Prof. Jon Adams
Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
Faculty of Health
University of Technology Sydney, Australia
Ultimo NSW 2007
Phone: +61 2 9514 4821
He had a session at ICCMR 2015.
[Research Methodology] Closing the research-practitioner divide in CAM research
through practice-based research networks (PBRNs): lessons learnt through PBRNs in Australia
Q1: How did you enter CAM research field?
A1: As is always probably the case, it’s quite a long and laborious story, but cut to the chase, I’ll tell you the short version. Even before going to University, I was interested in sociological questions, about all sorts of aspects of life. One area when I went to University and undertook sociology that I got quite excited about was healthcare. Now, one of the things that sociology as a discipline is very good at, is that it’s good at looking the fringe, marginal activities, the mavericks. The people that don’t do what everybody else does. And this was way back in the late 80’s, early 90’s, 1990’s. So this is twenty odd years ago. Complementary Medicine at that time in the UK was starting to grow and thrive, but it was still much more fringe and marginal than it probably it is now across most cultures including the UK.
So I got very interested sociologically in Complementary Medicine and Traditional Medicine and Integrated Medicine and from then, my interest has grown. I’ve got a senior academic position now and a career where I’m looking not just sociologically anymore at this topic, but I’m also looking at public health, health services research and drawing on a whole range of disciplines.
Q2: Could you please introduce your center, Australian Research Centre for Complementary and Integrative Medicine, ARCCIM?
A2: So the centre that I direct is the Australian Research Centre in Complementary and Integrative Medicine. It’s in a Faculty of Health in a very respected and a good institution of University, the University of Technology Sydney. The centre is the only centre worldwide which primarily looks at public health and health service research questions around Complementary Traditional Integrative Medicine. So, we are interested in clinical research, experimental design; but equally, if not more, we are interested in contextualising those designs and approaches to look at a broad evidence-based Complementary Medicine.
Our centre is the only centre in Australia which is funded by external government grants repeatedly. We have had over 14 grants from the National Health and Medical Research Council in the Australian Research Council. We hold or have held uh, 3 of only 5 fellowships ever funded by the Australian government on the topic of Complementary Medicine. We are certainly the premier research intensive centre of Complementary Integrative Traditional Medicine in Australia. And as you have probably heard there, we are doing something which is fairly different to what a lot of other centres and groups are doing around the world.
Q3: Do you think the unique feature of your centre is focusing on public health or health services research, compared with other CAM research centres?
A3: Other groups and other individuals and centres do, quite obviously, also touch upon public health and health services research topics around Complementary Integrative Traditional Medicine. But, what we are doing, which is really I think providing leadership for this space and this type of research is we are providing a critical mass and agenda and also are much wider vision and overview of what needs to be the agenda of critical public health looking at Complementary Medicine.
So, to give you a good example, we have many challenges in terms of public health and global health around the world. One would be displaced communities, the other would be climate change and another could be immigration and refugee issues. These are all issues along with obviously all sorts of newly emerging and well established diseases, poverty, social determinants and the diversity of inequity of health care and access to health care. These are issues facing to different degrees all countries of the world. We also though of course have chronically, we have the growth of the chronic illness, life style disease, we have aging populations all around the world. What we are trying to do is to illustrate and shed a light, a rigorous research, gaze if you like, upon what might be the role, what might be the challenges and what might be the opportunities of Traditional Complementary Integrative Medicine for all these public health and global health problems that we face.
Most of public health and most of health services research across the world; is that two well established fields. They ignore Complementary Traditional and Integrative Medicine. And what we are doing is reinserting those practices and behaviors because, to be frank with you, they make up the vast majority of healthcare seeking by most populations on the planet. It seems to me to be ludicrous to be looking at critical public health and health services, but ignoring a very large substantial um, proportion of behavior in the community around the world.
Q4: Could you tell us about practice-based research networks(PBRN) you are doing?
A4: Practice-based research networks make up a major stream of our programme at ARCCIM. And they really cut to one of the very key features and aims of the ARCCIM centre, which is to ensure that the research that gets done on health care more generally but in this case on Complementary Traditional Integrative Medicine is impactful, is relevant to practice, to practitioners and patients. It has to be translational research.
What we don’t want to do and encourage people to do is to design research for other researchers to read and understand. It’s good that researchers share and understanding of their researches but of course that’s not the prime aim. It’s about changing something. It’s about understanding, so you can translate that into everyday care, so you can translate that into better patient outcomes.
