RESEARCH PROPOSAL to Vanier-CIHR
1
Information for youth perinatal health:
Experiences of pregnant youth and their health care providers
This research project will explore the way pregnant youth and their health care providers (HCPs)
think about, seek, access, value and use health-related information: their perinatal health information
behaviour. Via qualitative inquiry into the health-related information experiences of pregnant youth and
their HCPs in British Columbia, I seek to shed light on knowledge translation and health behaviour
change processes related to youth perinatal health. Drawing on information science, critical studies and
health services research traditions, this interdisciplinary project aims to uncover values, rationales and
theories behind the use and non-use of medical evidence in perinatal health decision-making.
Background
Effective communication of health information to target audiences is a key element of
knowledge translation (KT) aimed at impacting both professional practice and public health.
Information is also a major concept in many models of health decision-making and behaviour change.
Yet, our knowledge of health information behaviour – the “receptor side” of KT - is limited.
Canada dedicates substantial resources to KT with the aim of improving the health of pregnant
women and newborns. Despite our investment in perinatal health information campaigns, we know little
about the role of such information in informing health decisions. While teenage pregnancy is associated
with a higher risk of many health problems to mother and baby, we know even less about
the informati
on
behaviour of and relating to pregnant youths than we do about mothers in general.
What health information do young (13-19 yrs) pregnant women and their perinatal HCPs think
about, seek, access, value and use? What is the role of such health information in informing perinatal
health decisions? In an attempt to explore answers to these questions, this project will investigate the
information behaviour related to youth perinatal health in British Columbia.
Objectives and Research Questions
By exploring the information experiences of pregnant youth in BC and their HCPs, I aim to: (1)
describe the health information behaviour of pregnant youth and perinatal HCPs, (2) identify values,
rationales and theories behind the use and non-use of medical evidence in perinatal health behaviour and
care in the study population, and (3) compare and contrast the observed health information experiences
with existing theories of health behaviour, information behaviour and knowledge translation.
This project will simultaneously explore: (a) the known public health priority area of medication
use during pregnancy and lactation, and (b) other health issues that emerge as priorities of the research
participants. Research questions will centre on ways young pregnant women and perinatal HCPs interact
with information to support perinatal health. How do participants identify information needs relating to
pregnancy or childbirth and health? Where do participants seek information, how do they go about it,
and why do they use the sources they do? What do they do with the information they find and receive?
Theoretical Approach
While researchers may use quantitative research methods to observe what is happening in youth
perinatal health (e.g., what patient or prescriber attributes appear to be correlated with potentially-
teratogenic prescriptions), qualitative exploration uniquely uncovers the why and how -- the meanings of
observed phenomena (e.g. how is the decision to prescribe or consume a high-risk medication made?).
Due to this project’s constructivist aim of understanding participants’ own perspectives and truths, I will
apply principles of emergent design in data collection and analysis. My methodology is further
influenced by critical feminist studies perspectives; thus power structures and hierarchies of privilege
and oppression will be significant concerns of both the ethics and analysis.
Methods and Procedures
RESEARCH PROPOSAL to Vanier-CIHR
2
Data Collection
This project will centre on a set of information experience studies of pregnant teens and perinatal
HCPs in British Columbia. Focus group interviews of purposively sampled peer groups will be the
primary mode of data collection. Focus group methods may allow better access to elite professionals,
put lay participants more at ease than one-on-one interviews, and allow us to explore social sharing of
information among peers – a concept central to the theory of Information Grounds. In-depth individual
interviews will be employed as needed in order to access individuals with perspectives of theoretical
value who are unwilling or unable to participate in a group setting. Interviews will be facilitated in a
semi-structured manner, embedding the pre-determined topic of medication decisions with an otherwise
open agenda to allow other themes to emerge as participants deem them important.
Interviews will make use of the Critical Incident Technique (CIT), asking participants to
recall
a
nd recount specific information-related experiences. CIT allows the interviewer to gather rich data on
topics that are important to participants and attempt to capture a close representation of the interviewee’s
experience in her own words. While CIT does not have the breadth of prospective techniques such as
information needs journaling, its strength lies in depth of the data, as well as the simplicity of
completion when compared to longitudinal data collection, with which participants may frequently be
unwilling or unable to comply.
Analysis
Data analysis will be inductive in nature, based on grounded theory strategies, but informed by
postmodern critical studies paradigms to look for themes of power hierarchies, privilege and oppression,
and faceted identities. Data will be examined iteratively, using constant comparison across data sources,
coded themes and memos. Analysis will be informed by Charmaz’s constructivist grounded theory
techniques, expanding the focus beyond processes to social worlds, and clearly acknowledging
the
impact
of participants’ social locations. Clarke’s postmodern situational analysis mapping
technique
s w
ill
be drawn upon as analytic tools.
Contribution to the Advancement of Knowledge
Strong qualitative research that answers some of the how’s and why’s behind youth perinatal
health behaviours will enrich our understanding of how best to “do KT” in this important area. Policy
makers, equipped with these results, will have a better understanding of the types of information that are
valued and used by health professionals and the public. Libraries and publishers need this information in
order to evolve to better meet the health information needs of patrons and customers. Health care
practitioners will gain an increased understanding of what information is influential to patients.
Significance to fields supported by the Canadian Institutes of Health Research (CIHR)
CIHR’s mandate includes the "translation of knowledge into improved health for Canadians,
more effective health services and products and a strengthened Canadian health-care system." In
accordance with this mandate, CIHR’s current strategic direction #3 is to “Accelerate the capture of
health and economic benefits of health research.” Research on the theory and practice of KT, such as
this project aimed at understanding the information behaviour of populations who are targets of KT
campaigns, supports this mandate and strategic direction.
This research, being highly interdisciplinary in nature, contributes toward goals within two of the
four CIHR “pillars”: health systems and services; and the social, cultural and other factors that affect the
health of populations. Further, it spans topics of interest to multiple Institutes, including the Institute of
Gender and Health, Institute of Health Services and Policy Research, and Institute of Population and
Public Health.
Candidate’s Role
Under the guidance of my proposed supervisor, Dr. Shoveller (CIHR Chair in Improving Youth
Sexual Health), I will design the research protocol and carry out the interviews and analysis. I will lead
in the authorship of peer-reviewed articles resulting from the research and present findings to academic,
birth-related, and health-information/KT focused audiences.
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