From the Lab to the Clinic: Collaboration Between Clinical SLPs and Health Services Research
I’m a research clinician. I fell in love with and have worked in research since my graduate training in speech-language pathology. I’ve spent the majority of my research career in rehabilitation research, face to face with hundreds of people with aphasia, administering thousands of hours of phonomotor therapy1, 2 and hundreds of hours of semantic feature analysis.3, 4
I have worked with my SLP research colleagues to determine the effectiveness of these treatments in a research setting, with real patients, real diagnoses, and real goals to improve their communication. Like you, I want to see our therapies translated to large-scale settings, but I also know this work can be difficult and slow.
A few years ago, I took a position as a qualitative researcher in health services research. My mind opened to a new world, and one of its goals is the translation of evidence-based practices to real-world settings. But one thing I noticed immediately was the need for more clinical rehab professionals in health services research!
What Is Health Services Research (HSR)?
HSR is a collaborative, multi-disciplinary, applied approach to research. It studies the role of social, financial, organizational, technological, and personal factors that “affect access to healthcare, the quality and cost of healthcare, and ultimately our health and well-being.”5
Most frequently, HSR involves mixed- or multi-methods, which use both quantitative and qualitative approaches to measuring change within a system. This approach integrates large population-level data sets with the lived experiences of people delivering or accessing care to provide an “enriched understanding of complex health research problems.”6
Where Do SLPs Fit In?
Struck by the relevance, practicality, and usefulness of HSR, I’d love to see more rehabilitation professionals conducting research in this arena—in particular, SLPs.
In the research center where I currently work, myself and another SLP work with primary care physicians, nurse practitioners, pulmonologists, cardiologists, dietitians, psychologists, epidemiologists, and administrators. While they are doing important research related to healthcare access, they do not have a focus on rehabilitation medicine or cognitive/communication impairments.
As SLPs, we offer a vital perspective on the role of language and cognition in rehabilitation, which can sometimes be overlooked in HSR. SLPs have much to offer HSR, especially since the individuals we work with do not only have communication disorders. They are accessing the healthcare system for multiple conditions, and yet their communication or mobility impairments may make accessing and paying for services all the more challenging.
Marrying HSR and Rehabilitation Research
If SLPs want to see the many amazing assessments and treatments we’ve developed move beyond the research setting to highlight the role language and cognition play in healthcare access, we need to collaborate with health services researchers.
Interested in research? Consider becoming an HSR pioneer! In commentary by a recently established rehabilitation-related HSR task force within the American Congress of Rehabilitation Medicine, the authors highlight both the relevance of HSR and rehabilitation as well as the need for collaboration between fields. In particular, they cite rehabilitation-related HSR research in physical therapy and state that “other rehabilitation disciplines are currently not as established as physical therapy.”7
That said, there are a few rehab professionals and organizations starting to bridge this gap:
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- Megan A. Morris, PhD, MPH, CCC-SLP—Megan and her colleague, Michelle L. Stransky, PhD, wrote a cover article for the ASHA Leader on how adults with communication disabilities struggle to access quality health care.
- Tracy M. Mroz, PhD, OTR/L—Tracy’s research includes a focus on health policy, home care, and rehabilitation services delivery and outcomes for older adults.
- American Congress of Rehabilitation Medicine (ACRM)—The ACRM’s mission is to improve the lives “of those with disabling conditions through interdisciplinary rehabilitation research.” Their programming includes a focus on population-level and health-services research.
Research is a dynamic and exciting field, and if you’ve ever considered taking that leap, now is an excellent time to become a part of the future of healthcare and speech-language pathology!
- Kendall, D. L., Oelke (Moldestad), M., Brookshire (Madden), C. E., & Nadeau, S. E. (2015). The influence of phonomotor treatment on word retrieval abilities in 26 Individuals with chronic aphasia: an open trial. Journal of Speech, Language, and Hearing Research, 58(3): 798–812.
- Kendall, D. L., Oelke (Moldestad), M., Allen, W., Torrence, J., & Nadeau, S. E. (2019). Phonomotor versus semantic feature analysis treatment for anomia in 58 persons with aphasia: a randomized controlled trial. Article submitted for consideration for publication.
- Gravier, M. L., Dickey, M. W., Hula, W. D., Evans, W. S., Owens, R. L., Winans-Mitrik, R. L., & Doyle, P. J. (2018). What matters in semantic feature analysis: practice-related predictors of treatment response in aphasia. American Journal of Speech-Language Pathology, 27(1S): 438–453.
- Kendall, D. L., Oelke (Moldestad), M., Allen, W., Torrence, J., & Nadeau, S. E. (2019). Phonomotor versus semantic feature analysis treatment for anomia in 58 persons with aphasia: a randomized controlled trial. Article submitted for consideration for publication.
- Lohr, K. N. & Steinwachs, D. M. (2002). Health services research: an evolving definition of the field. Health Services Research, 37(1): 15–17.
- Tariq, S. & Woodman, J. (2013). Using mixed methods in health research. JRSM Short Reports, 4(6): 2042533313479197.
- Graham, J. E., Middleton, A., Roberts, P., Mallinson, T., & Prvu-Bettger, J. (2018). Health services research in rehabilitation and disability—the time is now. Archives of Physical Medicine and Rehabilitation, 99(1): 198–203.
