Framework Analysis in Prevention: Developing Communication Between Researchers and Chronic Pain Patients

Introduction:A modified version of framework analysis, “best fit” analysis, as described by Carroll et al. (2011), has been successfully used in disciplines such as public health.

This study examined the utility of the framework analysis in an intervention development program, with participants who were at high risk for opioid abuse and had a non-cancer chronic pain.

Methods: The study utilized both quantitative and qualitative methods. Participants completed quantitative measures at Pre, Mid and Post intervention. At the end of intervention, a semi-structured focus group was conducted. The focus group consisted of open ended questions regarding the intervention, i.e. likes, dislikes, and improvements to facilitate discussion and feedback from participants. The intervention adapted Mindfulness and Multi-Family Group (MFG) components for chronic pain and were determined to have overlapping foci or themes. In an effort to avoid double coding variables, the themes from these processes were broken down into categories and combined, leading to a more concise set of themes. The group coded the transcripts independently then compiled their work. If agreement on coding was not met, the group evaluated the code, the categories, or the theme until consensus was met. After the deductive coding was completed, inductive themes were investigated. Next, as a group the codes were collated, again if agreement was not unanimous the theme, category or code were evaluated until consensus was reached.

Results: The analysis provided a fuller understanding of the participants’ experiences and thoughts on the intervention. The combined themes included; group experiences, skill building, chronic pain management, commitment to the interventions, and thoughts on the treatment. From the inductive piece it was found that all patients had a strong feeling of stigmatization associated with taking prescription opioid pain medication.

Conclusion: One of the Society of Prevention Science’s major objectives is to increase communication between the researchers and the population being studied, framework analysis is a valuable tool to help reach this goal. Adding a qualitative research component to prevention efforts and usability testing will add depth and participant insight that otherwise could be lost. This project provided support for this general postulate and the findings from this investigation will help frame future prevention strategies. The information learned from the qualitative will inform or improve future studies. This novel analysis could be used as a template for future prevention developments to foster communication between researchers and participants.

Citation: Carroll C, Booth A, Cooper K: A worked example of “best fit” framework synthesis: a systematic review of views concerning the taking of some potential chemopreventive agents. BMC Med res Methodol 2011, 11: 29.