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      The research crisis in American institutions of complementary and integrative health: one proposed solution for chiropractic profession

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          Abstract

          A crisis confronts the Complementary and Integrative Health (CIH) teaching institutions in the US. Research infrastructure is needed to build and sustain productive research programs and retain their own research faculty. In most health professions, this infrastructure is largely built through research grants. In CIH, most educational institutions are funded through student tuition, which has historically also had to be the source for building their research programs. Only a limited number of these institutions have emerged as National Institute of Health (NIH) grant-funded programs. As a result, the American chiropractic institutions have seen a retrenchment in the number of active research programs. In addition, although research training programs e.g., NIH’s K awards are available for CIH researchers, these programs generally result in these researchers leaving their institutions and depriving future CIH practitioners of the benefit of being trained in a culture of research.

          One proposed solution is to leverage the substantial research infrastructure and long history of collaboration available at the RAND Corporation ( https://www.rand.org) This article presents the proposed five components of the RAND Center for Collaborative CIH Research and the steps required to bring it to being: 1) the CIH Research Network – an online resource and collaborative site for CIH researchers; 2) the CIH Research Advisory Board – the governing body for the Center selected by its members; 3) the RAND CIH Interest Group – a group of RAND researchers with an interest in and who could provide support to CIH research; 4) CIH Researcher Training – access to existing RAND research training as well as the potential for the Center to provide a research training home for those with training grants; and 5) CIH RAND Partnership for Research – a mentorship program to support successful CIH research. By necessity the first step in the Center’s creation would be a meeting between the heads of interested CIH institutions to work out the details and to obtain buy-in.

          The future success of CIH-directed research on CIH will require a pooling of talent and resources across institutions; something that the American chiropractic institutions have not yet been able to achieve. This article discusses one possible solution.

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          A theoretical, practical, predictive model of faculty and department research productivity.

          Although numerous characteristics impact faculty research productivity, and although researchers have suggested comprehensive theoretical models to explain the relationship between these characteristics and levels of faculty research productivity, few studies have assessed these models. This study tests the ability of the Bland et al. (2002) model-based on individual, institutional, and leadership variables influencing faculty research productivity-to explain individual and group (department) research productivity within the context of a large medical school. This study used data from a University of Minnesota Medical School-Twin Cities vitality survey conducted in 2000 that had a response rate of 76% (n = 465 faculty). A statistical software package was used to conduct t tests, logistic regressions, and multiple regressions on these data. The validity of faculty, department, and leadership characteristics identified in the Bland et al. (2002) model were confirmed as necessary for high levels of research productivity. Faculty productivity was influenced more by individual and institutional characteristics; group productivity was more affected by institutional and leadership characteristics. The characteristics and groupings (individual, institutional, and leadership) in the Bland et al. (2002) model predict faculty research productivity. Research productivity is influenced by the interaction of the three broad groupings, and it is the dynamic interplay of individual and institutional characteristics, supplemented with effective leadership, that determines the productivity of individuals and departments.
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            Characteristics of a productive research environment: literature review.

            What environmental factors stimulate and maintain research productivity? To answer this question, the authors conducted an extensive review of articles and books on research productivity published from the mid-1960s through 1990. This review revealed that a consistent set of 12 characteristics was found in research-conducive environments: (1) clear goals that serve a coordinating function, (2) research emphasis, (3) distinctive culture, (4) positive group climate, (5) assertive participative governance, (6) decentralized organization, (7) frequent communication, (8) accessible resources, particularly human, (9) sufficient size, age, and diversity of the research group, (10) appropriate rewards, (11) concentration on recruitment and selection, and (12) leadership with research expertise and skill in both initiating appropriate organizational structure and using participatory management practices. Some of these characteristics are not surprising, although some findings were unexpected, such as that participative governance correlated consistently with research productivity. The differential impact of each of these 12 characteristics is unclear. It is clear, however, that the leader has a disproportionate impact through his or her influence on all of the other characteristics. Yet, an overarching feature of these characteristics is their interdependency. These factors do not operate in research groups as isolated characteristics. Rather, they are like fine threads of a whole fabric: individual, yet when interwoven, providing a strong, supportive, and stimulating backdrop for the researcher. The authors conclude that while at a distance the productive research enterprise looks like a highly robust entity, upon closer inspection it is revealed to be a delicate structure highly dependent on the existence and effective working of numerous individual, organizational, and leadership characteristics.
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              Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis.

              The purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope.
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                Author and article information

                Contributors
                coulter@rand.org
                310-393-0411 , pherman@rand.org
                Journal
                Chiropr Man Therap
                Chiropr Man Therap
                Chiropractic & Manual Therapies
                BioMed Central (London )
                2045-709X
                17 June 2019
                17 June 2019
                2019
                : 27
                : 32
                Affiliations
                [1 ]ISNI 0000 0004 0370 7685, GRID grid.34474.30, RAND Corporation, ; 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
                [2 ]ISNI 0000 0000 9632 6718, GRID grid.19006.3e, UCLA, ; Los Angeles, CA USA
                [3 ]ISNI 0000 0004 0527 5732, GRID grid.263841.a, Southern California University of Health Sciences, ; Whittier, CA USA
                Article
                251
                10.1186/s12998-019-0251-1
                6572733
                31236209
                bff2b811-104b-49ef-8d8e-77a8f6572347
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 December 2018
                : 24 April 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004459, RAND Corporation;
                Award ID: None
                Categories
                Commentary
                Custom metadata
                © The Author(s) 2019

                Complementary & Alternative medicine
                chiropractic research,complementary and integrative health research,research infrastructure,rand corporation

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