Building a Strong Foundation: Overcoming Obstacles in Applied Health Systems Research Through a Collaborative Approach From Funders

Within applied health research, collaboration between researchers and health service policy-makers is essential for effective, relevant, usable research. ¹ However, the role and engagement of research funding bodies must also be considered in being adaptable when ‘real world’ research circumstances change. Funding bodies typically have limited engagement with research teams. Researchers may provide reports throughout the project, with the funding organisation rarely becoming involved until project completion. Often, this limited engagement is preferred, with concerns about funding body interferences and the impact this may have on research transparency ² ; for example, censorship of results and pressure to alter wording.^2,3 However, our experience is that it is possible to maintain research integrity and achieve positive research experiences and outcomes while having targeted, close engagement with funding bodies, at least from a ‘real world’ research perspective.

In a recent multi-year mixed methods study we encountered challenges in administrating our project. We found strong collaboration and an outcome focused approach between the funding body and researchers, including regular communication, information sharing and flexibility, enabled the continuation of the project to draw meaningful conclusions. Here we outline some of the approaches used and associated positive outcomes achieved. It is hoped to encourage readers to think about changing environments, especially in ‘real world’ or translational research space, where it might be possible to work closely with funding bodies while retaining integrity of the research.

Regular Communication and Information Sharing

From the project outset, the funding body indicated interest in being part of the formal governance of the project. To establish the ‘ground rules’ for engagement between research parties, a formal Reference Group was established. The group was underpinned by a terms of reference with member roles and responsibilities, and regular scheduled communication to clearly set the expectations and boundaries for working together. The primary purpose of the group was to provide advice, input, and shared learning and problem-solving to the project. The Reference Group provided the mechanism to discuss project progress, what was working well and opportunities for further support and advice to the research process. Communication with the research body was more involved than keeping the funders updated with project progress with one-way communication from the project to the funders, it also involved the research body sharing the results of previously funded projects and openly discussing some of the challenges and learning that were relevant to the project. This included discussions about challenges they had previously observed in obtaining relevant research ethics approvals, which resulted in significant delays to project timelines in the past.

Flexibility in Adapting to Setbacks

The positive working relationship between organisations also enabled effective collaboration when challenges arose. During regular project meetings, organisations felt comfortable to communicate openly and early about potential project risks. Frank discussion was encouraged and was met with supportive responses from funders, who understood the complex nature of ‘real world’ health systems research and willingness to engage in problem solving without the threat of funding being impacted or withdrawn. When the project encountered a critical setback due to unavoidable ‘real world’ circumstances, organisations were able to collaborate to develop and implement effective solutions to continue with the project; with project deliverables moved and parts of the project re-focused. Without this flexibility and understanding the continuation of the project would not have been possible.

Supportive Engagement From a Research Funding Organisation

Given the challenges of conducting ‘real world’ research on health systems and services, a flexible, collaborative approach from organisations can be beneficial. Critically, this engagement must also be supportive of research ethics and integrity, with conditions established to ensure independence of the research and appropriate reporting of results. ⁴ While our project is ongoing, the current progress made would have been limited without the support of the funding body. We experienced no interfere with the project details, methodology or findings; instead the funder took on a supportive role focused on advice and problem-solving to get a good and useable research outcome. This unique approach has allowed a real-life example of action research.