Implementation research for digital technologies and tuberculosis

Implementation research for digital technologies and tuberculosis

TDR TDR

Implementation research for digital technologies and tuberculosis

A toolkit for evaluating the implementation and scale-up of digital innovations across the tuberculosis continuum of care.

Module 5

Planning and conducting IR

After conceptualizing your IR project, you need to plan how to conduct it. Regardless of how sound or innovative your proposal is, if you cannot demonstrate a coherent and effective plan for carrying out your proposed research, you are unlikely to receive funding. This module will guide you through the steps to prepare and launch your IR study

Planning for an IR study

Following the development of the IR study, the research team must create an appropriate plan for launching and commencing the study. A well-designed project plan will allow a team to effectively execute a study and ensure that it is being carried out as intended. A project plan typically encompasses the following components:

Project timeline

The project timeline breaks an IR study into its requisite tasks and identifies when they will be completed. It is most often presented graphically, such as in a GANTT chart or other graphic representation of the timeline. A GANTT chart can be produced with Excel or other proprietary project management software. The project timeline must encompass the entire duration of your study, from the planning to implementation and knowledge translation and dissemination (which will be discussed further in Module 6). Activities such as staff recruitment, processing ethics clearance and purchasing equipment must be accounted for; your timelines should not just start from the point at which the team is ready to begin the study. Figure 6 presents an illustrative GANTT chart from an IR project evaluating digital adherence technologies.

Research team composition

The proposal must outline the key members of the research team, and their roles and responsibilities. Typically, the CVs of the senior/lead research staff should also be provided as an appendix to the proposal. This section should convey enough information to convince potential funders that there is sufficient expertise on your team to conduct the proposed study effectively.

In general, research teams will include:

  • principal investigator/lead researcher
  • co-investigators/researchers; the specific profiles of the research staff will be based on the focus, objectives and research methodology of your study (e.g. public health specialist, social scientist, qualitative researcher, health economist, etc.)
  • research coordinator or project manager
  • data manager
  • data analyst
  • data collectors/research assistants.

Illustrative job descriptions have been included in the resource corner which can be adapted to facilitate recruitment or appointment of key research roles.

If the study is being led by NTP or other TB staff, additional support from people with technical skills related to the digital technology of interest may also be required for the team.

Budget

The research team must carefully think through what amount of funding is realistically needed from a potential funder to carry out the project (considering also other sources of funding and that some of the work may be done as part of routine activities). A study budget that is too low or inflated may be viewed negatively by potential funders or may undermine the ability of a research team to conduct the study. Research teams should be aware that funders may have the resources to verify how realistic a budget is. Additionally, costs related to a digital technology will depend on the maturity of the intervention – for example, costs associated with a new technology that is being piloted for scale-up will be quite different to the evaluation of a digital intervention that is already established.

It is advisable to check the requirements and restrictions of a potential funder before preparing a budget. For example, what currency must the budget be presented in? Are there suggested or required budget categories that must be used? Are there any inadmissible items such as overheads, indirect costs, travel-related expenses and/or salaries for research team members?

If the potential funding agency does not have any suggested/required budget categories, the budget should be organized around a set of meaningful categories that are relevant to the specific project (Table 12). Reflecting on the project timeline can help to identify what specific activities will need to be budgeted for.

Risk management plan

A risk management plan identifies the potential risks that may be encountered during the conduct of a research project and outlines suitable mitigation strategies and measures. Some funders require applicants to include a detailed analysis of study-related risks and mitigation strategies as part of a proposal submission. Even if not explicitly required by a potential funder, developing a risk management plan is an important part of good project management and should be completed. Examples of tools and techniques that can be used to identify possible risks include document reviews, information gathering techniques such as brainstorming, interviewing and SWOT (analysis strengths, weaknesses, opportunities, and threats).

