Partner Up for Research-to-Practice Progress Learn how to build a research-community partnership that can benefit clinicians and researchers and help put research into practice. Make It Work
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Make It Work  |   August 01, 2018
Partner Up for Research-to-Practice Progress
Author Notes
  • Sallie W. Nowell, PhD, CCC-SLP, is a research project coordinator in the Division of Speech and Hearing Sciences at the University of North Carolina at Chapel Hill. wallace.sallie@gmail.com
    Sallie W. Nowell, PhD, CCC-SLP, is a research project coordinator in the Division of Speech and Hearing Sciences at the University of North Carolina at Chapel Hill. wallace.sallie@gmail.com×
Article Information
Research Issues, Methods & Evidence-Based Practice / Make It Work
Make It Work   |   August 01, 2018
Partner Up for Research-to-Practice Progress
The ASHA Leader, August 2018, Vol. 23, 34-35. doi:10.1044/leader.MIW.23082018.34
The ASHA Leader, August 2018, Vol. 23, 34-35. doi:10.1044/leader.MIW.23082018.34
I sat quietly in the corner, attempting to make myself invisible, as students followed “the group plan” to complete activities at underwater-themed stations around the room.
“Tell me about a time you were in the blue zone,” the leader said, referencing the Zones of Regulation poster on the wall. When one student walked over to look at my notebook, I wanted to prompt him to “follow the group plan”—but I remembered my role and remained silent. Without acknowledging me, the student wandered back to the group, and the leader quickly gave him a sticker to reinforce this behavior.
This observation was the first of many during my partnership with the Chapel Hill TEACCH Center. The TEACCH Autism Program is a University of North Carolina-based system of community regional autism centers across the state.
I was researching the efficacy of the center’s Growing Learning and Living with Autism (GoriLLA) group intervention, which targets social-communication and self-regulation skills in children with autism spectrum disorder (ASD). The GoriLLA Group uses a structured TEACCHing framework and combines aspects of two curricula for children with ASD: Social Thinking and the Zones of Regulation (see sources).
Although the literature suggests that adapting or mixing treatment approaches may have advantages, few studies have evaluated this type of intervention. Our research-community partnership aimed to do just that.

Studying interventions within clinical practice settings as part of a research-community partnership has been shown to help bridge the evidence-to-practice gap.

Why partner?
Researchers and clinicians share the goal of developing evidence-based interventions that are effective in community settings, but the evidence-to-practice gap remains wide. And the traditional research model of studying interventions in controlled lab settings may lead to approaches that are not easily duplicated or adapted in real-world settings.
An alternative—studying interventions within clinical practice settings as part of a research-community partnership—has been shown to help bridge the evidence-to-practice gap (see sources).
Our partnership grew out of my dissertation research on social-communication and self-regulation interventions in children with ASD. Meanwhile, the Chapel Hill TEACCH Center sought to establish efficacy for the GoriLLA Group intervention before disseminating the program to other TEACCH centers.
This partnership was unique. Usually, researchers want clinicians to test a new or adapted intervention. In our case, we were establishing efficacy for a clinical program already in use. Either option is possible.
But how do researchers and clinicians forge these partnerships? Here’s what you need to consider before starting your own research-community partnership.
Clinical considerations
Research time is rarely built into a clinician’s schedule. But partnering with a researcher can reduce that burden and also provide evidence-based suggestions for thinking through treatment approaches. Researchers may also be familiar with grant opportunities to support research, statistical methods to evaluate research, and the Institutional Review Board process.
The biggest challenge for clinicians is time to participate in research while also meeting clinical responsibilities. Clinicians may feel restricted by having to implement an intervention with high fidelity (that is, adhering to the curriculum in the same way with all study groups) or by seeing only clients who meet study inclusion criteria. Moreover, clinicians may have concerns about their ability to individualize the treatment or respond to unexpected events while maintaining high treatment fidelity.
We avoided these potential difficulties. Administrators allowed clinicians to devote time to the research, we conducted assessments during evenings and weekends, and we built “bonus activities” into lesson plans to give clinicians flexibility to meet individual needs. We also trained master’s students to reliably administer research assessments, reducing the clinicians’ burden and strengthening research rigor by keeping assessors blind to whether children had already participated in the group.

Usually, researchers want clinicians to test a new or adapted intervention. In our case, we were establishing efficacy for a clinical program already in use.

Research considerations
In most cases, researchers are not regularly treating clients, and clinical partners can contribute valuable insight from their intervention experiences. Furthermore, interventions studied in a community setting with clinical partners are more likely to be sustained after the research is completed, because clinicians have had the chance to use the intervention, see it work and address barriers with support from researchers.
However, researchers may have to accept methodological compromises to accommodate clinical constraints such as policies, billing systems and productivity requirements. For example, having a comparison group—one that does not receive the treatment at all or is kept on a waiting list and receives the treatment after the intervention group—is not always possible in clinical settings, especially schools.
Building a partnership
If you’re thinking about a partnership, keep these considerations in mind.
  • Find a partner who shares your values. Look at a potential partner’s previous work and ask questions to determine if there is a good fit. A longer distance or a multidisciplinary approach may be required for an ideal fit.

  • Establish clear goals. Agree on research questions and methods for answering them. When the project is finished, what products will you have?

  • Institute shared terminology and a respectful learning environment. Clinicians and researchers often use jargon specific to their knowledge area, but your team will be stronger if everyone is on the same page and feels comfortable asking questions when there are ambiguities.

  • Set up team member roles. Be clear about who is responsible for what. Communicate these roles with clients/participants so they know who to go to with questions.

  • Develop a communication plan. When/where/how often will you meet to assess progress toward project goals? Who needs to be involved in what stages? How will you communicate results?

  • Compromise. Be open to ideas from your partners and consider how everyone’s collective ideas contribute to the success of the project.

  • Include students. Students can provide valuable services—and they may be more likely to participate in research-community partnerships in the future.

Properly considered, a research-clinical partnership is beneficial for both partners and helps put research into practice.
Sources
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Kasari, C., & Smith, T. (2013). Interventions in schools for children with autism spectrum disorder: Methods and recommendations. Autism, 17(3), 254–267. [Article] [PubMed]
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August 2018
Volume 23, Issue 8