A step-by-step approach to the research process

On the surface, research can appear a mystifying process. Vast numbers of theories, methodologies, designs, and measures are available to researchers, yet the selection of the most appropriate for each individual circumstance can be hard to make. This selection can be confounded by a perceived inherent tension in arts in health research: between the rigour of science and the creativity of arts. Consequently, in 2013, an international working group was formed of leading artists, arts researchers, health researchers, policy-makers, and funders who wished to bring arts in health research more into the research mainstream. The aim was to draw together the needs of health research and arts research and develop a tool that could be a reference point for the field; not a tool that would suggest that arts in health was somehow different or ‘exceptional’ from other sorts of research (as discussed in Chapter 9) or force either world to compromise, but rather a tool that would enhance collaboration and importantly raise awareness about the range of factors that should be carefully considered when designing an arts in health research project.

The tool developed drew on the UK Medical Research Council’s (MRC) guidelines for developing and evaluating complex interventions; interventions that might involve several different components as well as depending on certain environments or other contextual factors to achieve their impact.(1,2) The initial tool was published in 2015 and entitled ‘Aesop: A framework for developing and researching arts in health programmes’.(3)

More information about the initial project and the framework is published open access in the journal Arts and Health.(3)

This chapter takes the original paper published on the framework as its starting point, but moves beyond this, updating some of the scales and steps in the research process, as well as providing detailed explanations about what each step involves to give a bird’s eye view of the entire research process, providing an introduction to various decisions that researchers face. Although not explicitly a research methods chapter, it is intended to provide a framework on which more specific knowledge, such as research methods, can be hung. It should be noted that this chapter focuses specifically on researching arts in health interventions. For other types of research within arts in health, such as studies profiling arts engagement in different populations, studies looking at the longitudinal impact of the arts engagement on aspects of health, and lab-based mechanistic studies interrogating how and why the arts affect us, aspects of this chapter may still be of interest, but the framework provided here is not intended to cover them.

Broadly speaking, there are four stages to a research project: the development of the initial idea for a research study, the design of the study to explore this idea, the running of the research study, and the outcome of the research study. However, this framework breaks the process down into a number of substages to make it clearer to navigate:

• ? Developing a research study
• • Identifying the research problem and evidence base
• • Developing research questions
• • Developing a theory
• • Piloting and feasibility
• • Choosing a study team
• • Involving patients and public
• ? Designing a research study
• • Quantitative strategies
• • Qualitative strategies
• • Mixed methods strategies
• • Economic evaluations
• • Process evaluations
• ? Running the research study
• • Research implementation
• ? Outcome of the research study
• • Reporting results
• • Dissemination
• • Further implementation of the intervention

At each stage of a research study, researchers will have to make decisions about their ambitions for a project. Often ambitions are dictated by funding or deadlines: small budgets might mean that a project has to focus its objectives and incorporate a simpler design requiring fewer participants, whereas large budgets and long timescales could support the running of a complex design involving large numbers of participants across multiple sites. Other times, a project simply might not be ready for a more ambitious study: the first time a research study is being undertaken on a specific intervention, it can be sensible to undertake a small pilot study with a focus on exploring potential areas of impact with minimal risk rather than a large-scale, expensive, and timeconsuming study. Also, certain research questions do not demand large-scale studies but suit smaller and simpler designs. However, understanding the spectrum of possibilities for each decision within research can help a researcher to make an informed decision about where to situate their study. Consequently, throughout this chapter, the spectrum for each decision is laid out on a scale of 1-5 moving from less comprehensive to more comprehensive. This scale is not intended to imply that levels of1 or 2 are less valuable than levels 3-5, so studies at the lower end of the scale should not be overlooked but rather appreciated for what they do contribute and how they relate to and inform other studies.