Research as an Important Way of Knowing
A 74-year-old single African-American woman with a fractured hip will be discharged shortly from rehabilitation to her home. She appears reluctant to use the self-care techniques you taught her. You wonder whether rehabilitation has been effective in meeting its specified goals and what her future capabilities will be after she returns home.
You have learned how to use a new tool to assess the environmental barriers encountered by children with intellectual impairments. You wonder whether this instrument is more accurate and useful than previous ones you have tried.
A research article describes a progressive approach to promoting physical fitness for adults with intellectual impairments. You wonder whether you should implement these planning procedures in your own practice and whether they will be effective in meeting their goal in diverse geographic locations.
You need to initiate a new program to prevent low back injury in migrant farmworkers. Existing prevention strategies have not been effective in reducing the incidence of low back injury in this population. You wonder why traditional approaches have failed and how to develop an appropriate knowledge base from which to develop an efficacious program.
You notice in your home care practice that some clients need more visits than others to achieve the same health outcomes. You wonder what factors influence service need. You wonder how to increase health literacy and access to health information for people who cannot see.
You are interested in how the outcomes of Internet counseling for minor depression compares to on-site counseling outcomes.
Why is research necessary?
Health and human service professionals routinely have questions about their daily practice. Many of these questions, such as those just listed, are answered best through systematic investigation, or the research process. It is therefore unfortunate that many practitioners do not engage in research. This phenomenon may be caused in part by unfamiliarity with and misconceptions about the research process.
Research is challenging, exhilarating, and stimulating. As with other professional activities, research can also be time-consuming, tedious, and frustrating. The challenges and frustrations of conducting research occur because it is not a simple activity—particularly health and human service research, in which conducting research in service environments and understanding human behavior are often complex matters. Implementing a research study in the home, community, school, outpatient clinic, or medical facility can be much more challenging than research conducted in a laboratory or a setting that can be controlled by the investigator. Throughout this book, we discuss the specific dilemmas and design implications posed by research that is implemented in the health and human service practice (particularly in Part V, Improving Practice Through Inquiry).
There are many important reasons why you should understand the research process and participate in research activities (Box 1-1).
First, research is a systematic process to obtain scientific knowledge about specific problems encountered in daily life and professional practice.1 Thus it is an important way of finding answers to questions about needed interventions, practice outcomes, and clinical irritations. The fundamental goal of research for health and human services is to develop and advance a body of knowledge to guide professional activity. Research contributes to the development of a scientific body of knowledge in several ways. It generates relevant theory and knowledge about human appearance, experience, and behavior; it develops and tests theories that form the basis of specific practices and treatment approaches; and it examines, validates, or determines the effectiveness of different practices in attaining their intended and sometimes unintended outcomes.2
The second important reason to understand and participate in research is its overall impact on health definitions and theories, health care policy, and service delivery. The knowledge obtained through research is often used directly or indirectly to set standards for population health—to inform legislators and regulatory bodies about issues necessary to develop the most efficacious health and human service policies and service delivery models. Federal regulatory agencies and other fiscal intermediaries base many of their decisions and practice guidelines on empirical evidence or knowledge generated through the research process. Evidence from research has become increasingly used to identify “best” practices, as described in Chapter 24. Consider managed care; its very foundation uses systematic cost measures and specific outcome measures to yield data that then form the basis for policy, practice decisions, and implementation of treatment guidelines. Additionally, research provides the tools by which to compare diverse health definitions and needs, practices, health outcomes, and costs across practice settings. Using systematic, standard approaches allows professionals to make comparisons among different populations and diverse health and human service contexts to determine their level of efficiency and effectiveness.
The third reason to learn about research is to enable you to participate in research activities in your own practice setting. In many health and human service settings, practitioners establish or maintain a database of health information and derive statistical reports on client outcomes. In some settings, particularly in an academic health science center or teaching hospital, you or other members of your agency will participate in research to advance the research goals of the institution. You may have many diverse roles as a member of a research project. You may initially want to participate in the process as a data collector, chart extractor, interviewer, provider of an experimental intervention, or recruiter of participants into a study. These are all excellent, time-limited roles to learn firsthand the art and science of the research process. When you feel more comfortable and gain some experience with the process, you may want to serve as a project coordinator and become responsible for the coordination of the detailed tasks and daily activities of a research endeavor, or you may choose the role of the coinvestigator and assist in the conceptual development, design, implementation, and analytical components of a study. If you really become hooked on research, you may want to be a principal investigator and assume responsibility for initiating and overseeing the scientific integrity of the entire research effort.
