Internal Validity Is Not a Trivial Pursuit

The goal of gerontological nursing research is to improve the health and well-being of older adults. Yet, a variety of critics have faulted this and other health care research for failing to influence public health policy and decision making. Research, critics say, has produced conflicting findings and esoteric reports that are not useful to public policy makers or clinicians. The conditions under which a gerontological nursing intervention is researched may be quite different than the conditions under which a policy is implemented; therefore, implementing an intervention program on a large scale may yield different outcomes than found in the original study. As one public official at a department on aging told me in frustration, “I want a phone number I can call where the researcher on the other end will give me the answers to the questions I have or will get me the answers.” In other words, there is an expectation that the research community will produce a solution or “bottom line” evidence that is useful to policy makers. This expectation is understandable given the complex health problems facing older adults that desperately need solutions. This editorial presents some thoughts on protecting the science of discovery in gerontological nursing, while being responsive to the need for generalizable interventions that can inform policy. Federal agencies charged with health care research consider the nexus of research and public policy a priority. The Agency for Healthcare Research and Quality (AHRQ) (2002), for example, states in its mission: “AHRQ develops the evidence about what works in health care practice that enables providers, patients and consumers, system managers, purchasers, and policymakers to obtain real value for their health care dollar” (para. 1). The mission statement of the National Institutes of Health (NIH) also addresses the need to apply medical and behavioral knowledge generated through science to extend healthy life and reduce the burdens of illness and disability. The goals of NIH (2009b) include public accountability and social responsibility in the conduct of science. There is also an important time element that underscores the urgency of improving the connections between research and policy: The transfer of knowledge from research to practice takes an average of 15 years to achieve a use rate of 50% (Balas & Boren, 2000).