on August 28, is a first-time “meeting of the minds” of researchers, faculty, students, administrators at NC State. The SE CSC envisions this event as an opportunity to unite the various efforts across the campus to address global change.

What is global change, you say? Good question! It is a broad term meant to capture many of the complex changes occurring with regard to earth’s environmental, population, and food systems. Effectively conveying the importance and relevance of this broad concept was one of the fundamental challenges of the campaign.

 

From our proposal

The problem: Engage and persuade a diverse audience of stakeholders to attend the inaugural Global Change Symposium. Audiences included professors/researchers, administrators, and graduate students. SE CSC sought to engage an interdisciplinary group of researchers to unite the varying efforts of researchers across campus.

The solution: Create targeted messages for subgroups by type of audience and academic discipline using strategic channels to both inspire interest and justify benefits of attending the symposium.

As a team, we reviewed literature about communication campaigns, determined campaign goals, conducted focus group with stakeholders, developed messaging and communication assets, pretested messages with stakeholders, and created an evaluation plan. All of this culminated in a 80+ page campaign proposal which we presented to SE CSC in April.

Our team was delighted to find the SE CSC has utilized much of our campaign strategy and used materials we designed in their communication for the symposium on their website and emails, among others channels.

If you will be around Raleigh in August (sadly, I will not be!) I recommend you attend this exciting event to learn the latest about how NC State is addressing global change issues — and potentially get involved.

The Spring 2015 COM 529 Communication Campaigns course was taught by NC State Associate Professor of Communication Dr. James Kiwanuka-Tondo. Our team was made up of the following members: Matt Abele, Ben Lawson, Kelly Long, Tara Watterson, Alexa Wood.

Thesis: How do doctors talk to patients about sensitive topics?

During the last couple of weeks, I’ve been putting the final touches on my thesis research project. The question in the title of this post is the general question I’m pursuing with my thesis research.

A recent article published in the Chronicle of Higher Education reminded us that “despite decades of research, hundreds of campus task forces, and millions invested in bold experiments, college drinking remains as much of a problem as ever.” Thus, alcohol intervention conversations between medical providers and students about alcohol can be crucial to reducing problems associated with college binge drinking.

Presenting at my oral defense

Presenting at my oral defense

However, medical providers sometimes avoid alcohol-related conversations or brief alcohol interventions. So, I pursued with my thesis research the more specific question of, how do medical providers in university health centers communicate with patients about the sensitive topic of patient alcohol use?

Results from my qualitative analysis of 14 interviews with medical providers suggest that medical providers utilize the following communication techniques during alcohol-related conversations with patients:

Reading, writing, editing, reviewing, diagramming, etc etc etc!

The process: reading, writing, analyzing, editing, reviewing, diagramming, reflecting, etc etc etc!

  •  gathering more information (beyond screening data)
  • creating a nonthreatening environment
  • providing education about consequences
  • eliciting patient ownership
  • providing tips for harm reduction
  • continuing the conversation

Additionally, providers reported the following communication challenges to conducting brief alcohol interventions in this context:

  • choosing how and when to start the conversation
  • diagnosing a resistant population
  • establishing necessary rapport for a sensitive conversation
  • maintaining credibility despite uncertainty about the efficacy of interventions

With my poster at the graduate research symposium

I presented this research at the 10th annual NCSU Graduate Research Symposium earlier this month. My hope is that some of this research will be helpful to medical professionals in the field. I am also looking forward to submitting this research for publication. For now, I’m glad to be wrapping up this phase of my research!

With my committee at oral defense, from left to right: Chair, Dr. Deanna Dannels; Dr. Jessica Jameson; and Dr. Kami Kosenko

With my committee at oral defense, from left to right: Chair, Dr. Deanna Dannels; Dr. Jessica Jameson; me; and Dr. Kami Kosenko

I began this project more than a year ago and cannot be more excited to see it all come together! My thanks to the medical providers who met with me, the health center administrators who helped with this project, and to my committee.

 

Top Five Thesis Memes

Like many other graduate students out there, I’m in the thick of writing my thesis this winter. I’m researching the challenges and opportunities faced by medical providers when discussing patient alcohol use with patients. More specifically, I’m looking at how university medical providers communicate with college-age patients regarding binge drinking alcohol. It’s

Of course half of the time when I’m “writing my thesis,” I’m looking at #thesismemes. I’d like to share my favorites with my fellow thesis-writing friends. Here are my top five favorites:

Naturally, a cat meme to kick us off:

Memethesis1

via thesis kitten

And of course, these classics:

Memethesis1

via thesis memes

Memethesis2

via thesis memes

Ah, the dreaded defense!

via dudelol

via dudelol

Now for my final pick. It is not actually a meme, but rather, my favorite song written about thesis-ing, John Sampson’s When I Write My Masters Thesis. Fellow thesis writes, I trust you’ll enjoy it!