And PBRN is only one design or approach to achieving such relevance and translation but it’s a very good one. To quickly explain, the PBRN is where you set up a network of practitioners or practices in a particular profession; in our case, it may be chiropractic, it could be any complementary modality. And what you do is you recruit practitioners across that network who can then become a database to help you conduct more research. You may collect very basic data on those practitioners so you know what the landscape of the practice is, but then you can start doing nested focused studies within that PBRN database.
There’s a number of features to a PBRN. It’s got to be sustainable through time and maintain, so it grows research culture both in the practice and amongst researchers. It’s got to be systematically documented and maintained. So, of course, people need to be using regular systematic and valid measures when they are doing PBRNs. The practitioners, when they collect data on themselves, on their patients, they need to be doing this in a unified way across the network. But a PBRN in a very simple term is treating daily routine care as a laboratory for undertaking coordinated research to build capacity in a profession.
Q5: What is the happiest moment in doing research for you?
A5: That’s a question, that’s a bit tough to answer and I’ll be honest with you, not because I don’t have any happy moments but because I have too many. I enjoy many aspects of doing research. One of the things that’s a privilege of doing research whether it be qualitative or quantitative or what design is that you have the privilege to collect data, in our case, in health care from human beings, from other people. You get to listen to their stories, to understand them, to reflect on their experiences and then by default on your own. And that’s very rewarding to have a profession or a career where every day you are engaging in new things.
The one thing about research, I think which is always the case, is that research of course is very much, if you have a research career, I’m a research only professor. So, all my time is research. In many ways, people may see that every day is the same, you’re just doing research. But the point is it’s not just different projects, every single part of data collection and analysis, writing a paper, planning the design, collaborating with people nationally and internationally, um, traveling the world. I mean everything about it is from my point of view and my experience, highly exciting, very rewarding. It’s challenging as well and no day is the same.
There’s always, and as we all know, research is not just fantastically perfect, it’s always problematic. There’re always things that you don’t want to happen that do happen. You have to change plans; you have to think on your feet. You have to be flexible and versatile. But I like these things. I think these things make being a researcher or at least a research professor, when you have a lot of autonomy or seniority, you have some ability to just make each day more and more exciting.
I don’t know about keeping you young. That’s probably something else for other people to think about. But it’s definitely never becomes tiring; it never becomes dull for me. And I suppose that’s the test. It’s like any job or career. If you find yourself repeatedly being bored, you probably should do something else. Because there’s so much investment and time and effort has to go into being a good researcher who produces quality output. If you are getting bored, you are not really doing justice to what it is and you won’t continue anyway. So, for me, there are problems; nothing is perfect. But there are many things that I enjoy about being, I wouldn’t do anything else to be honest with you.
Q6: Could you please share advice or comments for young researchers in this field?
A6: Good point. Just to put some context on this, the ARCCIM, last year, founded and initiated the first ever international leadership scheme in Complementary Medicine research for early career researchers to develop their careers, to have critical mass and to think about how you can mentor on an international scale, people who are just entering the field and starting to do research. Now, this was a competitive process for this leadership scheme. It was about, we appointed 12 people from a pool of over 60 people. So that leadership scheme is providing on an international scale, some of the kind of resources that early career researchers need.
It wouldn’t be advice or wisdom. I wouldn’t be so vain. But what my early career researches in Complementary Medicine, do to get ahead to be successful and take with them. This is an area which doesn’t easily blend itself to being highly successful, famous. Complementary Medicine is not necessarily highly fashionable thing that governments want to fund all the time. Some do, most don’t. It’s a very difficult area and a challenging area. It’s not an advice at all.
But the one quality I would suggest the early career researchers is that if they are going to have a career in Complementary Traditional Integrative Medicine, that they should really think about is, “How am I going to have the resilience and the stamina to keep going?,” because it will not be easy. You’ll not get a grant every year and be highly successful every year. You may become highly successful but it will take a little bit of time.
The other thing to say is, like in any field of research, surround yourself with good people. People who have already been there, done other things. Not so they can just quickly tell you what they did, but so you can learn and grow and understand what they may or may not have done. And how you could do similar things, do different things, but do things better. So, never be afraid to ask people questions and to try and learn more. Every day is about learning in research. It’s part of, in response to your earlier question, why it’s so exciting, it’s not wow, I’m still learning. Everyone is learning all the time in the research field. The moment you feel like you are not learning, you should probably go and do something else. Because, there’s no way that you’d know in a lifetime what needs to be known about research. So, Stamina, Resilience. But be passionate about what you are doing as well. Yes, you can do science and be rigorous and be calculated and be very, very objective and do other things. But, have some passion as well. This has to be something you invest some of yourself into. It’s important.