The fourth reason to know about research is that it provides the tools by which you can learn about and be responsive to the experiences and needs of the individuals and groups you help in your professional practice.
The fifth reason to learn about and participate in research is to become a critical consumer of the growing body of research literature that is published in professional journals and other venues. Research not only yields a body of knowledge but also provides the evidence and reasoning strategies on which the investigator bases knowledge claims. Thus, research provides the foundation for informed professional decision making and action. By understanding the research enterprise when you read a research study, you will learn specific findings and also how the knowledge was generated and whether it can be applied to various settings, persons or areas of practice. Understanding the thinking and action processes of research will provide you with the necessary skills to determine the adequacy of research outcomes and their implications for daily practice.3 Most important, the knowledge you gain about research findings has the potential to improve your practice and thus improve the health and quality of life of the people you serve (patients, clients, families) and the health of your community.
As you can see, there are many reasons to learn about the research process. Most important, whether conducting a study or just using systematic techniques in your professional activity, the procedures and methodologies used in research can improve how you think and act in your daily practice. They answer two fundamental questions: “How do you know?” and “So what?” “How do you know” is answered by explicating the evidence to support claims and the ways in which the evidence was obtained and interpreted. The “so what” question refers to use of knowledge. Now that you have the knowledge, how can it best be put to use? This text offers a range of methodologies and techniques, including case study, analysis of audio or video recordings, single-case design, observation, and in-depth interviewing. As a health care or human service professional, you can use each to gain better insight into a particularly difficult practice situation or, in general, to advance all aspects of your professional practice. For example, if you are experiencing difficulty effectively interacting with and thus treating a child with a developmental disability, borrowing a technique from research (e.g., recording a session and systematically analyzing verbal and nonverbal interactions frame by frame) may provide important insights to better approach this particular individual.
Let us assume you have been asked to assess the functional ability of residents who live in a congregate living facility in the community to improve self-care skills. You may want to set up a single-subject design to monitor your program and its effectiveness in attaining its outcome and then share findings with staff and administrators. First, you would take several baseline assessments of the resident's functioning over several days using a standardized functional measure. Second, you would introduce your strategies to improve self-care. Then you would reassess the residents over several days using the same functional assessment. This simple and easy approach allows you to obtain systematic information about your treatment and its outcome. The point is that many aspects of the research process can be easily incorporated into your daily practice to improve your own as well as professional knowledge about methods to achieve practice outcomes.
One final point should be made regarding the importance of participating in research. As health and human service professionals engage in the research process, they contribute to the development of knowledge and theory and help to identify new practice approaches, validate existing strategies, and improve practice. Through this research activity, health and human service professionals are participating in the advancement and refinement of the research process itself and its application to professional issues and service settings. Health and human service professionals who are involved in research today will make significant contributions to the evolution of research methodologies.4–6
What is research?
Research is not “owned” by any one profession or discipline. It is a systematic set of ways of thinking and acting and has distinct vocabularies that can be learned and used by anyone.
Many definitions of research can be found in texts, ranging from a very broad to a very restrictive understanding of the research endeavor. A very broad definition suggests that research includes any type of investigation that uncovers knowledge. In contrast, a formal and more restrictive definition of research implies that only one type of strategy, such as a quantitative orientation, is valid. Many researchers use the classic (but we believe restricted) definition offered by Kerlinger, who defined scientific research as “systematic, controlled, empirical, and critical investigation of natural phenomena guided by theory and hypotheses about the presumed relations among such phenomena.”7 Whereas a broad definition includes any type of activity as research, a restrictive definition, such as Kerlinger's viewpoint, implies that the only legitimate approach to scientific inquiry is hypothesis testing.
In contrast, we define research in such a way as to reflect and allow for a wide range of ways of knowing or systematic approaches to knowledge building. As such, our definition of research is as follows:
Research is defined as multiple, systematic strategies to generate knowledge about human behavior, human experience, and human environments in which the thinking and action processes of the researcher are clearly specified so that they are logical, understandable, confirmable, and useful.
