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17 | Reflections on Publishing Research
The trials and tribulations of survey research.
A paper that I've been working on with a team of other folks was published in the Journal of the American College of Nutrition.
It took about 2.5 years from the start of the project to publication, and it's been a wild ride.
In today's episode, I share some of what went into the research and publication process, and a few things that I learned along the way.
I hope you enjoy these reflections on what goes into a seemingly simple - and imperfect - publication & that hearing more about this process helps you to have a deeper appreciation for the studies you use in your work.
Next week, I'll be back to more clinical topics :).
Accessing the paperSadly, it's not open-access. I talk about this a bit in the episode. I do have 50 free e-copies to give out, so please do reach out if you'd like one of them. You can check out the abstract on PubMed.
Here's the full citation:
Cherpak-Castagna, C. E., Gafton, E. N., Nault, D., Van Lare, S. J., & Freeman, K. C. (2021). Cross-Sectional Survey of Graduate Clinical Nutrition Students Describing Dietary Choices and Recommendations. Journal of the American College of Nutrition, 1–10. Advance online publication. https://doi.org/10.1080/07315724.2020.1863282
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Transcript
(00:02)
Well, hi there. Welcome to In the Clinic with Camille. My name is Camille Freeman. I am a licensed nutritionist and a registered herbalist, and I mentor other highly trained practitioners who need help building, growing and managing their practices, as well as help with complicated cases.
(00:18)
So normally in this podcast, I talk to you about things related to being a practitioner and working in the clinic.
(00:23)
And today I want to share something just a little bit different because I think it might be helpful and it might give you a new perspective in some ways.
(00:30)
So what I wanted to share is that I have recently had a paper published in the Journal of the American College of Nutrition.
(00:38)
And when I say I don't just mean me individually, but as part of a team team of wonderful collaborators, including Christine Cherpak-Castagna, Eleonora Gafton, Daryl Nault, and Sherryl Van Lare
(00:49)
So all of us have just had this paper published. The paper is called Cross-sectional Survey of Graduate Clinical Nutrition Students describing dietary choices and recommendations along title.
(01:02)
And I wanted to share a little bit with you about the process of designing this work, engaging in the research and then getting it published, because I think it will be perhaps interesting and helpful for those of you who rely on clinical research and research literature for your work.
(01:21)
And also perhaps for those of you who may be interested in doing research and publishing yourself, get a little bit of an inside scoop about what's behind this particular publication.
(01:34)
So for a long time, I've been very interested in whether going to nutrition school changes people's eating behavior is one thing to learn about nutrition and how you would apply clinically.
(01:44)
But I'm really curious about whether people change their own dietary behaviors from the beginning of the program to the end of a program. And this has been something that's been on my mind for a long time. So back in 2018, I was taking a class and part of that class was about research design. And so a team of us started to think about designing some research and we decided to try to tackle this question about whether nutrition students, clinical nutrition students' diets change as they go through a program.
(02:20)
And of course, if we really wanted to get an answer to this question, what we would need to do would be to follow people from a beginning of a program to the end. And a lot of people in that takes time.
(02:31)
Most graduate level clinical nutrition programs in the United States anyway, are somewhere between two to four plus years, depending on how many how much time it takes people to graduate and so forth.
(02:42)
So it's a really long study.
(02:43)
We need quite a number of people to get a good sense of the answer to the question and quite a hefty budget, which we did not have to back up.
(02:53)
We also have no real data informing this. There hasn't been much work. Previously on to answer this question or even answering, what do nutrition students actually eat? There are some data out there about related to disordered eating and so forth, especially at the undergraduate level, but there really isn't much existing on this topic.
(03:16)
So we said, OK, well, if that's our ultimate question, we have something we need to back up a little bit and answer some preliminary questions first, such as what are nutrition students eating, what are what do they think they might recommend and so forth.
(03:29)
So we decided to do cross-sectional survey for reasons of time efficiency and also for reasons of budget. So we cross-sectional survey just means you're taking a snapshot in this case. We are taking a snapshot of people, whether they were towards the beginning of the program, in the middle of their programs or towards the end of a clinical nutrition program to try to find out what were they currently eating, had they made any changes to their diets recently?
(03:54)
And also what did they anticipate recommending to clients?
(03:58)
So we're curious as well about whether your personal diet would inform the diet that you might recommend for clients. Again, this is not these are not questions that we could answer in our study, but we could start laying the groundwork to get answers in bigger studies.
