Sites were chosen on the basis of their reputation for excellence in
a minimum of two of three areas of interest: research, clinical care,
and education. Using snowball sampling, we queried North American
leaders in the field of integrative medicine, and the key stakeholders
at each of the initial sites visited, to identify potential study
sites, until no new sites were identified [13].
Interviewees were chosen on the basis of their role at the
participating center, and represented leadership from all facets of the
program (research, clinical care, education, and administration). A
minimum of two investigators attended each site visit (and in three
instances, three investigators attended). One investigator attended all
site visits (SV). At each centre, questions were asked about the
clinical, research, educational and administrative aspects of the
integrative medicine program. As well, the participants were
interviewed with regards to critical factors for success regarding the
team, its resources, structure and process. A summary of the site visit
interview guide is provided in Table 1 and a complete version can be obtained by contacting one of the authors (SV).
During the interviews, field notes were recorded
independently by the investigators to ensure reliability. Field notes
included both the content of answers to the questions in Table 1,
as well as details about the environment and interaction between
practitioners observed during the visit. Team meetings were held after
each visit to reach consensus on the information recorded and to ensure
that it was as complete as possible. Interviews were not audio-taped
because many took place as part of a "tour" of the site and background
noise made recording difficult. Content analysis techniques were used
to identify key issues that emerged from the field notes [14,15].
These were discussed at team meetings until consensus was reached. We
received permission from each site to make the content of this
manuscript public.
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