Our definition has three important components (Box 1-2). First, we state that research is more than one type of investigative strategy; that is, research is not just hypothesis testing, as suggested by Kerlinger, but rather is represented by a broad range of strategies that are systematically implemented. In contrast to the definition offered by the restrictive view, we recognize the legitimacy and value of many distinct types of investigative strategies. Second, our definition emphasizes that research is composed of thinking processes and specific actions (action processes) that must be clearly delineated and articulated. We believe that the beauty and efficacy of the research process lie in the explication of how and on what basis a knowledge claim is made. Third, we characterize thinking and action processes as logical, understandable, confirmable, and useful to meet the criteria of research. That is, in contrast to the broad inclusive definition of research, our approach clearly distinguishes the boundary between research and other forms of knowing (e.g., through trial and error) by establishing these important criteria. Let us examine the three major components of our definition in greater detail.
Research as Multiple Systematic Strategies
The first component of our research definition emphasizes the value of varied systematic strategies to understand the depth and range of research questions and queries posed by health and human service professionals. These multiple research strategies can be categorized as representing either naturalistic inquiry or experimental-type research. These two broad categories of research strategies are based in distinct philosophical traditions, follow different forms of human reasoning, and define and obtain knowledge differently. Naturalistic inquiry refers to a wide range of research approaches characterized by a focus on understanding and interpreting human experience within the context in which experience occurs. Experimental-type research refers to a range of designs characterized by a focus on prediction and hypothesis testing. Chapter 3 examines the differences between these research traditions, their philosophical roots, and their implications for health and human service research. Naturalistic inquiry tends to be idiographic; that is, it focuses on specific phenomena in a context and seeks to highlight the complexity of these phenomena. Experimental-type approaches examine and characterize what is typical about one or more groups; this approach is referred to as nomothetic.
Our viewpoint, however, reflects a school of thought that has been expressed in numerous professional and academic disciplines. This school of thought proposes that both naturalistic inquiry and experimental-type research strategies have equal importance in establishing a scientific base of health and human service practice and in adequately examining the diversity of human experiences and behaviors. Idiographic and nomothetic understandings each reveal different, valuable, and necessary knowledge.
This viewpoint also firmly asserts that it is not reasonable to critique naturalistic research using experimental language because each approach represents a distinct epistemology, or way of knowing and obtaining knowledge.8,9 As Gareth Morgan, cited by Patton, eloquently claimed:
“It is not possible to judge the validity or contribution of different research perspectives in terms of the ground assumptions of any one set of perspectives, since the process is self-justifying. Hence the attempts in much social science debate to judge the utility of different research strategies in terms of universal criteria based on the importance of generalizability, predictability and control, explanation of variance, meaningful understanding, or whatever are inevitably flawed: These criteria inevitably favor research strategies consistent with the assumptions that generate such criteria as meaningful guidelines for the evaluation of research…. Different research perspectives make different kinds of knowledge claims, and the criteria as to what counts as significant knowledge vary from one to another.”9
Another implication of our perspective is that combining or mixing methods is an important and purposive approach to the study of many of the complex issues of current concern to health and human service professionals. As Bonilla-Silva asserts with regard to the study of contemporary racism, “The research strategy that seems more appropriate for our times is mixed research designs because it allows researchers to cross-examine their results.”10
Research as Thinking and Action Processes
The second important component of our definition of research refers to thinking and action processes. Thinking processes and action processes represent the different ways of reasoning and the specific series of actions that distinguish naturalistic and experimental-type investigators in the conduct of their research. Experimental-type research uses primarily a deductive form of human reasoning. Naturalistic inquiry primarily uses inductive and abductive forms of reasoning. Each leads to different types of research action and generates different information or knowledge. Table 1-1 summarizes the major characteristics of these approaches to reasoning.
TABLE 1-1
Major Characteristics of Inductive/Abductive and Deductive Thinking
| Inductive/Abductive | Deductive |
| No a priori acceptance of truth exists | A priori acceptance of truth exists |
| Alternative conclusions can be drawn from data | One set of conclusions is accepted as true |
| Theory is developed | Theory is tested |
| Relationships are examined among unrelated pieces of data | Relationships are tested among discrete phenomena |
| Concepts are developed based on repetition of patterns | Concepts are tested based on application to discrete phenomena |
| Perspective is holistic | Perspective is atomistic |
| Multiple realities exist | Single, separate reality exists |
Deductive Reasoning and Actions
Experimental-type researchers primarily use deductive reasoning. This type of reasoning involves moving from a general principle to understanding a specific case. On the basis of a theory and its propositions, hypotheses are derived and then formally tested. Health and human service professionals use deductive reasoning every day in their practices.2,11 As an example, a professional proceeding from the theory that clinical depression is a mood state that manifests in flat affect, sleep disturbance, change in appetite, and dysphoria would ascertain the degree to which a client had these symptoms. If there were sufficient presence of each of these symptoms, the therapist would deduce, on the basis of the general theory, that the client was clinically depressed. The therapist would then use theory deductively to determine how best to treat the depression, to define outcomes, and then to test treatment efficacy by assessing the theorized outcomes.
