Learning About Qualitative Research.

 

As the summer progresses, I have moved onto the second phase of my internship at Supportive Living Incorporated. I am helping conduct a qualitative research project about the exercise program I was helping facilitate. This has given me an excellent chance to reflect on the on-site work I did as a fitness trainer, and put the program into a public health policy perspective.

The process of conducting qualitative research has been a fascinating, because in my studies thus far I have only taken classes about quantitative research. Quantitative research uses statistical and mathematical techniques to analyze observable facts. The central question of most quantitative research is “how can I use mathematics to give statistical significance to a quantifiable change. The gold standard of clinical quantitative research is of course the randomized controlled trial, which I had been taught to trust above all else.

In my current internship, I have begun to see the flaws in relying too heavily on one type of research. Due to a number of complex sociological factors, it is essentially impossible to randomize and control a large enough sample size of adults with brain injuries to do quantitative research on the exercise program. What our team can do, however, is conduct interviews asking participants and their families to share their thoughts and opinions on the program. Using these opinions themselves as our data, we can then look for the patterns in people’s experiences, and use these patterns to analyze the effectiveness of the program, and ultimately look for ways to improve the program.

As an intern, it is my job to transcribe and “code” the interviews. Transcription means listening to recordings of the interviews and typing them out on a word processor to create a hard copy. “Coding” is way of labeling and organizing bits of conversations from the transcripts. Similar quotes can be collected from multiple interviews, or a researcher can see how many times a particular topic was brought up in a single interview. You can also tag important pieces from an interview so a researcher can easily access the exact quote they need at a later point in time. You can see what a coded transcript looks like here.

Doing research in this way is much more productive for the purposes of Supportive Living Incorporated than a randomized controlled trial would be. A randomized controlled trial could only tell us about the size of a specific change in a strictly defined, predetermined aspect of our client’s fitness. Qualitative research allows us to work in reverse. We can gather all of our data, and then decide what questions are important to ask and look into further. Additionally, we can look to current literature being written about brain injury across the country and even internationally to see if the patterns we are seeing have been seen before, and what other clinics have done in similar situations.

My research advisor has given me the freedom to look into the research questions of my own choosing. I’ve chosen to focus on four aspects that I heard participants talk about repeatedly in the interviews that I transcribed and coded. The four aspects of brain injury I’ve been researching are:

  • Body Image/Self Perception of people with brain injuries
  • Depression and Suicide Risk for People with Brain Injuries
  • Traditional Physical Therapy for Brain Injury and its Effectiveness
  • Social Benefits of the Exercise Program

Reading through interviews and finding quotes about these topics has been a really interesting experience. The research I’m doing will be used in a forthcoming article about brain injury rehabilitation to be published in a scientific journal. I feel incredibly lucky to be involved with such a meaningful project and can’t wait to see where my research will lead me.

 

Here’s a video made about the exercise program with me in it!

Julia Doucett ’16

 

Beginning at Supportive Living Incorporated

SUPLIVING

This summer I am thrilled to be working for Supportive Living Incorporated as a fitness trainer/research intern.  This internship has two parts. To start off, I’ve been helping run a three day a week fitness program for adults with brain injuries. Later this summer, I will be working off site on a research project that will hopefully help SLI improve their wellness program as well as advocate for state funding. As the research portion of my internship is not fully underway yet, I’ll spend this blog post talking about the fitness program and my experience so far working as a personal trainer.

About Supportive Living Incorporated and the Wellness Center:

Supportive Living Incorporated (SLI) is a non-profit organization dedicated to ensuring that adults with brain injuries lead meaningful, fulfilling lives in their communities. To do this, SLI has created four residential programs that provide affordable and supportive housing for brain injury survivors. Brain injury can effect anyone at any time, and its impact is usually far reaching and life long. SLI recognizes this, and is a unique organization in the brain injury rehabilitation field because it offers comprehensive care that takes into account the many different needs of those living with brain injuries. First and foremost, SLI houses are not nursing homes.  The four residential centers operated by SLI were all developed to be the least restrictive environments possible and to focus on opportunities for independent living. As a public health student, I am fascinated by SLI’s all inclusive and life long approach to brain injury rehabilitation. SLI aims to not solve the individual challenges faced by those with brain injuries, but rather the entire puzzle. In addition to independent housing, SLI offers social programming, career services, family support, life skills training, case management support, money management, health care services, and more. SLI also conducts research in the brain injury rehabilitation field. You can read more about the history of SLI here.

