Health Research: Almost All Studies Around the World Are Delayed

Research studies often follow an overall recipe: first, researchers have a research question. Then they design a project. After that, they recruit participants and collect data. The next step is to analyse the collected data. Finally, the results are presented.

But what really happens behind the scenes in this often lengthy and complex process?

Almost All Studies Are Delayed

Researcher Meghan Bradway at the Norwegian Centre for E-health Research realized she was immersed in seeking answers to these questions.

"Our work includes investigating how technology such as smartwatches, mobile apps, and other digital devices can affect people's health and coping abilities. Researchers and partners use project tools to conduct the study. In addition, the team members communicate both digitally and in person with each other," says Bradway.

She has noticed a significant trend.

"Almost all studies around the world are delayed. Too many are not completed on time or on budget. Something needs to be done, especially since technological development is outpacing slower research," she says.

Two Questions

Bradway believes that researchers need to learn from one another to improve project management.

She started with two questions: How do researchers manage complex studies in digital health? And what technologies and strategies do they use to collaborate?

Bradway and her colleagues reviewed previous research and identified relevant studies. They then contacted the researchers and requested interviews. Fifteen researchers from eight international studies agreed to participate, most of whom were women. The interviews were conducted between 2020 and 2022.

"The aim was to gain insight into technology use, but also into the human factors. Among other things, we wanted to hear about how people experienced inequalities and relationships," Bradway explains.

Had to Take a Trial-and-Error Approach

The interviews showed that several of the researchers did not feel like "born" project managers. Nevertheless, they took on leadership roles in their teams. One researcher said in the interview:

"I'm not a technology person. I'm a nurse... I was kind of just put into this leadership role, so I think in the beginning I didn't know much about how to do it... It was trial and error."

Many who were new to digital health research found it exciting. The majority agreed that having team members with different professional backgrounds was beneficial. Some pointed out that partners were eager at the start but often lost interest toward the end.

A common understanding of the goal and a good working environment were emphasized by several as important. One participant commented:

"I think it really helped to say, 'You can all talk in the team meeting. We're all learning together. You can offer valuable insights from an administrative point of view that will be beneficial to the program.' I told people that their talents were valuable."

Used the Technology They Had Available

The respondents were asked which technologies they used in their research projects. Some responded that it could be random—they used technological solutions purchased by their employer.

One respondent reported having five different Microsoft Teams accounts. Many interviewees stated that email was the most common form of communication and that collaborators could be reluctant to work together on another digital platform.

Privacy and Data Security Requirements

Researchers also pointed out that the rules for processing personal data meant that the study was delayed.

This could happen, for example, if they had to transfer data from electronic patient records or national health registers. Sometimes privacy and security requirements posed a major barrier, as one person described:

"It took more than 1.5 years to get the complete data."

In one study, participants had to apply to retrieve data from a database each time they wanted access to the dataset. Exporting the data required the knowledge of another researcher who was not easy to reach.

Email Most Commonly Used

The research teams mostly used email in their daily work, despite the fact that it was demanding to keep track of the flow of information there.

Sometimes they had the opposite problem: they didn't receive enough emails. This could happen if they needed a response from a partner. Information could slip away when employees left or new ones joined.

Some teams used mobile messaging apps when exchanging non-sensitive information. Some people became stressed by receiving messages "day and night" and opted out of group chats.

People in almost all teams responded that they had used cloud solutions such as Google Drive. The advantage was that they could work on the documents simultaneously. However, some said that people had access but never logged into the solutions.

Finally, the team members were asked what they would have done differently.

"Many answered that it was a good idea to plan which technological solutions should be used for different purposes and phases. But few had managed this well in practice. Some thought that automatic data extraction would have made the work easier," says Bradway.

Include It in Educational Programs

What was the conclusion?

"Good communication and information flow were essential for the researchers to achieve their goals. If everyone in the group was able to put their egos aside, everything went more smoothly," says Bradway.

Collaborating across disciplines, faculties, social sectors, and countries is difficult. The researchers who did it best were able to agree on the vision and were clear about tasks and responsibilities. They communicated consistently.

"Researchers often experience culture shock when they start working with people from other industries and sectors. It takes time to adapt to this. Those who are responsive and adaptable have a big advantage," emphasizes Bradway.

She believes that project tools should be developed that support research effectively. "The tools must contribute to good interdisciplinary collaboration. They should provide a better alternative than the many 'digital silos' that exist today."

"A study is not a list of objective tasks to be performed. It requires good insight into human and psychological factors and good leadership. These things affect the climate of cooperation. It would be a step forward if universities included more of these topics in courses and study programs," says Bradway.

Reference

Meghan Bradway et al: What the textbooks don’t teach about the reality of running a digitally enabled health study: a phenomenological interview study. BMC Digital Health, 2024. Doi: 10.1186/s44247-024-00124-6