This study aims to test the feasibility and effectiveness of a reporting and feedback intervention for facilitating and promoting organizational change efforts with respect to the research integrity climates of the research services at 42 participating VA facilities. As one of its core missions VA supports research intended to improve the health and well-being of veterans. Unethical research behavior that compromises the quality or validity of human subject research may directly harm research participants, and indirectly harm others subsequently affected by implementation of unreliable or invalid research results. To preserve the trust and support of veterans and the public in VA research, it is essential that the enterprise maintains the highest ethical standards. There is growing evidence of the crucial role played by organizational climates in maintaining ethical research conduct and avoiding undesirable research related behavior. We have documented high levels of undesirable research-related behaviors among academic researchers in university settings, ranging from the questionable and irresponsible, to formally defined misconduct. We have also documented associations between researchers' self-reported behaviors and organizational characteristics such as their climates, perceived equitability of resource distribution processes and outcomes, and productivity demands placed on researchers. The research integrity climates in VA facilities have never been systematically assessed, meaning research leaders may be uninformed about where their climates are strong and where they are deficient. This project directly addresses these knowledge gaps. Our goals are informed by recommendations from the 2002 Institute of Medicine report, Integrity in Scientific Research: Creating an Environment that Promotes Responsible Conduct, which promotes a performance-based approach to foster research integrity and best practices. Specific recommendations include: (1) the establishment and ongoing measurement of structures, processes, policies, and procedures, within organizations, (2) evaluation of the institutional environment supporting integrity in the conduct of research, and (3) use of this knowledge for ongoing improvement. Using our recently validated Survey of Organizational Research Climates (SORC), implemented via a web- and mail-based survey process, we will collect baseline data on the research integrity climates of the research service in 42 VA facilitie by canvassing all research-engaged staff. After randomly assigning VA facilities in equal numbers to either a basic feedback arm or an enhanced feedback arm, and using the SORC results as the basis of the intervention content, we will report back to local research leadership, both via a webinar and mailed materials, summary information regarding seven dimensions of their research integrity climates, along with aggregated comparison data for all other facilities included in the study. In the enhanced feedback arm, we will also work directly with facility research leaders to identify specific weaknesses in their research climates, and help them to identify organizational actions and initiatives they can mount to bring about positive change in their local climates. Several months following these interventions, we will assess via phone interviews with research leaders in these same facilities what organizational change initiatives have been planned or implemented. We will disseminate the results of this trial, as well as facility-de-identified summary results of the baseline climate measures through interactions with both HRS&D and ORD leaders. The impacts of accomplishing these aims will include: 1) establishing baseline measures of research climates and research related behaviors in the VA, 2) providing initial comparative feedback to VA leaders in appropriate positions to motivate positive change in settings where less than best practices may be occurring and 3) determining whether a VA-wide initiative would be beneficial, and whether enhanced or basic feedback would be sufficient to bring about positive organizational change in research integrity climates.
Research conducted in the VA generates important and valuable contributions to knowledge as well as to the health and well-being of Veterans. Thus, aiming for research excellence in the VA is not an abstract goal, but is an essential component of excellence in health care for Veterans. To preserve the trust and support of veterans and the public in VA research, it is essential that the enterprise maintains the highest ethical standards. Directly responsive to the FOA, our project will provide the first systematic measures of the integrity of research climates in the VA; provide comparative feedback about their climates to VA research leaders to motivate change initiatives in these climates if needed; identify specific sites in VA where research integrity appears to be well established; and actively disseminate identified research best practices. The information and infrastructure established by this project will lay the groundwork for leaders throughout the VA to initiate programs to remediate practices that are less than ideal.
|Martinson, Brian C; Mohr, David C; Charns, Martin P et al. (2017) Main outcomes of an RCT to pilot test reporting and feedback to foster research integrity climates in the VA. AJOB Empir Bioeth 8:211-219|