Methodological and logistical challenges to conducting multi-site partnered research in the VA healthcare system

In 2008-09, VA's Chiropractic Services program and Center for Implementation Practice and Research Support (CIPRS) obtained funding from the Samueli Institute to study the implementation and characteristics of new chiropractic services in the VA healthcare delivery system. The funded study, “Variations in Implementation and Characteristics of Chiropractic Services” (VICCS) was designed to generate policy-, practice- and research-relevant findings and insights using a scientifically rigorous approach employing applicable theory, methods, measures, and data collection instruments. Data collection proceeded during 2010-2011, followed by data analysis and reporting in 2012. Although carrying out multi-site research in VA and other large systems is generally challenging, partnership (research-policy-practice) projects face additional challenges. Further, this study encountered additional complex issues related to its focus on the integration of chiropractic services within a large healthcare system. As an emerging field, Integrative Health Care faces the problem of a widely accepted and applied definition. For integrative chiropractic care, definitions can range from simply incorporating certain aspects of chiropractic services into biomedical settings to new forms of medical practice. This session shares insights and “lessons learned” for successfully developing and conducting research within a complex environment, using VICCS as an example. Methodological and logistical issues to be presented include: selection and recruitment (criteria; reviews/permissions/approvals; site replacement); multiple agency compliance; managing resources (time, money and people); and analyzing varied data sources.