Q&A with Dr Tracey Chantler

Tracey Chantler is a Research Fellow in Health Services and Systems Research at the George Centre for Healthcare Innovation. She supports the social science research components of projects which form part of the Essential Health Care programme. With a background in nursing, her professional experience includes international health development, clinical vaccine research, applied social research and teaching masters level social science courses.

What is your job and what does it involve?

My professional title at the George Institute is Research Fellow in Health Services and Systems Research and the particular expertise I bring to this role is in qualitative research; design, methods and analysis. I work with a multi-disciplinary team of epidemiologists, clinicians, health informaticians and bio-medical engineers.

Currently most of my time is dedicated to the Seamless User-centred Proactive Provision of Risk-stratified Treatment for Heart Failure (SUPPORT-HF) research programme. In the initial stages of this programme we are developing a mobile health home monitoring system (SUPPORT HF Application), which heart failure patients can use to record their symptoms and measure their blood pressure, heart rate, weight and respiratory function. This data is sent electronically to a server where it can be remotely reviewed by cardiology specialists.

The SUPPORT HF Application also includes existing British Heart Foundation, Heart Failure Matters and Health Research Experiences Group information video clips about heart failure and managing symptoms. We are asking study participants to comment on them in terms of how they help them manage their condition. My role as an ethnographer on this project is to observe how a diverse group of 70 heart failure patients and their ‘carers’ (families, friends, care staff) interact with this technology and interview then about their experiences of using it. To date we have recruited 28 participants from Oxfordshire and we plan to add another study site in the adjacent county of Wiltshire (Swindon Town) from the autumn.

In addition to SUPPORT HF, I am involved in another programme of research called UNVEIL-CHF. This programme aims to investigate the degree and determinants of inequalities in management and outcomes of care for hospitalised heart failure patients and to estimate the value of implementation strategies in increasing the uptake of evidence-based clinical guidelines. My role is to identify methods (eg surveys, organisational studies/analyses), which can be effectively used to measure organisational features of hospitals associated with high standards of care.

How long have you been working at The George Institute and what attracted you to working here?

I joined the George Institute in January 2013 and have enjoyed my first eight months at the Oxford offices. I passed my PhD (London School of Hygiene and Tropical Medicine) in June 2012 and was looking for a post-doctoral position, which would allow me to contribute actively to research with concrete health outcomes. I have a background in international public health and was keen to work in an academic environment, with an institute, which has an international and a domestic research portfolio.

What are your research and/or professional interests?

In my PhD I critically analysed the relationship between community engagement (CE) and ethical practice in paediatric vaccine research (malaria and rotavirus). This analysis was informed by ethnographic fieldwork conducted in western Kenya from 2008-2010.

In my thesis I argue that far from being an unproblematic good CE offers a lens into new and pre-existing inequalities, which affect the implementation of research in resource-limited settings. In order to address the tensions and contradictions, which arise in CE it is essential to discuss questions of social justice and to engage materially, through a broader distribution of resources, with the community where research takes place. In a nutshell, talking is a good starting point but talking without action is unhelpful.

My professional experience and research interests include: nursing; international health development (Haiti); clinical vaccine research; applied social research in the field of immunization; teaching masters level social science modules at LSHTM (2007-2013), and University of Oxford (2005-2006); and the qualitative evaluation of innovative trial monitoring approaches with The Global Health Network.

I have started to apply some of this experience to my work with the GI. For example as part of the SUPPORT HF programme we organised a co-design workshop in April with 12 potential users of the heart failure monitoring system, and currently I am involving patient representatives in reviewing and rewriting study information and recruitment materials for a new study site.  This fits neatly with one of the GI’s goals namely ‘to develop tools to empower people to improve their own health’. This goal is core to the SUPPORT HF research programme, which seeks to use mobile technology to augment communication between heart failure patients and health professionals and increase access to health care services.

I am passionate about creating mutually beneficial learning spaces and this is one of the drivers for setting up a GI qualitative research methods forum with Stephen Jan (Health Economist, GI Australia). We still need to refine our ideas but a short-term goal is to run a two to three day course on methods for process evaluations in health services research with colleagues from the George Institute in India at the University of Hyderabad.

What inspires you in the work you do?

In short I believe in using my skills and experiences to help people live healthier lives and to increase access to professional education. To unwind at the end of the day I spend time with my two children and our Labrador puppy.

My teenage girls are keen athletes and I enjoy watching them and have started to participate in 5km and 10km runs. I find that running or any aerobic outdoors exercise helps clear my mind and overcome those passing moments of writer’s block.

A saying I live by is taken from the writings of Julian of Norwich, the renowned medieval English anchoress and Christian mystic: “All shall be well all manner of things shall be well.” One last bit of information about me is that one day I want to master the pottery wheel, and in an even more energetic moment to climb a high peak like Mount Kilimanjaro, Mount Kenya or Ben Nevis in Scotland.