A similar process occurs in research. Using a deductive type of reasoning, the researcher begins with the acceptance of a general principle or belief based on a particular theoretical framework. This principle is then applied or used to explain a specific case or phenomenon. This approach involves “drawing out” or verifying what is already accepted as true.12
For example, a researcher is interested in testing an intervention to improve the health of caregivers of people with dementia. In this case, the researcher may begin from a framework of caregiver-burden theory that assumes the characteristics or behaviors of the person with dementia negatively affect the health and well-being of and therefore place a burden on caregivers. Accepting this principle as truth, the deductive researcher will be interested in testing the effectiveness of interventions that are designed to reduce burden by providing education, teaching behavioral skills management, or providing respite.
Inductive Reasoning and Actions
Researchers who work within a naturalistic framework primarily use inductive reasoning. This type of reasoning involves moving from a specific case to a broader generalization about the phenomenon under study. In some forms of naturalistic inquiry, inductive reasoning involves fitting data, such as a set of observations or propositions of an existing theory. Health and human service professionals also use this form of reasoning in everyday practice.
For example, let us assume you need to determine the discharge plans for a woman with dementia. You have concerns about her ability to live alone, based on your knowledge of dementia as a progressively deteriorating condition. However, you do not know anything about the circumstances of this particular woman, her personal goals and those of her family, or her specific living arrangements. By observing her in a clinical context, as well as conducting in-depth interviewing with the patient and her family members, you discover that an adequate plan for monitoring and caring for this woman has been put into place. Thus, you make a discharge decision based on systematic information you uncovered inductively.
A similar reasoning process occurs in research. The researcher searches for general rules or patterns by linking specific observations, which represents an inductive reasoning process. There is no “truth” or general principle that is accepted a priori (“from the former”) or before the study begins. Consider the example of caregiving previously discussed. To derive an understanding of the nature and scope of caregiver burden, one type of inductive research approach could involve examining the daily life experiences of caregivers and their own perceptions of their activities. Using a variety of data collection techniques, such as observation and in-depth interviewing, the researcher might reason inductively by searching for patterns across observations of different caregivers. From this approach, the researcher would be able to develop an understanding of the specific situations that cause stress and burden, as well as the types of intervention that would be most useful in promoting caregiver health. The researcher, proceeding inductively, might seek to reveal or uncover a truth based on the perceptions of caregivers. Intervention principles would then be developed based on the researcher's interpretations of the perceptions of caregivers.
Abductive Reasoning and Actions
As we illustrate here, the two research traditions are typically characterized as using deductive and inductive reasoning processes; experimental-type research uses deductive reasoning, and naturalistic inquiry uses inductive reasoning. However, according to Flick, von Kardorff, and Steinke,13 this representation is not completely accurate. Some approaches in naturalistic inquiry are best characterized as “abductive.”14 Abduction is a term introduced by Charles Peirce15 and currently used by researchers and logicians to refer to the iterative process of naturalistic inquiry. This process involves the development of new theoretical propositions that can best account for a set of observations, which cannot be accounted for or explained by a previous proposition or theoretical framework. The new theoretical proposition becomes validated and modified as part of the research process. In this way, ethnography and some other forms of naturalistic inquiry, such as grounded theory,16 are considered to be “theory generating.” In deductive reasoning the data are controlled by the hypotheses. In inductive reasoning, an attempt is made to fit the data to a theoretical framework or to a set of identified and well-defined concepts. In abductive reasoning, the data are analyzed for their own patterns and concepts, which in some cases may relate to available theories and in other cases may not relate.
Differences in Knowledge
Each type of reasoning will result in the generation or production of a different form of knowledge. An inductive or abductive reasoning approach in research is used to “uncover” or “reveal” theory, rules, and processes. A deductive reasoning approach is used to describe, test, or predict the application of theory and rules to a specific phenomenon. Both approaches can be used to describe, explain, and predict phenomena, although only recently has inductive reasoning been valued as contributing to explanation and cause-and-effect relationships.
