2 Chapter 2: The Research Process

Learning Objectives:

• Understand the role of research methods in testing health-related theories.
• Recognize the importance of empirical evidence in validating scientific theories within health research.
• Identify the interdisciplinary nature of health studies and the contributions of various scientific disciplines.
• Appreciate the cyclical, non-linear, and iterative nature of the health research process.
• Gain familiarity with the ABCD study as an example of large-scale research in adolescent brain development.

Key Terms:

• Empiricism: The practice of basing knowledge on observable and measurable evidence, often through planned observations and studies.
• Empirical Research Methods: A process of making planned observations to produce new knowledge or contest existing knowledge, using tools like surveys or lab tests.
• Scientific Theories: Explanations supported by empirical evidence that undergo rigorous testing to confirm their ability to explain and predict health outcomes.
• Interdisciplinary: Involving multiple academic disciplines, each contributing unique perspectives and methodologies to the study of health.

The Purpose of Research Methods is to Test Theories

The purpose of research methods in health sciences is fundamentally to test theories. Think of theory as an explanation about how or why things work, like a detective’s hunch about the perpetrator. Methods seek to prove or disprove this explanation (theory), like the detective’s toolkit—the magnifying glass, fingerprints kit, and interrogation techniques used to figure out if the hunch is right. In health studies, researchers use different tools (methods) like surveys or lab tests to see if their explanations (theories) of health behaviors or treatments actually hold up when closely examined.

The term empiricism refers to making observations about the world around us. These empirical observations (facts) form the basis of our knowledge. Empirical research methods are a process of making planned observations, in which we carefully plan “the whys, hows, whats, whos, and whens” of our empirical studies. Through empirical studies, researchers produce new knowledge or contest existing knowledge.

In health research, scientific theories are explanations supported by empirical evidence. These scientific theories undergo rigorous testing to confirm their ability to explain and predict health outcomes. For example, a theory might suggest that a specific dietary intervention could reduce the risk of developing diabetes; empirical research would involve designing a study to test this hypothesis, often through randomized controlled trials (discussed in Chapter 3).

Theories not only inspire the research questions we pose but critically shape the methodologies we choose, directly influencing the design of our studies and the interpretative frameworks we apply to our findings. Through this iterative process of theory and empirical testing, health sciences advance, refining our understanding of health behaviors, treatments, and outcomes.

Interdisciplinary Nature of Health Studies

Research tests theory. In health research, theory is often (and increasingly) interdisciplinary, and the central disciplines are introduced here.

Biomedical Sciences

Theoretical Approaches: Biomedical sciences approach health from a biological and physiological standpoint, focusing on understanding the mechanisms of disease at the molecular, genetic, and cellular levels. Theories often involve the pathogenesis of diseases, the biological basis of health and aging, and the genetic predispositions to certain conditions.

Methodological Approaches: Biomedical sciences utilize a diverse array of research designs, from experimental lab-based studies to large-scale epidemiological surveys, ensuring a comprehensive approach to understanding health and disease. The most fundamental techniques include bioinformatics for analyzing genetic data, molecular biology methods for studying cellular processes, and pharmacological assessments to evaluate treatment efficacy.

Public Health

Theoretical Approaches: Public health integrates theories from epidemiology, behavioral sciences, and environmental health to understand how public issues (social factors external to individuals) influence health outcomes.

Methodological Approaches: Public health fields utilize quantitative methods like statistical analysis of population data, surveillance, and epidemiological studies to identify risk factors and trends. Qualitative methods, including interviews and focus groups, assess community health needs and evaluate public health interventions. Public health also encompasses policy analysis and health impact assessments.

Psychology and Behavioral Sciences

Theoretical Approaches: In the behavioral sciences, theories of cognitive, emotional, and social processes inform the design of studies that aim to identify the underpinnings of health behaviors. The fields focus on the mind and brain development, including mental health and disorders, to examine how psychological factors influence health behaviors and outcomes.

Methodological Approaches: Psychology and behavioral sciences share many methodological standards and approaches as biomedical fields. This includes a range of research designs, including randomized controlled trials for behavioral interventions, psychological assessments (e.g., surveys and questionnaires) and task-based experiments to measure mental health outcomes, and longitudinal studies to track behaviors over time.

Social Sciences

Theoretical Approaches: Social sciences typically align with public health approaches and contribute theories related to social determinants of health, health disparities and health equity, and the socio-economic and cultural factors affecting health behaviors.

Methodological Approaches: Employs both qualitative methods (e.g., ethnography, narrative analysis) to explore how social contexts and identities affect health and quantitative methods (e.g., social network analysis, statistical modeling of social data) to measure the impact of social factors on health outcomes.

Environmental Sciences

Theoretical Approaches: Environmental sciences approach health research with focus on how environmental exposures (chemical, biological, physical) impact health outcomes.

Methodological Approaches: Methodologies include environmental monitoring to measure pollutants and hazards, epidemiological studies to link exposures to health outcomes, and geographic information systems to analyze spatial data related to environmental health risks.

Data Science and Informatics

Theoretical Approaches: Health research increasingly leverages data science and informatics, employing complex models from computer science and statistics to interpret vast datasets, such as genomic sequences or epidemiological trends, thereby uncovering patterns that inform health outcomes and interventions. Theories regarding machine learning and predictive modeling are used to analyze large datasets and identify patterns that may not be evident through traditional statistical methods, as well as the use-cases for new health interventions.

