Table 1

Illustration for choosing among six research approaches practical for family medicine research

1. Name(s): Michael Fetters
2. Research topic: HPV vaccination
3. Clinicalstory: In our clinic serving Japanese and Asian patients in the USA, many parents refuse HPV vaccination for their children.
4. Six practical approachesProblemInformation neededType of interventionImplementation strategyEvaluate and plan the next steps
SurveyImmunisations of girls aged 11–12 years old or less on team 3.What is literature on parent/child attitudes about HPV vaccination?Develop or adapt existing survey for self-administration?Distribute throughout the clinic system.Examine practices in best and worst centres.
Qualitative interviewsFewer Japanese families accepting HPV vaccine?What is literature on HPV vaccination in Japan? Cultural issues and HPV?Interview mother, daughters, physicians.Conduct interviews in the practice.Adapt materials, adjust consent, community article.
Quality improvementAdministration seeks 80% vaccine uptake in those aged 11–12 years old.What is my clinic's HPV
vaccination rates? What is literature on QI and HPV?
Organise clinic focus on HPV vaccine, posters, prompts and so on.Implement PDSA process (Plan, Do See, Act).Reassess in 3 months, cyclically, make further changes.
Curriculum developmentGP residents need training on how to discuss vaccines.What is the current curriculum? Deficits?
Problems? Examples?
Teach knowledge and skills in giving, and communication skills.Assess baseline, intervene, assess if improved.Change components of curriculum not effective/popular.
Clinical policy analysisShould boys 11–12 receive HPV vaccination?Policy of government, other countries, WHO speciality organisation.Critique policy.Examine assumptions, make persuasive argument.Disseminate to government, specialty organisations.
Case studyResponding to Japanese parents’ culturally driven HPV vaccine concerns.Literature on cultural adaptations to make programme acceptable.Review clinic rates, interview staff, parents, current media.Develop culturally adapted programme and assess effectiveness.Assess rates after intervention, disseminate results.
5. Research title: Improving (HPV vaccination of eligible adolescents) in (a family medicine clinic serving overseas Japanese patients): a (quality improvement) study.
6. Nextsteps: (1) identify current HPV vaccination rates; (2) discuss with staff members a strategy to improve; (3) search the literature for other similar experiences.
  • GP, general practice; HPV, human papillomavirus; QI, quality improvement; WHO, World Health Organization.