(04:13)
So that's what we are trying to do. And y'all we started doing this in the fall of 2018. It is now late February of 2021, and our research has just now been published.
(04:27)
So from the conception of the study design to the birth of the paper, it has been quite a long time. And you see some of these studies published and they seem relatively straightforward. Ours is not a particularly complex study, but y'all it was multiple, multiple years and so many hours and so much time and love and frustration that went into this. And hopefully, when you are reading other people's research, you can also kind of tap into that sense of time and commitment and effort and everything that goes into even the most imperfect of studies.
(05:06)
I certainly have a new appreciation for research that I'm reading every time I undertake a project like this.
(05:15)
So I hope that's a takeaway point for you.
(05:18)
Some of you may be interested in this survey that we administered the survey, there wasn't a survey, a validated survey for us to work with, so we had to design one, which was quite exciting.
(05:29)
One thing that you may not know is that when you're designing a survey, you have to take into account how many people you think might answer it because it makes a difference in terms of how many questions you can ask.
(05:42)
If you only think you're going to have a small number of people answering the survey, you really need to keep the number of questions down.
(05:50)
And while we would have loved to have hundreds of thousands of graduate-level clinical nutrition students in the U.S. to answer our survey, there just aren't that many out there.
(06:00)
So we had to design our survey for we were hoping to get somewhere in the range of four or five hundred people to answer it, which we knew was a stretch goal.
(06:08)
OK, and so what happened is the number of questions that we wanted to ask to the number of questions we did ask was probably about a third. We started with a very long survey and we had to kind of whittle it down to be much more concise due to some of the issues related to analyzing the statistics and so forth.
(06:27)
So we weren't able to ask everything that we wanted to ask.
(06:31)
And all the survey we designed a survey. We ran it by multiple other faculty members at MUIH. We ran it by somebody with expertise in statistics and research design.
(06:44)
We had a expert analysis of somebody with experience and nutrition and nutrition related research.
(06:52)
We did a pilot survey for the small group of graduate-level clinical nutrition students and all of that just to get the survey, just to get the survey in shape.
(07:04)
And then we had to reach out to schools offering graduate-level clinical nutrition programs and ask them to participate. And we identified I believe it was 16 or 17 different schools who offer clinical nutrition programs at the graduate-level. I reached out to contacts at each one of these schools and asked them if they would be willing to administer a short survey.
(07:30)
The survey was anticipated to take about five minutes to their students.
(07:33)
We had an email already formulated that they could send out.
(07:38)
We were just asking them essentially to email students in these programs twice within a certain time frame.
(07:44)
And we had five schools who very graciously agreed to participate, which was amazing and wonderful.
(07:52)
And I so, so appreciate the contacts at these schools, the other faculty and administrators who worked with us to make this happen. But unfortunately, 10 or 11 of the schools just never responded. And that was it was kind of disappointing to have people not even respond to outreach from a colleague seeking to do research. It certainly, I know certainly people are busy and there's a lot going on. It's easy to miss emails.
(08:23)
We did email repeatedly and so forth. But it was kind of a bummer, especially with some of the schools where we previously had relationships with them.
(08:35)
Just didn't write this back, however, we still were able to reach five people, students at five different universities. We did have to go through an institutional review board to make sure that our project was ethical.
(08:50)
We actually had to go through that twice at two different universities.
(08:54)
This was extra ethical just to make sure that we were not.
(08:59)
We were not unduly influencing people that we were making good use of their time, and this was an important information that needed to happen and so forth.
(09:07)
So after all of that, we administered the survey. We had just over 200 people complete the survey. So not as many as we'd hoped, but still tons of data to work with.
(09:18)
Another thing that I really learned from this is how how very, very appreciated it is when people actually take the time to take the survey. We really were at the mercy of these students who I know are very busy and have so much going on and did not have to take out five or 10 minutes from their day to do this survey. And just so grateful for everyone who really who did do that.
(09:41)
I certainly after having done survey research, I'm very, very inclined. Now, any time I see anybody else's survey that they're doing for research purposes where I am in the eligible group, I always take the time to do it because I know how much work and effort goes into it and how much they're hoping that people will take it.
(10:01)
And, you know, it's a certain amount of vulnerability just to be like, please, please, to help me because I really want to get this data and we really want to know how we can, how we can answer our questions and move this field forward.