Methodological Approaches: Data science methods feature machine learning and artificial intelligence infrastructure and applications, to analyze complex health data from a range of sources, such as electronic health records (EHRs), genomics, brain and body imaging, and wearables.

The Health Research Process

While health research spans disciplines, the research process is the same across fields. Figure 2 illustrates this intuition, showing the cyclical, non-linear, and iterative nature of the research process.

Figure 1: The Iterative Research Process

Theory & Hypothesis: The research cycle begins with the formulation of a research question and/or hypothesis (described in Chapter 3). The research question is grounded in empirically backed theory, meaning, theory that is backed by evidence and scientific literature. This foundational research step serves to inform the study’s design by refining the research question and guiding the choice of methodology.

Design Study: Informed by the background research and theory, the next step is to design the study (described in Chapters 3-7). This involves outlining the research methods, deciding on the variables, and planning how data will be collected, processed, and analyzed. Often, as researchers advance a study design, they realize that the research question or hypothesis needs to be modified, or vice-versa. This iteration to align research questions and research methods ensures that the study will effectively test the hypotheses and answer the research question. For this reason, Figure 2 shows the feedback loop between hypothesis generation and study design, which occur simultaneously.

Perform Study: This stage is the execution of the research plan where data is gathered through the chosen methods (the topic of Chapter 8). The integrity of the research process during this phase is vital for obtaining reliable and valid results.

Analyze Results: Once the data is collected, it moves into the analysis phase (described in Chapter 9). Here, researchers employ various techniques, from statistical analysis to qualitative content analysis, to interpret the data and identify significant patterns, relationships, and trends. This step is pivotal in making sense of the data in relation to the research question.

Results vs. Theory: Researchers then assess how the findings from the data analysis align with the existing literature and the hypotheses posited at the outset. This involves interpreting the data, situating the findings within the broader context of the field, and considering their implications. Following interpretation, results are presented to the scientific community and potentially the broader public, sharing new knowledge and insights gained from the study.

Feedback Loop: Results may spur further questions, or lead to revisions of established knowledge, which inspires new hypotheses, or alternative methods. This iterative loop allows for the refinement of theories and methods based on the latest findings, driving the progression of knowledge forward.

Table 1 provides an overview of each of these steps formalized in the research process. The remainder of this manuscript covers each step in subsequent chapters.

Table 1: Formal Steps of the Research Process
Research Question & Hypothesis (Chapter 3)	Identifying the research problem and formulating specific research questions, objectives, and hypotheses, and ensuring that they align with the proposed study design. For example, exploring the link between diet and heart disease.
Study Design (Chapter 4)	Outlining the type of study and methods, planning how the research will be conducted, and ensuring that the study design will answer the research question. For example, choosing between a cross-sectional and longitudinal study design.
Literature Review (Chapter 5)	Reviewing existing literature to contextualize the research within the current body of knowledge and justify the proposed research question and study design. For example, analyzing past clinical trials on heart disease treatments.
Sampling (Chapter 6)	Identifying appropriate quantities and qualities for the sample, a subset of the population for study. For example, random sampling from a patient registry.
Instrumentation (Chapter 7)	Selecting and validating tools and methods for measurement of variables and data collection. For example, using validated questionnaires to assess dietary intake.
Procedures (Chapter 8)	Outlining detailed processes for data collection and ethical considerations. Additionally, pre-registering studies a priori to data collection. For example, defining standard operating procedures for conducting interviews with study participants and ensuring their data protection and privacy.
Data Analysis (Chapter 9)	Applying appropriate techniques to examine the collected data. For example, using statistical software to perform regression analysis.
Reporting Results (Chapter 10)	Considering and reflecting on the research findings in relation to existing scientific literature, and communicating these findings to the scientific community and the public. For example, publishing a paper in a peer-reviewed journal.

Introduction to the Adolescent Brain Cognitive Development (ABCD) Study

The ABCD study is a hallmark study of the National institutes of Health (NIH) hallmark studies, and we will use it throughout this text for illustrative examples of the research process outlined in Table 1. The ABCD Study is the largest long-term study of brain development and child health in the United States. Funded by the NIH, it involves leading researchers from the fields of adolescent development and neuroscience. The study has enrolled 11,880 children aged 9-10 and follows their development into young adulthood, using advanced technology to investigate how various experiences like sports, video games, social media, sleep patterns, and smoking interact with a child’s changing biology to affect their health, brain development, and various other outcomes. The study aims to provide valuable insights to support the health and success of children and young people.

Summary

In this chapter, we explored the fundamental aspects of health research, emphasizing the iterative process of theory testing and the interdisciplinary approach that drives this field. We discussed how empirical research methods are essential for advancing our knowledge of health, as they allow for the systematic investigation of theoretical predictions. The contributions of disciplines such as biomedical sciences, public health, psychology, and data science were examined, showcasing their unique methodological approaches. Additionally, we familiarized with the ABCD Study, highlighting its significance as a comprehensive long-term research project on adolescent brain development. This chapter lays the groundwork for understanding how rigorous scientific methods are applied to unravel the complexities of health and human development.