FALLING THROUGH THE CRACKS: Limitations of the Study

All research findings contain inherent limitations, particularly community-based studies conducted in real world conditions which cannot be easily controlled by the researcher(s). Some of the limitations of this study include:

Sampling adequacy: There were no private health care providers or broader-based community organizations (e.g., social services, schools) included in the study due to budgetary constraints and insufficient staff. Likewise, funding limits prevented inclusion of consumers in the survey.

Organizational complexity: Variation among local health plans, as well as the complexity of their organizational structures, presented difficulties both for the survey team (e.g., attempting to obtain responses from appropriate staff ) and for health plans (e.g., attempting to describe their operations in a survey based on a public health model).

Selective reimbursement: Community health centers and public health nursing agencies were reimbursed for their participation in the study. Health care plans and hospitals were not reimbursed; thus, the extent of their motivation and participation may have been impacted by the time and consideration they were able to give to this project.

Potential researcher bias: Possible bias is present in all studies; however, qualitative methodology is more vulnerable due to fewer built-in safeguards. Analytic procedures in qualitative methods are not as clearly defined as in quantitative methods. On the other hand, quantitative studies may pursue an inappropriate research question due to lack of sufficient descriptive data.

Local application: This study was limited to Hennepin and Ramsey county organizations; therefore, the findings from this survey are not applicable beyond those counties.

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