(10:14)
So just passing that on to you in case that makes a difference for you, when you see a survey, a request for you to participate in the survey, that it's just so welcome and so grateful. We're so grateful as researchers when people do help us out in that way. So that was a big learning for me. We did. We submitted our paper. So many, so many added so many drafts, such a wonderful team of people that I worked with.
(10:42)
So grateful for that as well.
(10:44)
That makes a big difference to be working with people who are compassionate and generous and understanding and thoughtful in their communication, even when it's such a frustrating process. So, so many times, so many revisions, so many little details of getting the references right and formatted properly in the getting the word count under the under the limits for the journal and so forth.
(11:06)
We did submit this only to the Journal of the American College of Nutrition, and it was accepted after one round of revisions. So we're very grateful for the review process and the feedback that we got from.
(11:19)
The seems like only one individual reviewed the paper from that person, and then the last thing I wanted to share with you is the accessibility issue.
(11:29)
We, y'all, so many, so many years, so much time, so much effort went into this paper. And we know extremely low budget situation.
(11:39)
And when we went to go and publish it, it was thousands and thousands of dollars in order for us to make this research open access that we would have had to pay, which we just don't have a budget for.
(11:52)
So, unfortunately, the paper is I don't know, I think it costs $45. $45, if you want to access this paper for 48 hours, which is very disappointing.
(12:04)
I actually have a code for 50 free copies that if people, if you are really interested in actually reading the paper and you want to see our data, especially if you're doing anything overlapping on this, please email me and be happy to get you one of the 50 copies.
(12:20)
If they haven't been taken yet, you can access me, you can find me through my website www.camillefreeman.com. If you are on my mailing list in the email that I've sent, you could just reply to it and it goes right to me.
(12:29)
But I was really bummed that it's not, after so much work and the generosity of so many people that we don't have, it's not open access.
(12:38)
And next time, I really hope to do more research to see if we can find somewhere to publish it that has a more affordable, open access option or, you know, a ways that we could get this into people's hands. We do have the option, I believe, of sharing preprint switch. And of course, we do have these 50 free copies that I'd be happy to help people out with if they need them. But I, I do have some issues, the ethical issues related to the publishing industry and so forth.
(13:08)
A question for a different time. But anyway, I just want to give you that little behind the scenes glimpse of how much work and effort and love goes into something even so seemingly simple as a basic survey.
(13:21)
And yes. So to share that with you, thanks to everyone who has provided support along the way.
(13:29)
And if you have any questions about the process or you'd like a copy, please reach out and let me know. I'll put a link to access the article on PubMed in the show notes and on my website for anybody who would like to see it.
(13:44)
All right. I hope that was helpful for you. Next time, I will be back with some more info related to clinical practice. I hope to see you then. All right. Take care, everybody.
Well, hi there. Welcome to In the Clinic with Camille. My name is Camille Freeman. I am a licensed nutritionist and a registered herbalist, and I mentor other highly trained practitioners who need help building, growing and managing their practices, as well as help with complicated cases.
(00:18)
So normally in this podcast, I talk to you about things related to being a practitioner and working in the clinic.
(00:23)
And today I want to share something just a little bit different because I think it might be helpful and it might give you a new perspective in some ways.
(00:30)
So what I wanted to share is that I have recently had a paper published in the Journal of the American College of Nutrition.
(00:38)
And when I say I don't just mean me individually, but as part of a team team of wonderful collaborators, including Christine Cherpak-Castagna, Eleonora Gafton, Daryl Nault, and Sherryl Van Lare
(00:49)
So all of us have just had this paper published. The paper is called Cross-sectional Survey of Graduate Clinical Nutrition Students describing dietary choices and recommendations along title.
(01:02)
And I wanted to share a little bit with you about the process of designing this work, engaging in the research and then getting it published, because I think it will be perhaps interesting and helpful for those of you who rely on clinical research and research literature for your work.
(01:21)
And also perhaps for those of you who may be interested in doing research and publishing yourself, get a little bit of an inside scoop about what's behind this particular publication.
(01:34)
So for a long time, I've been very interested in whether going to nutrition school changes people's eating behavior is one thing to learn about nutrition and how you would apply clinically.
(01:44)
But I'm really curious about whether people change their own dietary behaviors from the beginning of the program to the end of a program. And this has been something that's been on my mind for a long time. So back in 2018, I was taking a class and part of that class was about research design. And so a team of us started to think about designing some research and we decided to try to tackle this question about whether nutrition students, clinical nutrition students' diets change as they go through a program.
