Strategies for sustaining successful international collaborative projects: A case study Professor Debra Creedy
NUS Presentation Title 2006 Overview There is a world-wide trend towards collaborative international research teams. This paper draws on my experience of participating in an international research consortium on PTSD and Childbirth. Using the Consortium as a case study, this paper explores: the need for careful preparation in collaborative efforts, and consideration of: methodological research issues financial, operational and structural issues ownership of data and dissemination of research findings Update on recent successes and outcomes of the collaboration long-term plans
NUS Presentation Title 2006 International collaborations Academics belong to a worldwide scholarly community. Extending the boundaries of knowledge has always entailed international collaboration to varying extent. Conducting research carries with it statutory and ethical responsibilities that may be tested through international projects Such projects can enhance cross-cultural understanding, exploration of new technologies and generate scientific breakthroughs, innovations and new practices.
NUS Presentation Title 2006 What is Post-traumatic Stress Disorder? Adverse childbirth experiences related to unexpected medical intervention, severe pain, or threat of death may evoke fear and overwhelming anxiety for some women. Acute trauma symptoms may include flashbacks, nightmares, numbness, irritability, sleep disturbances, anger, being easily startled, hyper- vigilance (especially regarding the baby), avoidance of reminders of the traumatic event, panic attacks, and physiological responses such as sweating and palpitations (DSM-IV, American Psychiatric Association). Symptoms persist for 1 month and affect daily functioning
NUS Presentation Title 2006 Why focus on PTSD? World-wide studies report depression following childbirth (varies from 10 30%). Anxiety symptoms reported by >30% of women Common co-morbidity of depression and anxiety 2-9 % of women experience acute PTSD, and 30% experience three or more trauma symptoms (Ayers & Pickering, 2001; Creedy et al 2000; Gamble, 2003; Wijma, Soderquist & Wijma, 1997) Scientific inquiry Relatively few studies on PTSD following childbirth Extent to which PTSD following childbirth differs from other traumas has not been investigated. Gender differences in the experience of trauma has not been investigated Aligned with international priorities - safe childbirth, positive start to life; preventing mental illness
NUS Presentation Title 2006 PTSD and Childbirth Consortium Funded by British Psychological Society and European Scientific Research Council for 3 years. Group of 26 researchers and consumers from 9 countries (UK, Australia, USA, Netherlands, Sweden, Italy, Switzerland, Brazil, Hong Kong/Singapore) Multi-disciplinary psychology, psychiatry, nursing/midwifery, obstetrics, epidemiology. Capacity building (inclusion of PhD students) Day 2 of meetings open to other health professionals Consortium members present research findings and conducted workshops. Nominal fee.
NUS Presentation Title 2006 Elements of success 1.Funding Enabled formation of group; covered cost of meetings; defrayed cost to members. 2.Focus Clear focus and shared interest of members. Invitation to key researchers in field (1) 2 page proforma on current projects and areas of interest circulated; (2) 5 min presentation on latest unpublished work. 3. Agree on rules of engagement eg, attendance, commitment to the consortium; contribution 4.Involve all members in defining aims of research An early task was to develop goals of the Consortium and possible research projects. These were discussed at length (face-to-face, email) and progressed at subsequent meetings
NUS Presentation Title 2006 Elements of success 4.Research methods and instruments carefully selected Initial analysis of completed studies Workshop on possible instruments, further investigation, and then selection Enables comparisons between countries easier Arms of project according to expertise, funding potential, and available resources 5.Assessment tools are psychometrically appropriate in all languages Linguistic and cultural translations, back-translation need to be valid and reliable
NUS Presentation Title 2006 Elements of Success 7.Communicate regularly and consistently Set up regular meetings and conference calls, distribute notes. Agree on and enforce action points and timelines. 8.Establish a web-site for the consortium (commencing soon) 9.Pay attention to challenges Consultation and decision-making Tolerance and disagreements Communication and flow of information Rules and responsibilities Satisfaction Cost-benefits Leadership
NUS Presentation Title 2006 Current project themes A meta-analysis of existing databases 6 studies (n=7,000) Exploration of theory of trauma (think tank approach) Characteristics of trauma symptoms manifestations Measures validation of existing measures developed by members; development of new measures Design addressing limitations and developing the ideal protocol for the research question (think tank approach) Interventions Cochrane systematic review; refining existing approaches
NUS Presentation Title 2006 Research considerations 1. Consider time required to obtain ethics approval from each institution Requirements, timelines, charges are not uniform 2. Draw on expertise of all members for comparative analysis and interpretation This improves quality of analysis 3.Collect organizational variables about institutions where data will be collected. Policies, values and environment differ Are sites/practices comparable
NUS Presentation Title 2006 Research considerations 4.Be innovative Do not re-invent the wheel Extensive literature reviews are essential before starting research 5.Undertake pilot testing in all participating sites not selected few 6.Open data ownership Each institution has its own dataset, but ownership in context of collaborative effort written agreement
NUS Presentation Title 2006 Research considerations 7.Inform all members about work on data analysis and manuscripts to avoid conflict and duplication. 8. Avoid/minimize modifications to aims/ instruments when new researchers join or new research interests emerge 9. Agree on rules for dissemination of findings 10. Agree on acknowledgements for published work
NUS Presentation Title 2006 Collaboration Outputs 1. Contributed to professional development -mini-conferences -Workshops CBT, evidence-based practice, research planning, midwifery counselling 2. Contributed to capacity building -PhD students received expert critique, support -Opportunities to present their work and speak with leading researchers in the field 3. International symposium (6 papers) -XV Congress of the International Society of Psychosomatic Obstetrics & Gynecology, Kyoto Japan, 13 - 16 May 2007.
NUS Presentation Title 2006 Collaboration Outputs Successful grants Creedy D, Gamble J, Fenwick J, Barclay L Buist A, Thalib L. & Ryding E. Improving postpartum womens mental health: A RCT of a midwife-led counselling intervention. NHMRC (Grant ID 481900) 2008 2010 $649,400 Grant applications under review - Australia (ARC) - UK and Sweden Publications in preparation Seek ongoing funding for the Consortium