Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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1006 — Rapid Qualitative Assessment for the National Rural Health Evaluation Center: Bringing the "Voice of the Veteran" into Large-Scale, Partnered Research

Lead/Presenter: Karen Drummond, COIN - North Little Rock
All Authors: Drummond KL (VA HSR&D Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System) Abraham TH (VA HSR&D Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System) Finley EP (Veterans Evidence-Based Research, Dissemination, and Implementation Center, South Texas Veterans Health Care System) Haro E (Veterans Evidence-Based Research, Dissemination, and Implementation Center, South Texas Veterans Health Care System) Townsend JC (VA HSR&D Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System) Littman AJ (Seattle/Denver COIN & Seattle Epidemiologic Research & Information Center, VA Puget Sound) Hudson TJ (VA HSR&D Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System)

Objectives:
In a mixed-methods evaluation project in partnership with the Office of Rural Health and the Quality Enhancement Research Initiative we conducted qualitative interviews with a national sample of rural Veterans. To obtain timely answers to high-priority questions, we employed Rapid Qualitative Analysis (RQA) methods to ensure rapid feedback to operational partners. This presentation describes our specific methods and the benefits and challenges of using RQA in large-scale partnered research.

Methods:
We conducted semi-structured telephone interviews with 154 enrolled Veterans in ten counties representing higher- (N = 5) and lower-than-average (N = 5) utilization of VHA care. First, we analyzed interviews using a template format to create a summary of each interview across several broad domains including: experiences accessing healthcare; barriers to seeking or remaining in care; the social, economic, and cultural context of help seeking; and perceptions of health care and resource needs. We then compiled summaries into a matrix for each county to examine results across domains. Finally, we compared matrices across counties to identify unique and shared aspects of Veterans' access, and experiences, and needs.

Results:
We have found that RQA methods are highly functional in large evaluation projects for providing timely feedback to operational partners but present certain challenges. Advantages include its feasibility for conducting immediate and continual analyses, the template and matrix formats that allow us to summarize and compile qualitative data across multiple themes, and the ability to quickly examine our data in order to triangulate qualitative findings with quantitative results. Challenges include the need to distill a large amount of data for our partners while preserving its complexity, as well as a lack of adequate time to perform more nuanced analyses that require deeper engagement with the data.

Implications:
RQA methods allow researchers to provide feedback to operational partners in a timeline consistent with operational needs while preserving methodological rigor, yet there are significant challenges and limitations to be addressed.

Impacts:
Findings from rapid qualitative analysis, particularly when collected in a manner that complements parallel quantitative analyses, support development of realistic, Veteran-centered recommendations for improving access to healthcare for rural Veterans.