(02:20)
And of course, if we really wanted to get an answer to this question, what we would need to do would be to follow people from a beginning of a program to the end. And a lot of people in that takes time.
(02:31)
Most graduate level clinical nutrition programs in the United States anyway, are somewhere between two to four plus years, depending on how many how much time it takes people to graduate and so forth.
(02:42)
So it's a really long study.
(02:43)
We need quite a number of people to get a good sense of the answer to the question and quite a hefty budget, which we did not have to back up.
(02:53)
We also have no real data informing this. There hasn't been much work. Previously on to answer this question or even answering, what do nutrition students actually eat? There are some data out there about related to disordered eating and so forth, especially at the undergraduate level, but there really isn't much existing on this topic.
(03:16)
So we said, OK, well, if that's our ultimate question, we have something we need to back up a little bit and answer some preliminary questions first, such as what are nutrition students eating, what are what do they think they might recommend and so forth.
(03:29)
So we decided to do cross-sectional survey for reasons of time efficiency and also for reasons of budget. So we cross-sectional survey just means you're taking a snapshot in this case. We are taking a snapshot of people, whether they were towards the beginning of the program, in the middle of their programs or towards the end of a clinical nutrition program to try to find out what were they currently eating, had they made any changes to their diets recently?
(03:54)
And also what did they anticipate recommending to clients?
(03:58)
So we're curious as well about whether your personal diet would inform the diet that you might recommend for clients. Again, this is not these are not questions that we could answer in our study, but we could start laying the groundwork to get answers in bigger studies.
(04:13)
So that's what we are trying to do. And y'all we started doing this in the fall of 2018. It is now late February of 2021, and our research has just now been published.
(04:27)
So from the conception of the study design to the birth of the paper, it has been quite a long time. And you see some of these studies published and they seem relatively straightforward. Ours is not a particularly complex study, but y'all it was multiple, multiple years and so many hours and so much time and love and frustration that went into this. And hopefully, when you are reading other people's research, you can also kind of tap into that sense of time and commitment and effort and everything that goes into even the most imperfect of studies.
(05:06)
I certainly have a new appreciation for research that I'm reading every time I undertake a project like this.
(05:15)
So I hope that's a takeaway point for you.
(05:18)
Some of you may be interested in this survey that we administered the survey, there wasn't a survey, a validated survey for us to work with, so we had to design one, which was quite exciting.
(05:29)
One thing that you may not know is that when you're designing a survey, you have to take into account how many people you think might answer it because it makes a difference in terms of how many questions you can ask.
(05:42)
If you only think you're going to have a small number of people answering the survey, you really need to keep the number of questions down.
(05:50)
And while we would have loved to have hundreds of thousands of graduate-level clinical nutrition students in the U.S. to answer our survey, there just aren't that many out there.
(06:00)
So we had to design our survey for we were hoping to get somewhere in the range of four or five hundred people to answer it, which we knew was a stretch goal.
(06:08)
OK, and so what happened is the number of questions that we wanted to ask to the number of questions we did ask was probably about a third. We started with a very long survey and we had to kind of whittle it down to be much more concise due to some of the issues related to analyzing the statistics and so forth.
(06:27)
So we weren't able to ask everything that we wanted to ask.
(06:31)
And all the survey we designed a survey. We ran it by multiple other faculty members at MUIH. We ran it by somebody with expertise in statistics and research design.
(06:44)
We had a expert analysis of somebody with experience and nutrition and nutrition related research.
(06:52)
We did a pilot survey for the small group of graduate-level clinical nutrition students and all of that just to get the survey, just to get the survey in shape.
(07:04)
And then we had to reach out to schools offering graduate-level clinical nutrition programs and ask them to participate. And we identified I believe it was 16 or 17 different schools who offer clinical nutrition programs at the graduate-level. I reached out to contacts at each one of these schools and asked them if they would be willing to administer a short survey.
(07:30)
The survey was anticipated to take about five minutes to their students.
(07:33)
We had an email already formulated that they could send out.
(07:38)
We were just asking them essentially to email students in these programs twice within a certain time frame.
(07:44)
And we had five schools who very graciously agreed to participate, which was amazing and wonderful.
