Indicator analysis / Co-creation / Impact measurement
Interdisciplinary approach
CAIR combines quantitative research, such as surveys, comparison of pharmacological data and other aggregate health service indicators, with qualitative methods that explore stakeholder perceptions. In addition, we will conduct participatory research to involve the community in actions co-creation, whose impact will be analyzez by comparing the indicators before and after their implementation, as well as a qualitative analysis.
Timing
The project has a 5-year duration and these are its main phases:
- 2025: We will evaluate how the health system addresses the three selected health problems through a population survey, a survey of patients who collect their medicines in community pharmacies, aggregated health service indicators on drug consumption and primary care consultations. In addition, we will include qualitative methods to explore stakeholders’ health perception.
Population survey:
These surveys will be conducted in person, using a random, representative sample (2021 census) or at workplaces, as appropriate. Participants will complete the questionnaire using an electronic form specifically designed for the study, using a tablet.
Pharmacy Surveys:
Participant selection will take place at the community pharmacies collaborating in the project. A member of the research team will be responsible for fieldwork at the participating pharmacies, recruiting and surveying patients, and supporting community pharmacists throughout the study period until the required sample size is reached.
Aggregate health data indicators:
A protocol will be established to request the corresponding data focused on medication consumption, volume of consultations in primary care at the population level, and according to subgroups of interest (age, sex, etc.).
Qualitative research:
· Sociogram or role mapping: The workshop will be conducted in a participatory format, will last approximately two hours, and will be facilitated by a technical team specializing in social and participatory research. Through participatory dynamics, participants will collectively identify and analyze the relationships, influences, and levels of collaboration among key actors, using visual tools. The results will subsequently be systematized to guide subsequent phases of the study, such as the selection of participants for interviews and focus groups.
· In-depth interviews: Semi-structured interviews, with flexible guides that can be adapted based on the results of the sociogram, and the initial interviews, conducted in person and lasting between 60 and 90 minutes. These interviews will be conducted by social research professionals.
· Discussion groups: Moderated by an experienced facilitator, audio-recorded, and subsequently transcribed. Sessions will last approximately 90 minutes. Initial guidelines may be adapted based on the results of the sociogram and interviews.
All interviews and focus groups will be audio-recorded, transcribed, and subsequently anonymized following guidelines developed by the UMH Global Health Research Group.
- 2026-2028: Participatory research based on the co-creation of community initiatives to promote psychological well-being, cardiovascular health and antibiotic resistance prevention. The design, implementation and evaluation of the actions will be done iteratively over 3 years.
Co-creation process:
The co-creation phase will begin by drawing on quantitative and qualitative data from the previous phases of the project, such as surveys, sociograms, and interviews. This data will guide the initial suggestions for thematic areas or lines of work, but will also allow for adjustments based on the needs and priorities of the population participating in these information sessions.
- 2029: We will analyze the impact of community initiatives, through a before-after comparison of the survey indicators and an interrupted time series analysis of health service data. Furthermore, we will qualitatively analyse the broader contextual aspects associated with its effectiveness, such as the adoption, implementation and sustainability of the initiatives.
Ethical aspects
This research project respects the principles established in the Declaration of Helsinki, adopted at the 18th World Medical Assembly in 1964 and amended in Fortaleza at the 64th Assembly in 2013. It also respects the provisions of the Council of Europe Convention on Human Rights and Biomedicine and the UNESCO Declaration on the Human Genome and Human Rights.
CAIR has a robust process for both medical data anonymization and data protection in accordance with current European legislation. To this end, in addition to its own supervisory mechanisms, we have received a favorable opinion from the Drug Research Ethics Committee of the Elche-Vinalopó University Hospital.