Almost two years; 2,000 supervisors, health investigators, data processing personnel and managers; 200,000 subjects; 200,000 anemia tests; more than 100,000 HIV tests; three national reports; 29 state reports; and 500 published reports. That's what went into a survey of family health in India.
And the primary company behind this research, which is sponsored by U.S. agencies and conducted in numerous developing countries throughout the world, is Macro International of Calverton.
Its work has helped the privately held survey research firm seize about $300 million in federal contracts this year, representing its largest proposal season in its 42 years, even amid the economic slump. Most of the contracts, ranging from $2 million general management projects to the $142.5 million contract with the U.S. Agency for International Development, are spread over five years.
Macro is one of many Maryland companies that focus on social research, data from which can be used to effect public behavioral changes, including those involving health.
"It's about the selection of people in the company. It's a personality thing. The people at Macro are interested in social issues," said Greg N. Mahnke, president and CEO of Macro. "We're looking for a cross between Indiana Jones and Einstein."
Primarily a government contractor, Macro has more than 1,200 employees, with 400 in Calverton and the rest at eight other locations throughout the country. Performing survey, research and marketing work for clients in 150 countries, the company has annual revenues of about $150 million, according to its Web site.
Macro's bigger projects include school-based surveys on risks facing high school students for the Substance Abuse and Mental Health Services Administration and work for USAID, which has yielded more than 200 surveys in more than 75 countries, focusing on HIV/AIDS and other health issues.
Macro also recently won a $10 million contract for a project designed to strengthen multi-sector, national HIV/AIDS monitoring and evaluation in Kenya. The company focuses on building capacities within research areas for locals to perform their own research and develop health care initiatives, rather than sending its own workers.
"We want to create a range of service offerings from identifying the problems and creating the programs to address them to fact-gathering to evaluating the outcomes. It's the classic quality improvement schedule," Mahnke said.
Good intentions,
limited funding'
Social and Scientific Systems in Silver Spring shares this same tack in advancing public health missions. Its work includes a $400 million multiyear contract to coordinate and support the AIDS Clinical Trials Group, the largest project of its kind in the world, according to spokeswoman Mona Feldman.
Social and Scientific Systems, established 31 years ago, works with more than 90 countries and has more than 500 employees. It provides support for the National Institutes of Health and other health-related federal and state agencies, as well as USAID.
Background work for the site trials is conducted through contracts ranging from several thousand to millions of dollars. One of these included the study of 50,000 sisters of breast cancer patients to determine what environmental factors play a role in the disease.
Other companies such as Synthesis in Rockville host most of their research inside the U.S.
Synthesis specializes in fusing its research, primarily with the Department of Health and Human Services, with online management to provide rapid feedback, which clients use to apply for additional grants, said president Ruth Anne Gigliotti.
"Many programs have good intentions, but limited funding. We want our clients to be able to show that their program is working," she said.
Gigliotti emphasized that research isn't just waiting for a certain point to analyze data but should instead be viewed as a continuous real-time effort.
Synthesis' biggest project is a three-year $3.5 million contract to develop performance management tools to review a federal program that offers services to runaway and homeless youths. The 10-year-old company employs 20 people and has annual revenues of about $5 million.
Social Dynamics in Potomac also seeks to improve programs and organizations through empirical data collection and analysis. The company's major focus is on education and social service evaluation studies within the U.S.
Sharon Livingston, immediate past president of the Qualitative Research Consultants Association in St. Paul, Minn., said real-time data presentation is among the trends in the research field, including more investment in research via cell phones and texting, more psychological follow-up research and more general use of the Internet.
Macro also wants to stay on top of new technology, including taking the lead on cell phone research, said Kristin Jones, corporate communications director.
Cell phone research presents several problems, because it requires subjects to use their time to answer questions. But the number of people choosing cellular instead of land lines is starting to make samples of only cord-users unrepresentative, Jones said. Macro has been working to offer surveyors chances to buy one survey question at a time and then host the cell phone research itself.
Livingston also expects work in the study of HIV, hepatitis C and addictions behavior to be the fastest-growing areas within health research particularly.
Mahnke said Macro's future interests lie in energy and environment research, especially regarding water use, but he hopes the federal government will also direct more money toward health care for soldiers and their families.