1
|
Lalji R, Muñoz Laguna J, Kauth J, Hofstetter L, Kurmann A, Adams J, Kongsted A, von Wyl V, Puhan MA, Hincapié CA. What Gets Measured Gets Managed: A Scoping Review of Musculoskeletal Research Conducted Within Practice-Based Research Networks. Am J Phys Med Rehabil 2024; 103:e113-e121. [PMID: 38682899 DOI: 10.1097/phm.0000000000002485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
ABSTRACT Musculoskeletal conditions are often managed in primary care settings. To facilitate research and healthcare quality, practice-based research networks offer sustained collaborations between clinicians and researchers. A scoping review was conducted to describe characteristics of practice-based research networks used for musculoskeletal research and musculoskeletal research conducted through practice-based research networks. Practice-based research networks were identified from 1) musculoskeletal-studies identified in OVID Medline, CINAHL, and Embase databases from inception to 5 February 2023 and in ClinicalTrials.gov and 2) from practice-based research network registries and websites. Among active musculoskeletal-focused practice-based research networks (i.e., currently recruiting and conducting research), an assessment of practice-based research network research good practices was performed. After screening 3025 records, 85 studies from 46 unique practice-based research networks met our eligibility criteria. Common conditions studied were low back pain (28%), musculoskeletal conditions not otherwise specified (25%), and osteoarthritis (19%). Thirty-two practice-based research networks (70%) were deemed to be active. Among active musculoskeletal-focused practice-based research networks, best practice data management information was retrievable for most (53%). Because of the scarcity of publicly available information, a large proportion of practice-based research network research good practice items was not assessable. Practice-based research networks have provided an avenue to assess clinical practice and patient outcomes related to musculoskeletal conditions. Further work to increase the transparency of musculoskeletal practice-based research network research practices is warranted.
Collapse
Affiliation(s)
- Rahim Lalji
- From the EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland (RL, JML, LH, AK, CAH); Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland (RL, JML, LH, VvW, MAP, CAH); University Spine Centre Zurich (UWZH), Balgrist University Hospital, Zurich, Switzerland (RL, JML, LH, CAH); Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland (JK); Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia (JA); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (AK); Chiropractic Knowledge Hub, Odense, Denmark (AK); and Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland (VvW)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Wangler J, Jansky M. Primary care involvement in clinical research - prerequisites, motivators, and barriers: results from a study series. Arch Public Health 2024; 82:41. [PMID: 38504310 PMCID: PMC10953082 DOI: 10.1186/s13690-024-01272-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Long-term reinforcement in the role of primary care and improvement the healthcare system as a whole requires the involvement of GPs in clinical research processes. However, many clinical studies fail due to failure to achieve sample population targets amongst GPs and their patients. This issue has been identified and discussed, but effective strategies to overcome it are still lacking. One of the reasons is that the positions, requirements, and experiences of GPs on participating in clinical research have hardly been examined up to now. METHODS The years 2021 and 2022 saw three quantitative and qualitative surveys amongst GPs in Germany with the aim of shedding light on the attitudes, experiences, and potential issues regarding the involvement of primary care in clinical research projects and participation in cluster-randomised controlled trials (cRCTs) in a general sense. This overview summarises and abstracts conclusions gained from the exploratory series of studies and compares the results with the current research situation. From here, this contribution will then develop an approach towards optimising the integration of GPs into clinical research. RESULTS Most of the GPs asked associated clinical research with opportunities and potential such as closing gaps in healthcare, using evidence-based instruments, optimising diagnostic and therapeutic management, and reinforcement of multiprofessional healthcare. Even so, many GPs unsure as to how far primary care in particular would stand to benefit from studies of this type in the long term. Respondents were also divided on willingness to participate in clinical research. GPs having already participated in Innovation Fund projects generally saw a benefit regarding intervention and cost-benefit relationship. However, some also reported major hurdles and stress factors such as excessive documentation and enrolment requirements, greater interference in practice routines, and sometimes poor integration into project processes such as in communication and opportunities to play an active role in the project. CONCLUSIONS Results from the studies presented provide indications as to how GPs perceive clinical research projects and cRCTs as a whole and from their existing project experience, and on the requirements that studies would have to meet for GPs to be willing to participate. In particular, making sure that clinical studies fully conform with GPs would play a major role; this especially applies to freedom to make medical decisions, limitation of documentation obligations, interference in regular practice routine, greater involvement in research planning, and long-term reinforcement in the role of primary care. Clinical research projects and cRCTs should be planned, designed, and communicated for clear and visible relevance to everyday primary care.