(07:52)
And I so, so appreciate the contacts at these schools, the other faculty and administrators who worked with us to make this happen. But unfortunately, 10 or 11 of the schools just never responded. And that was it was kind of disappointing to have people not even respond to outreach from a colleague seeking to do research. It certainly, I know certainly people are busy and there's a lot going on. It's easy to miss emails.
(08:23)
We did email repeatedly and so forth. But it was kind of a bummer, especially with some of the schools where we previously had relationships with them.
(08:35)
Just didn't write this back, however, we still were able to reach five people, students at five different universities. We did have to go through an institutional review board to make sure that our project was ethical.
(08:50)
We actually had to go through that twice at two different universities.
(08:54)
This was extra ethical just to make sure that we were not.
(08:59)
We were not unduly influencing people that we were making good use of their time, and this was an important information that needed to happen and so forth.
(09:07)
So after all of that, we administered the survey. We had just over 200 people complete the survey. So not as many as we'd hoped, but still tons of data to work with.
(09:18)
Another thing that I really learned from this is how how very, very appreciated it is when people actually take the time to take the survey. We really were at the mercy of these students who I know are very busy and have so much going on and did not have to take out five or 10 minutes from their day to do this survey. And just so grateful for everyone who really who did do that.
(09:41)
I certainly after having done survey research, I'm very, very inclined. Now, any time I see anybody else's survey that they're doing for research purposes where I am in the eligible group, I always take the time to do it because I know how much work and effort goes into it and how much they're hoping that people will take it.
(10:01)
And, you know, it's a certain amount of vulnerability just to be like, please, please, to help me because I really want to get this data and we really want to know how we can, how we can answer our questions and move this field forward.
(10:14)
So just passing that on to you in case that makes a difference for you, when you see a survey, a request for you to participate in the survey, that it's just so welcome and so grateful. We're so grateful as researchers when people do help us out in that way. So that was a big learning for me. We did. We submitted our paper. So many, so many added so many drafts, such a wonderful team of people that I worked with.
(10:42)
So grateful for that as well.
(10:44)
That makes a big difference to be working with people who are compassionate and generous and understanding and thoughtful in their communication, even when it's such a frustrating process. So, so many times, so many revisions, so many little details of getting the references right and formatted properly in the getting the word count under the under the limits for the journal and so forth.
(11:06)
We did submit this only to the Journal of the American College of Nutrition, and it was accepted after one round of revisions. So we're very grateful for the review process and the feedback that we got from.
(11:19)
The seems like only one individual reviewed the paper from that person, and then the last thing I wanted to share with you is the accessibility issue.
(11:29)
We, y'all, so many, so many years, so much time, so much effort went into this paper. And we know extremely low budget situation.
(11:39)
And when we went to go and publish it, it was thousands and thousands of dollars in order for us to make this research open access that we would have had to pay, which we just don't have a budget for.
(11:52)
So, unfortunately, the paper is I don't know, I think it costs $45. $45, if you want to access this paper for 48 hours, which is very disappointing.
(12:04)
I actually have a code for 50 free copies that if people, if you are really interested in actually reading the paper and you want to see our data, especially if you're doing anything overlapping on this, please email me and be happy to get you one of the 50 copies.
(12:20)
If they haven't been taken yet, you can access me, you can find me through my website www.camillefreeman.com. If you are on my mailing list in the email that I've sent, you could just reply to it and it goes right to me.
(12:29)
But I was really bummed that it's not, after so much work and the generosity of so many people that we don't have, it's not open access.
(12:38)
And next time, I really hope to do more research to see if we can find somewhere to publish it that has a more affordable, open access option or, you know, a ways that we could get this into people's hands. We do have the option, I believe, of sharing preprint switch. And of course, we do have these 50 free copies that I'd be happy to help people out with if they need them. But I, I do have some issues, the ethical issues related to the publishing industry and so forth.
(13:08)
A question for a different time. But anyway, I just want to give you that little behind the scenes glimpse of how much work and effort and love goes into something even so seemingly simple as a basic survey.
(13:21)
And yes. So to share that with you, thanks to everyone who has provided support along the way.
(13:29)
And if you have any questions about the process or you'd like a copy, please reach out and let me know. I'll put a link to access the article on PubMed in the show notes and on my website for anybody who would like to see it.
(13:44)
All right. I hope that was helpful for you. Next time, I will be back with some more info related to clinical practice. I hope to see you then. All right. Take care, everybody.
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