Understanding Disparities in Persons with Multiple Chronic Conditions: Research Approaches and Datasets. 8.2.5 Complementary Methods


In addition to the analysis of large databases and intervention research, several other research methods
may shed light on the epidemiology of and remedies for MCC disparities.

  • Qualitative Methods such as interviews, focus groups, and observation can be enlightening when there are a small number of cases to study (as in the case of the “long tail” of the MCC distribution, described above). Qualitative methods are also useful when the research is at a formative stage, or when insights are needed to interpret quantitative findings. Finally, qualitative research can also address disparities by helping to identify best practices in personalized care and self-management, so that these practices can be extended to populations that bear a disproportionate burden of disease or poor outcomes.
  • Metasynthesis, a technique to facilitate comparisons across qualitative studies, might uncover potential disparities that could be tested with quantitative methods, or shed light on the different kinds of obstacles faced by people with specific combinations of MCC.
  • Analyzing data from rare disease surveillance systems may point to disparities that could also be tested in other datasets.
  • A positive deviance approach is recommended by Rust et al. wherein researchers look for example of health equity, or the absence of disparities, or trends in disparities reductions, and look for explanations and interventions that can be tried in other communities. (Rust et al. 2012). A promising area for a positive deviance study is research to understand why the Hispanic population has a lower burden and slower accumulation of MCC compared to non-Hispanic White and non-Hispanic Black populations.

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