WHERE TO BEGIN: HELPING TO SHAPE THE TOPIC
Irrespective of the research experience of the investigator, conducting a literature review concerning the decisions that need to be made vis-a-vis delivery characteristics is an essential part of the research process and integral to the success of designing an effective intervention program. As discussed in Chapter 23, a succinct and current review of the literature is also critical for preparing a grant proposal for an intervention project that supports the design of the intervention. A current and thorough but succinct literature review demonstrates the relevance and uniqueness of the proposed study; introduces the theory guiding the intervention; and also informs the reviewers that the investigator is current and aware of recent theories, findings, and methodological approaches.
In general, a literature review, though sometimes tedious, serves many purposes. It provides insights into relevant theories and conceptual frameworks and also provides information on work that has been done to date, what needs to be done, and what works and what does not with regard to strategies for delivering a particular intervention. A literature review also provides valuable information on state-of-the- art methodologies for delivering interventions and roadblocks encountered by other researchers. This can help save time and effort. In other words, designing an intervention cannot be done in a vacuum; the selection of a delivery characteristic (e.g., use of face-to-face or group format) must be informed in part by prior research and hence the literature. Let’s say an intervention is designed to help cancer patients modify their daily lifestyle to address pain. A literature review will reveal that providing education alone about cancer and pain management via a brochure will not be a sufficient form of delivery if the goal is behavioral change or modifying the way a person actively monitors pain.
An additional valuable aspect of a literature review that is often overlooked is that it helps to identify other researchers working in an area who can be called upon for expert consultation to further shape ideas about the intervention design or even to serve as collaborators. Today, conducting a literature search is relatively easy with the powerful search engines available on the Internet.
It is also always important to meet with other investigators and potential collaborators to learn from their experiences as to what works and what does not visa-vis the design of an intervention’s delivery characteristics. The topics addressed in behavioral interventions and their design characteristics are complex and require a multidisciplinary team approach. Thus, obtaining input from other investigators is critical when deciding upon a particular delivery approach. For example, assume an investigator is interested in evaluating whether a cognitive training program has an impact on the cognitive abilities and brain functioning of older adults. In this case, the team might include a neuropsychologist who can provide advice on what domains of cognition should be targeted by the intervention and on measures that should be included in the study to assess change in cognitive abilities; an expert in neuroimaging; someone with expertise in cognitive aging; and a statistician. If the training involved computer-based games, the team would need to be expanded to include programmer/computer scientists. Each would bring a particular perspective and knowledge of his or her respective literature to help inform decision making as it concerns the delivery characteristics of the intervention. For example, decisions would need to be made as to the length of exposure a participant has to the computer-based game to evince a benefit; also, decisions would have to be made concerning the nature of the visuals used in the program and features that might motivate individual participation. All of these decisions need to be informed by theory, existing evidence, and direct experience that such experts can contribute. One challenge, of course, is fostering communication among team members (see Chapter 22) as they will represent different disciplines, speak a “different language,” and may have a different perspective on the problem. However, in the long run, input from others reflecting various perspectives is often essential to designing the characteristics of a behavioral intervention. These types of meetings also foster “buy-in” to the project and foster teamwork.