Collapse
Affiliation(s)
- Julian Wangler
- Centre for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg, University Mainz, Am Pulverturm 13, Mainz, 55131, Germany.
| | - Michael Jansky
- Centre for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg, University Mainz, Am Pulverturm 13, Mainz, 55131, Germany
| |
Collapse
|
3
|
Redmond R, Steel A, Wardle J, Adams J. Naturopathic knowledge and approaches to managing endometriosis: a cross-sectional survey of naturopaths with experience in endometriosis care. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:153-164. [PMID: 36087288 DOI: 10.1515/jcim-2022-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Endometriosis is a chronic gynaecological disease with varying symptomatology and negative health outcomes. To ensure the best care for women with endometriosis, women require a multidisciplinary team approach. While some women consult with naturopaths for endometriosis, there has been little research on naturopathic knowledge and the naturopathic approach to endometriosis care. METHODS This cross-sectional survey recruited naturopaths with experience in menstrual disorders from the Practitioner Research and Collaboration Initiative (PRACI) a Practice-Based Research Network (PBRN). Data collection was conducted via an online self-administrated 62-item questionnaire. RESULTS Invitations were sent to 109 naturopaths who self-reported having experience in menstrual disorders, of whom 29 completed the survey (26.6% response rate). Naturopaths perceived endometriosis to be caused by inflammation (n=28, 96.5%) and risk factors associated with familial history (n=26, 89.6%). Many naturopaths aimed at reducing inflammation (n=27, 93.1%) and supporting gastrointestinal function (n=25, 86.2%) in their prescriptions. Naturopaths reported using various healthcare referrals to support women with endometriosis, primarily general practitioners (n=12, 41.3%), acupuncturists/Traditional Chinese Medicine practitioners (n=11, 37.9%), and gynaecologists (n=9, 31%). Naturopaths reported receiving referrals from general practitioners (n=8, 27.5%) and psychologists (n=6, 20.6%). CONCLUSIONS Naturopathic knowledge and management of endometriosis targets known problematic areas of endometriosis that can have debilitating effects on women's quality of life. Naturopathic care has the potential to align with important health outcomes for women with endometriosis however, further attention is needed to assess the effectiveness and continue to establish a multidisciplinary approach involving naturopathic care.
Collapse
Affiliation(s)
- Rebecca Redmond
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia
| |
Collapse
|
4
|
Peters S, Chakraborty SP, Barton C, Sturgiss EA, Mazza D, De Leon-Santiago M, Staunton-Smith T, Russell G. Building a practice-based research network for healthcare integration: a protocol paper for a mixed-method project. BMJ Open 2022; 12:e060524. [PMID: 35680253 PMCID: PMC9185579 DOI: 10.1136/bmjopen-2021-060524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Practice-based research networks (PBRNs) are sustained collaborations between healthcare professionals, researchers and members of the community that develop, conduct and report on research relevant to local needs. While PBRNs have traditionally been focused towards primary care practices and their patients, there has been increasing interest in how they may help facilitate healthcare integration. Yet, little is known on the ways in which PBRNs can best integrate with the broader healthcare system, in particular Advanced Health Research and Translation Centres. The overall project aim is to build a sustainable collaboration between a PBRN and an Advanced Health Research and Translation Centre to generate a research platform suitable for planning, undertaking and translating research to improve care across the healthcare continuum. METHODS AND ANALYSIS We will use a developmental evaluation design. Our iterative approach will be informed by a programme logic model and consists of: preparation work (pre-implementation assessment, literature review, community and stakeholder engagement), adaptation and building for a sustainable collaboration (strategy for recruitment and sustainment of members) and planning for network action (designing and implementing priority initiatives, monitoring and follow-up). ETHICS AND DISSEMINATION This project was approved by the Monash Health ethics committee (ERM Reference Number: 76281; Monash Health Ref: RES-21-0000-392L) and the Monash University Human Research ethics committee (Reference Number: 29786). Dissemination will take place via various channels, including relevant national and international committees and conferences, peer-reviewed journals and social media. Continuous dissemination to and communication with all participants in this project as well as other relevant stakeholders will help strengthen and sustain the network.
