Strategies for sustaining successful international collaborative projects: A case study Professor Debra Creedy

Strategies for sustaining successful international

collaborative projects: A case study

Professor Debra Creedy

NUS Presentation Title 2006

Overview

There is a world-wide trend towards collaborative international research teams.

This paper draws on my experience of participating in an international research consortium on “PTSD and Childbirth”.

Using the Consortium as a case study, this paper explores:

the need for careful preparation in collaborative efforts, and consideration of:

– methodological research issues– financial, operational and structural issues– ownership of data and dissemination of research findings

Update on recent successes and outcomes of the collaboration

long-term plans


International collaborations

Academics belong to a worldwide scholarly community.

Extending the boundaries of knowledge has always entailed international collaboration to varying extent.

Conducting research carries with it statutory and ethical responsibilities that may be tested through international projects

Such projects can enhance cross-cultural understanding, exploration of new technologies and generate scientific breakthroughs, innovations and new practices.


What is Post-traumatic Stress Disorder?

Adverse childbirth experiences related to unexpected medical intervention, severe pain, or threat of death may evoke fear and overwhelming anxiety for some women.

Acute trauma symptoms may include flashbacks, nightmares, numbness, irritability, sleep disturbances, anger, being easily startled, hyper-vigilance (especially regarding the baby), avoidance of reminders of the traumatic event, panic attacks, and physiological responses such as sweating and palpitations (DSM-IV, American Psychiatric Association).

Symptoms persist for 1 month and affect daily functioning


Why focus on PTSD?World-wide studies report depression following childbirth (varies

from 10 – 30%).

Anxiety symptoms reported by >30% of women

Common co-morbidity of depression and anxiety2-9 % of women experience acute PTSD, and 30% experience

three or more trauma symptoms (Ayers & Pickering, 2001; Creedy et al 2000; Gamble, 2003; Wijma, Soderquist & Wijma, 1997)

Scientific inquiry

Relatively few studies on PTSD following childbirth

Extent to which PTSD following childbirth differs from other traumas has not been investigated.

Gender differences in the experience of trauma has not been investigated

Aligned with international priorities - safe childbirth, positive start to life; preventing mental illness


PTSD and Childbirth Consortium

Funded by British Psychological Society and European Scientific Research Council for 3 years.

Group of 26 researchers and consumers from 9 countries (UK, Australia, USA, Netherlands, Sweden, Italy, Switzerland, Brazil, Hong Kong/Singapore)

Multi-disciplinary – psychology, psychiatry, nursing/midwifery, obstetrics, epidemiology.

Capacity building (inclusion of PhD students)

Day 2 of meetings open to other health professionals – Consortium members present research findings and conducted workshops. Nominal fee.


Elements of success1. Funding

Enabled formation of group; covered cost of meetings; defrayed cost to members.

2. Focus

Clear focus and shared interest of members. Invitation to key researchers in field – (1) 2 page proforma on current projects and areas of interest circulated; (2) 5 min presentation on latest unpublished work.

3. Agree on rules of engagement – eg, attendance, commitment to the consortium; contribution

4. Involve all members in defining aims of research

An early task was to develop goals of the Consortium and possible research projects. These were discussed at length (face-to-face, email) and progressed at subsequent meetings


Elements of success

4. Research methods and instruments carefully selected– Initial analysis of completed studies

– Workshop on possible instruments, further investigation, and then selection

– Enables comparisons between countries easier

– Arms of project according to expertise, funding potential, and available resources

5. Assessment tools are psychometrically appropriate in all languages– Linguistic and cultural translations, back-translation need

to be valid and reliable


Elements of Success

7. Communicate regularly and consistently

Set up regular meetings and conference calls, distribute notes. Agree on and enforce action points and timelines.

8. Establish a web-site for the consortium (commencing soon)

9. Pay attention to challenges– Consultation and decision-making– Tolerance and disagreements– Communication and flow of information– Rules and responsibilities– Satisfaction– Cost-benefits– Leadership


Current project themes

A meta-analysis of existing databases – 6 studies (n=7,000)

Exploration of theory of trauma (think tank approach)

Characteristics of trauma symptoms – manifestations

Measures – validation of existing measures developed by members; development of new measures

Design – addressing limitations and developing the ideal protocol for the research question (think tank approach)

Interventions – Cochrane systematic review; refining existing approaches


Research considerations

1. Consider time required to obtain ethics approval from each institution– Requirements, timelines, charges are not

uniform

2. Draw on expertise of all members for comparative analysis and interpretation– This improves quality of analysis

3. Collect organizational variables about institutions where data will be collected.– Policies, values and environment differ– Are sites/practices comparable



4.Be innovative– Do not re-invent the wheel– Extensive literature reviews are essential

before starting research

5.Undertake pilot testing in all participating sites not selected few

6.Open data ownership– Each institution has its own dataset, but

ownership in context of collaborative effort – written agreement



7. Inform all members about work on data analysis and manuscripts to avoid conflict and duplication.

8. Avoid/minimize modifications to aims/ instruments when new researchers join or new research interests emerge

9. Agree on rules for dissemination of findings

10. Agree on acknowledgements for published work


Collaboration Outputs1. Contributed to professional development - mini-conferences- Workshops – CBT, evidence-based practice,

research planning, midwifery counselling

2. Contributed to capacity building- PhD students received expert critique, support- Opportunities to present their work and speak with

leading researchers in the field

3. International symposium (6 papers)- XV Congress of the International Society of

Psychosomatic Obstetrics & Gynecology, Kyoto Japan, 13 - 16 May 2007.


Collaboration Outputs

Successful grants

Creedy D, Gamble J, Fenwick J, Barclay L Buist A, Thalib L. & Ryding E. Improving postpartum women’s mental health: A RCT of a midwife-led counselling intervention. NHMRC (Grant ID 481900) 2008 – 2010 $649,400

Grant applications under review

- Australia (ARC)

- UK and Sweden

Publications in preparation

Seek ongoing funding for the Consortium


Good Luck!!

Documents

Strategies for sustaining successful international collaborative projects: A case study Professor Debra Creedy