My Experience so far as a Fitness Intern:

Working as a personal trainer for SLI’s wellness center has been a phenomenal experience so far. On my first day, my supervisor, Peter Noonan, sat down with me and the other fitness interns, and gave us a “crash course” he called “Brain Injury 101.” We learned the difference between traumatic vs acquired brain injuries as well as the common complications that occur after a brain injury. We then met with personal trainers from an organization called Access Sport America  who developed and run the fitness program for SLI. Finally, I met the individuals that I personally will be working with.

From 2:00-3:00 I will work with Terry, a middle aged garden enthusiast who suffered anoxic brain damage after having a heart attack about six years ago. Terry was confined to a wheelchair for about a year but is now able to walk completely on her own, though she still struggles with coordination as well as memory issues. Terry’s goals for exercising are to improve her coordination, core strength, and cardiovascular fitness so she can participate in one of her favorite activities- horseback riding.

From 3:00-4:00 I will be working with Lisa, who is quite a bit older than Terry but nevertheless full of life. She loves telling, and retelling, stories from her youth, including how she lead her high school basketball team to win the state championships and about how her two brothers “toughened her up.” Lisa usually uses a wheelchair but is adamant about using her walker for the fitness program. With Lisa I will work on walking and strength training to maintain her current level of fitness and keep her from being dependent on her chair full time.

Finally from 4:00-5:00 I work with Louise, who suffered her brain injury as an infant when she fell out of a window. Louise is also of advanced age, and is not afraid to speak her mind! I’ve found working with Louise to be particularly beneficial because she is always giving me tips and advice on how to safely and respectfully do things like help her stand up and walk. Louise suffers from seizures but other than that has very few cognitive impairments from her injury. With Louise the focus will be entirely on walking, as she does not get a chance to walk during the rest of the week, and needs to maintain the muscles and circulation in her legs.

I am loving that I can experience three totally different cases, each with different goals and needs for this program. An important thing I have learned about brain injury rehabilitation is how individual each person’s rehab journey is. Just like no two brains are the same, no two injuries are the same, and so SLI’s fitness program tries to offer one-on-one training as much as possible, so that a trainer can focus on one person’s individual needs at a time. This also creates a wonderful interpersonal relationship between the trainers and the individual they are working with. I can’t wait to bond with Terry, Lisa, and Louise at a personal level!

My Goals:

My career goal is to become a physical therapist. As a fitness trainer, I will be doing therapeutic exercises to rehabilitate people with disabilities. This work will prepare me for the work in physical intervention I hope to do as a physical therapist. I will also be making connections within the physical rehabilitation field, which will be invaluable as I begin to network relationships with physical therapists that can assist me in my prospective applications to graduate programs.

My academic goal is to apply and expand upon what I have learned as a Health, Science, Society, and Policy major.  In the fitness program, my responsibility of administering therapeutic exercises will utilize and expand upon my academic knowledge of physiology, biology, and exercise science. Working with the brain injury community will further my knowledge about the disability field, which I have studied academically. My duties as a research intern will utilize/expand upon my academic studies of epidemiology, statistics, research methods, as well as health policy.

My personal goal is to form intimate relationships with the adults in the exercise program. Interacting with this population every day, I hope to be a fitness trainer, and also a friend. As a physical therapist I want to be as supportive and understanding as possible towards people with disabilities and know how to best serve their unique needs. While teaching this population, I will also discover a great deal about disability on a personal level, something I believe you can only truly learn through hands on experience.

That’s all for now! To see what the space and fitness program looks like, check out this video:

– Julia Doucett ’16