Let us examine the type of knowledge that is generated by each reasoning approach. The researcher working deductively will assume a theoretical truth before engaging in the research process and will apply that truth to the investigation. In the caregiver example, the researcher would assume that all caregivers will experience a form of burden and therefore may benefit from a stress-reduction intervention. The stress-reduction intervention may take the form of group psychoeducational counseling sessions and would be based on existing caregiver burden theory. Research that tested this intervention approach has found it to be only mildly effective in reducing caregiver stress and only for some caregiver study participants.17 Thus, the question remains as to why all caregivers do not benefit at the level at which researchers expect.
In a study proceeding inductively or abductively, the researcher might be looking for an intervention approach to emerge from what is learned from those who will receive the intervention. Caregiver research that uses an inductive process may therefore find that caregiver experience cannot be completely understood or explained by caregiver burden theory or addressed by stress-oriented interventions alone. New interventions would be suggested by inductively oriented inquiry, such as a broader array of services, based on the specific needs and care issues identified by the study participants.
The deductive approach could show that a stress-reduction intervention benefits some caregivers. The inductive approach could reveal that burden theory is too limited to understand comprehensively the multiple needs of this group and that other theories and types of interventions would be helpful to consider.
As you can see, each type of reasoning and research approach produces important information from which to advance services to caregivers. It is also possible to use both types of reasoning to address a research problem. For example, you can use an inductive or abductive approach to identify specific areas of caregiver needs and then use a deductive strategy to test systematically the outcome of an intervention that addresses the identified needs. This inductive-abductive-deductive approach is currently being used to develop and test community-based health and human service programs for underserved and culturally diverse populations. First, investigators use inductive strategies to uncover the health and wellness beliefs and needs of the target group. On the basis of the findings and theoretical frameworks that are refined, intervention strategies are developed, implemented, and systematically evaluated.
The integration of different forms of reasoning makes intuitive sense. In our daily lives, we naturally engage in all forms of reasoning. Likewise, health and human service professionals combine knowledge gained from both deductive and inductive reasoning to derive appropriate treatment plans.
Research as Four Basic Characteristics
The third important component of our research definition refers to the criteria we use to characterize the research activity and differentiate it from other ways of knowing about a phenomenon. We have stated that scientific knowledge may be generated by multiple research strategies using inductive or abductive or deductive reasoning. Any research strategy, whether based on inductive or abductive or deductive reasoning, must conform to the four criteria of being logical, understandable, confirmable, and useful.
Logical
In research, there is a unique way of thinking and acting that distinguishes it from other ways we use to know, understand, and make sense of our experiences. Charles Peirce,15 one of the founders of the scientific research process, identified other ways of “knowing” as the following: (1) authority—being told by a respected or trusted source; (2) hearsay—secondhand information that is not verified; (3) trial and error—knowledge gained through incremental doing, evaluating, and modifying actions to achieve a desired outcome; (4) history—knowing indirectly through collective past experiences; (5) belief—knowing without verification; (6) spiritual understanding—knowing through divine belief; and (7) intuition—explanations of human experience based on previous unique and personal organization of one's own experience.
In these other forms, knowledge is gained unsystematically, and it is not necessary to clarify the evidentiary basis or the logical thinking and action processes by which the information is obtained and asserted. Think about how an individual gains knowledge about parenting or providing care to a person who requires assistance. Informal caregivers tend to learn how to provide care through trial and error. Information as to what works and what does not work to achieve a desired goal is gained incrementally, over time, by trying different techniques and informally evaluating their outcome. Many caregivers also use intuition and hearsay or information from other caregivers, family, and friends who may make suggestions based on their own history and experience. Different from this informal set of thinking and action processes, research must be based on systematic thought processes and methodical investigative activities that include documentation, analysis, and drawing conclusions.
By “logical,” we mean that the thinking and action processes of a research study are clear, rational, and conform to accepted norms of deductive, inductive, or abductive reasoning. Logic is a set of reasoning methods that involves defined ways of thinking and methodically relates ideas to develop an understanding of phenomena and their relationships. The systematic nature of research requires that the investigator proceed logically and articulate each thought and action throughout the research process.
Understandable
It is not sufficient for a researcher to articulate a logical process. This process, the study outcomes, and its conclusions need to be explicit, make sense, be precise, be intelligible, and be credible to the reader or research consumer. If you cannot understand the research process, it cannot be used, confirmed, or replicated.
