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Diverse and innovative research approaches are needed to tackle complex health and social care challenges

COVID-19 has demonstrated the importance of novel and ambitious research designs. Programme Director of NIHR Programme Grants for Applied Research, Professor Elaine Hay, explains why bold methodologies should come to the fore as we face another pressing health issue: multiple long-term conditions.

The pandemic has had a great impact on society, on our health and social care systems, and on us as individuals. In the field of science, one of COVID’s impacts has been to highlight the need for research to be nimble, timely, equitable and inclusive.  

Traditional research methods, such as randomised trials, still have their place and have answered crucial questions about how to treat this dreadful disease. 

However, COVID-19 has reinforced the importance and relevance of other applied research methodologies. The use of qualitative enquiries, analyses of routinely collected data and modelling studies (to name but a few) have provided insights into the influence of social inequalities and ageing populations on health and wellbeing.

The role of methodological innovation in applied research

Some examples of what can be achieved with different types of methodologies can be seen in our drive to increase the diversity of study types and designs submitted to the Programme Grants for Applied Research (PGfAR). This initiative has resulted in some interesting proposals, using a range of programme structures and methodologies. 

Studying the effects of care home closures was the central theme of one University of Birmingham programme of research, which brings together national data on care home closures and interviews with staff and service users with a cost-consequence analysis element, a concept from health economics.   

Another programme uses systematic reviews, qualitative research, and quantitative analyses of administrative education data to investigate the impact of special educational needs or disability provision on children’s health.

A PGfAR award at the Christie NHS Foundation Trust is applying rapid-learning methodology to real-world data from lung cancer patients to determine a heart dose limit for radiotherapy, with linked quantitative and qualitative research on the advantages and disadvantages of this approach.

And a fourth programme uses social science and policy methods along with data analysis and feasibility trials to investigate how to improve stroke care.

Confronting the complex health and care challenges of our times

Diverse research methodologies can likewise help us tackle another of the biggest challenges within our health and social care systems, multiple long-term conditions (MLTC).

The pandemic has shone a light on the adverse effects that comorbid mental and physical conditions have on both short and long-term quality of life and survival from COVID-19, yet these effects are not limited to people with COVID. Many communicable and non-communicable conditions have a debilitating influence on the physical and mental wellbeing of individuals, particularly the most disadvantaged in society, who are often under-represented in funded research.

But in order to truly grasp the nettle on MLTC, and implement strategies to reduce their impact on individuals, families, society and our health and social care systems, we need a paradigm shift in the way health, social care and public health researchers work with each other, and with representative and inclusive communities.

To help meet this challenge I am proud to be introducing a new initiative, bringing together our desire to see further methodological innovation in applied research with the commitment to fund research into MLTC.

Our new scheme ‘Expanding diversity: call for proposals addressing NICE and NIHR MLTC priorities’ will run throughout 2022 over PGfAR competition rounds 38 (February), 39 (June) and 40 (November), and Programme Development Grants rounds 33 (March), 34 (July) and 35 (November). 

In conjunction with the Research Design Service and Clinical Research Network, a webinar will be held on 9 December, where potential applicants can learn more about the call.

Just as new approaches to health research have helped countless patients with COVID-19, our initiative for new and varied research methods and partnerships for PGfAR could deliver the similar benefits for people with MLTC.

Professor Elaine Hay, Programme Director, NIHR Programme Grants for Applied Research


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The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.