Examples of potential risks that may be encountered include:

  • lack of resource commitment
  • unexpected budget cuts
  • loss of some research team members before completion of the tasks
  • no stakeholder inputs received after study is launched
  • equipment breakdown or issues with software
  • breaches to data security and/or privacy
  • contextual/political risks (e.g., changes to internet privacy laws)
  • lack of political and/or executive buy-in
  • limited user capacity or interest in the technology
  • poor interoperability/incompatibility with existing digital ecosystems

To develop a risk mitigation plan, an appropriate strategy to mitigate each identified potential risk should be identified. For example, loss of research staff could be mitigated by developing a contingency plan, and/or the training of other project staff. The risk mitigation template can be used to think through potential risks and design an appropriate mitigation plan.

You will also need to budget for any evaluation, knowledge translation and dissemination costs or activities. This will be discussed in Module 6.

Monitoring the implementation of an IR study

Finally, in preparing to launch an IR study, a monitoring plan must be developed to ensure that the study is being implemented as intended. Continuous monitoring throughout the study period enables a team to make course corrections as needed during the IR process. For example, monitoring during the recruitment phase will enable you to make changes to your strategy if your team are having troubles reaching the desired number or composition of participants. The overall responsibility for monitoring the IR study conduct and ensuring adherence to project timelines and budgets lies with the project managers/team leader. Most funders will require a clearly articulated plan for monitoring and assessing the implementation of activities associated with an IR study.

Developing a monitoring plan

The first step in developing a monitoring plan is to break down the IR study and identify what the key activities are and how these activities contribute to the overall study objectives. The project timeline that was developed earlier in this module will help with this.

Secondly, you will need to determine how you will measure your project activities; this includes developing indicators or milestones and identifying an appropriate source of data that can be used to demonstrate progress against the indicators. In addition, you will also need to determine the frequency of monitoring, the person who will be responsible for the monitoring, and a system for ensuring the monitoring results are regularly assessed and fed back into the project if needed so that changes and modifications can be made along the way.

Launching and conducting an IR study

Once the project plans are completed, agreed upon by all involved parties and approved by relevant management groups and ethical committees, the execution of the research project can begin. It is recommended that the entire research team (including any stakeholders, partners, and front-line workers) participate in the launching of the project. Their involvement enhances ownership and promotes accountability. During the launch, the team members can, once again, review the project goal, objectives, indicators and project plans.

Executing your research study involves both conducting and monitoring your proposed activities in line with project plans, timelines and monitoring plan described above. Regular and effective communication among the team members is crucial throughout the entire process and regular meetings should be held among the entire research team to discuss project progress, review monitoring data and address any potential issues and solutions as they emerge.

Proposal checklist: Project plan — Impact

Proposal checklist

Exercise: With your team, develop the project plan for your IR study by completing the templates included in this module. When you are done, work through this checklist to make sure this section includes all necessary information and is correctly formatted.

Component
Project plan
  • Presents a clear indication of the timeframe for the project and the times when each aspect of the project will be implemented
  • Accounts for the development, implementation, and knowledge translation stages of the study
Component
Research team composition
  • Describes the members of your team as well as the experiences and assets they bring to the study
  • The team is multi-disciplinary and diverse, and represents the scope and focus of your study
  • Includes roles and responsibilities of everyone included in the research team, including those profiles that need to be recruited
Component
Budget
  • Outlines the resources needed to effectively conduct the proposed research
  • Is realistic in the context of the research setting
  • Aligns with budget categories suggested by the funder OR is organized sensibly according to logical categories
  • Aligns the budget clearly with the proposed activities included in the project timeline
Component
Risk Management
  • Identifies potential risk to the implementation of the study and applies mitigation strategies using the Risk Mitigation template.
Component
Monitoring plan
  • Describes the activities that will be undertaken to monitor the implementation of the study
  • Describes the data sources used to support monitoring activities as well as the frequency of monitoring and identifies individuals who will be responsible for doing so
Component
Launch and execution
  • Coordinated by team leadership, and according to agreed timelines, sets out the plans for a coordinated launch involving stakeholders, partners and front-line workers; lays out communication strategies for team members aligned with the monitoring plan

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