Historically, researchers using naturalistic inquiry did not typically identify the specific steps involved in their investigative process. Currently, however, a significant body of literature describes and makes explicit the thinking and action processes of different forms of naturalistic inquiry.18–20 Investigators who work out of the naturalistic tradition are advancing the standards of quality by which to judge such research. How are we to distinguish a casual observation of emergency room behavior from a scholarly interpretation of underlying patterns in that setting? Researchers have actively addressed this critical issue.9,10,19–21
Confirmable
By “confirmable,” we mean that the researcher clearly and logically identifies the strategies used in the study so that others can reasonably follow the path of analysis and arrive at similar outcomes and conclusions. The claims made by the researcher should be supported by the evidence and research strategy and should be accurate and credible within the stated boundaries of the study.
Useful
Research generates, verifies, or tests theory and knowledge for use. In other words, the knowledge derived from a study should inform and potentially improve professional practice and client outcome. Each researcher, consumer, or professional judges the utility of a study on the basis of his or her own needs and purposes. Usefulness is a subjective criterion in that it is based on the researcher's judgment about the value of the knowledge produced by a study. However, the value of a study and the usefulness of knowledge become more widely accepted as the new knowledge increasingly stimulates further research and promotes the testing or verification of new or existing theory and practice.
Setting the Stage
As a professional in a public health agency, you are focusing on smoking cessation and prevention. Given the increasing use of the Internet for disseminating health information, you decide to use this venue as a major part of your work. However, the literature reveals that there are significant disparities in access to Web-based health information due to literacy and visual access barriers. You decide to verify this theory with research and proceed to test your solutions systematically.
To inform your work, you conduct your first research project to answer the following questions:
To conduct this initial project, you systematically measure two variables for smoking on selected Web sites: literacy level and ability for a text reader to convert text to oral presentation. To measure these variables, you select instruments that match the definitions of reading level and access and provide numeric ratings of each. Your results reveal that only 1 of the 50 randomly selected Web sites that you tested could be translated from text to oral presentation by a text reader and that the average Web site was written at an 11th-grade literacy level.
Now that you have verified the accuracy of the theory, you once again return to the literature. On the basis of research demonstrating that few Web designers address visual access and literacy level, you develop an innovation that uses automated software to translate existing Web sites into 4th-grade literacy (the average reading level of the American public) and to accessible formatting. To test the efficacy of your innovation, you formulate the following research questions:
1. To what extent did users improve in their comprehension when using the translated Web sites?
2. To what extent do diverse web users feel comfortable in using, navigating, and interacting on the new Web sites?
3. What changes need to be made to improve Web use and comprehension?
To answer these questions, you design a mixed method study. You recruit individuals with diverse visual abilities (full vision to no vision) and with low literacy levels. After screening them for inclusion into the study and testing their comprehension of the original site, you then ask them to access and read or hear the information on the experimental site. To answer Question 1, you compute statistics to determine the differences in comprehension of the original and of the experimental Web site.
Questions 2 and 3 are answered in a focus group (a group interview in which a facilitator poses questions, and group members respond in an open-ended fashion).
Your finding indicates that comprehension and access improved when using the new Web site. Moreover, even many subjects who had typical vision preferred the oral version of the text. Subjects provided multiple recommendations for improving navigation and ease of use, as well as appearance preferences for the Web sites.
From this research agenda, you have learned important principles and knowledge to guide practice. First, you have verified the magnitude of literacy and visual access barriers to health information on the Web. Second, you have identified that these barriers could be remediated and selected software innovation as the method to do so. Third, you tested the intervention and found that it met your goals of comprehension and accessibility. Finally, you have Web user recommendations to further improve the Web site. You are now ready to expand this pilot to decrease disparities in Web-based health information.
Summary
Our definition of research represents our conceptual framework and guides our subsequent discussions in this book. It is based on a philosophical position that the multiple realities that shape health and human services require an approach to research that is informed by multiple research traditions and design strategies. Our approach to research is practical; that is, the purpose and question of an investigator guide the selection of appropriate methodologies, and in turn the questions asked and the knowledge gained must be useful to the clinical, professional, and consumer communities.
Research is critical to health and human service professionals to advance the knowledge base by which clinical decisions are made. Research informs knowledge development and daily practice, and professionals can participate in this activity in many ways.
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