Written by Abeera Shahid

Sitting in my summer internship office in Vancouver, I got an email that presented me with the opportunity of pursuing a research placement at The Australian Partnership Prevention Centre (TAPPC) as a Queen Elizabeth Scholar.

The project was a qualitative study on an electronic monitoring platform being used in prevention. Little did I know that the platform I was about to study was not so different from the ones I had been using all summer in my sales job to track potential clients. Life is funny in this way, where you end up in places that you were meant to be. One thing naturally progresses to the next, almost like a carefully crafted storyline.

During my internship in Sydney, I gained insights that I know will influence my story moving forward in unanticipated ways. Here are a few of those insights:

1. The challenges of monitoring prevention

We already have healthcare systems that care for us when we get sick, but prevention is about creating a system that keeps us healthy. How do you monitor such a system to understand how it works and demonstrate its value? To begin unpacking this question, our research team is studying the Population Health Information Monitoring System (PHIMS) developed to support and monitor the program delivery of childhood obesity prevention programs in New South Wales. Health Promotion officers in Local Health Districts are the primary users of PHIMS and responsible for the delivery of these prevention programs to early childhood services and primary schools.

While learning about PHIMS, I have had more questions about what it means to monitor prevention. I’ve wondered about the implications of measuring and how we decide what’s important to capture in a technology system. Unlike a clinical monitoring system, you can’t record simple outcomes like blood pressure. What data is collected and how it’s used has to be negotiated between practitioners and policy makers. I have realized that monitoring prevention is not a simple task, but by navigating the challenges, we have the potential to highlight how systems that keep us healthy are just as important as those who help us when we are sick.

2. The value of ethnography

Our research project’s goal of studying day-to-day use of PHIMS required a methodological approach that could capture the nuances of technology use in practice. Ethnography is an immersive way of collecting data and emerged out of the discipline of anthropology as a way of understanding cultural differences. Individuals from our research team spent time with the Health Promotion Officers, giving them a behind-the-scenes glimpse of how the system worked in action. Instead of starting with pre-determined questions or a hypothesis, an ethnographic approach involves the researcher observing the environment and trying to make sense of what is going on. The resulting data from this work were field notes, which are the researcher’s documentation of what happened and their learnings in that environment.

I was fascinated by this methodology and how it revealed information that may not be possible to capture in interviews or surveys. I read stories from the field about how PHIMS changed the way users did their work and the ways users developed their own tools to make the technology work for them. I saw the dynamic relationship between the users and technology, with each feeding back on the other. Before my internship, I had limited exposure to qualitative methods like ethnography during my health sciences degree. A few months later and I am convinced that a qualitative tool kit is something every health sciences student should learn to develop because it opens us up to exploring questions in new ways.

3. Navigating Partnership Research

Our research project is done in partnership with the policy makers behind the prevention programs, system designers of PHIMS, and the practitioners who use PHIMS in program delivery. I was fortunate to attend partnership meetings and observe the value of bringing together different stakeholders. I learned that when research is done in partnership, it requires us to find new ways to communicate. For instance, I helped put together a visual presentation that showed the breadth of our qualitative data in a way that others could engage with it.

Partnership research is fluid and there is a lot of experimenting in finding the best way to collaborate. It is rewarding to see policy makers and system designers get excited about the research project and how they can use insights to inform their work. At the same time, partner involvement allows the research team to ask questions and understand the data in new and unique ways because of the diversity of perspectives involved.

Overall, my internship with TAPPC has exposed me to a plethora of ideas around prevention, the role of technology, new methodologies, and a partnership approach to research. As I grapple with how to connect the dots, I take comfort in something Steve Job’s said, “you can’t connect the dots looking forward; you can only connect them looking backwards.”

Abeera’s experiences in Sydney included more than work.

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