Using Mixed Methods to Investigate Condition Management Programmes Carly Reagon Department of Occupational Therapy

Introduction Research investigating the effectiveness of Condition Management Programmes Mixed methods - why choose this methodology? - what are the challenges? My journey as a researcher

What are Condition Management Programmes? Since 1979, number of incapacity benefit (IB) claimants have trebled to 2.7 million or 7% of UK population Research suggests most IB claimants want to work Research also suggests that work is good for you! As part of the Pathways To Work scheme, Condition Management Programmes (CMPs) aim to help people overcome barriers to work Launched in 2003, national roll out from 2006

Barriers to work for IB claimants Health condition Side effects of medication Age Lack of skill/qualifications Lack of confidence Disempowerment Condition management Group and 1:1 sessions - anxiety management - work-related skills - pain management etc. Biopsychosocial approach CBT MDT

Aims of the research To explore the effectiveness of 3 NHS-led CMPs in Wales in terms of: 1.Enabling individuals to manage their health condition(s) better 2.Moving individuals closer to work, education or training

Methodology Case study Collation of outcome measures for CMP participants across 12 months (SF36v2, GSES, HADS) (N=247) Qualitative interviews with CMP participants, managers, and practitioners (N=27)

A mixed methods approach An evolving methodology Combining quantitative and qualitative research methods within a single study ? A third research paradigm (Johnson and Onwuegbuzie 2004)

Why choose mixed methods? The complexity of healthcare research Answering research questions effectively Gaining new insight Appeals to a wider audience?

Aims of the research Effectiveness in terms of: 1.Enabling individuals to manage their health condition(s) better 2.Moving individuals closer to work, education or training Quantitative data: before and after outcome measure scores of physical health, mental health, and self efficacy Qualitative data: perceived behavioural change, motivations, challenges, approaches, professional relationships

The start of the journey Happy qualitative researcher Curious qualitative researcher Scared researcher

Challenges of using mixed methods When and how to mix: During data collection? Data analysis? Interpretation? Concurrent triangulation strategy (Creswell 2009) Learning new skills Combining results e.g. discrepancies Triangulation

How to mix successfully! Preparation Organisation Focus The right software Learning from others Pluck!

Some preliminary results 1. Outcome data show significant increase in mental health scores, but only slight increase (and in some cases, decrease) in physical health scores - Qualitative data emphasise management NOT treatment - Participants gave examples of worsening physical health but increased ability to cope

Some preliminary results 2. Significant positive increase in mental health scores, but still below average for general population - Qualitative data question work as an outcome - Rather CMP is first step on the ladder

Some preliminary results 3. Qualitative data very positive about CMPs -Participants want to give something back - Outcome data provide cases where health has become worse

Still a long way to go Happy qualitative researcher Curious qualitative researcher Scared researcher Enthused researcher

Questions?