Collapse
Affiliation(s)
- Sanne Peters
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | | | - Christopher Barton
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | - Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Notting Hill, Victoria, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | | | | | - Grant Russell
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| |
Collapse
|
5
|
Virnau L, Braesigk A, Deutsch T, Bauer A, Kroeber ES, Bleckwenn M, Frese T, Lingner H. General practitioners' willingness to participate in research networks in Germany. Scand J Prim Health Care 2022; 40:237-245. [PMID: 35770652 PMCID: PMC9397419 DOI: 10.1080/02813432.2022.2074052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate general practitioners' (GPs') willingness to participate in long-term medical research and in research networks (RNs). DESIGN AND SETTING Cross-sectional survey among German GPs around Halle-Wittenberg and Leipzig in 2020. SUBJECTS Random sample of 905 GPs. MAIN OUTCOME MEASURES AND RESULTS Response rate 37%, 69% female. Overall, 57% were interested in participating in medical research, 34% in an active role in a RN. Interest in RN participation was positively associated with male sex, younger age, previous experiences in medical research, being involved in teaching undergraduates, and having qualification in a further specialty. Main motivators were improving patient care, giving a more realistic picture of GP care, and carrying out research on topics within their own interest areas and a reliable contact person at the leading institution. Most GPs were not afraid of reduced earnings; however, time investment was the main barrier for participation. GPs were willing to dedicate twice as much time to research when remuneration was offered. High rated topics were polypharmacy, chronic diseases, drug safety and adverse drug reactions. CONCLUSION GPs are interested to participate in practice-based research. The study results providing useful and generalizable insights in barriers and motivators should be considered when building and running GP-RNs.KEY POINTSThere is a difference between general practitioners' (GPs') overall interest in clinical research and their job and socio-demographic related readiness to participate in research networks (RNs).GPs are interested in RNs when it is a resource of and leading to enhanced patient-oriented care.GPs are willing to dedicate twice as much time to research when remunerated.GPs need a reliable counterpart within the leading institution.
Collapse
Affiliation(s)
- Larissa Virnau
- Institute of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Annett Braesigk
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Tobias Deutsch
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Eric Sven Kroeber
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Markus Bleckwenn
- Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
- CONTACT Thomas Frese Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, Halle/Saale06112, Germany
| | - Heidrun Lingner
- Institute of Medical Psychology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
6
|
Uvhagen H, von Knorring M, Hasson H, Øvretveit J, Hansson J. Factors influencing early stage healthcare-academia partnerships. Int J Health Care Qual Assur 2018; 31:28-40. [PMID: 29504843 DOI: 10.1108/ijhcqa-11-2016-0178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to explore factors influencing early implementation and intermediate outcomes of a healthcare-academia partnership in a primary healthcare setting. Design/methodology/approach The Academic Primary Healthcare Network (APHN) initiative was launched in 2011 in Stockholm County, Sweden and included 201 primary healthcare centres. Semi-structured interviews were conducted in 2013-2014 with all coordinating managers ( n=8) and coordinators ( n=4). A strategic change model framework was used to collect and analyse data. Findings Several factors were identified to aid early implementation: assignment and guidelines that allowed flexibility; supportive management; dedicated staff; facilities that enabled APHN actions to be integrated into healthcare practice; and positive experiences from research and educational activities. Implementation was hindered by: discrepancies between objectives and resources; underspecified guidelines that trigger passivity; limited research and educational activities; a conflicting non-supportive reimbursement system; limited planning; and organisational fragmentation. Intermediate outcomes revealed that various actions, informed by the APHN assignment, were launched in all APHNs. Practical implications The findings can be rendered applicable by preparing stakeholders in healthcare services to optimise early implementation of healthcare-academia partnerships. Originality/value This study increases understanding of interactions between factors that influence early stage partnerships between healthcare services and academia in primary healthcare settings.
Collapse
Affiliation(s)
- Håkan Uvhagen
- Department of Learning Informatics Management and Ethics (LIME) and Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - Mia von Knorring
- Department of Learning Informatics Management and Ethics (LIME) and Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - Henna Hasson
- Department of Learning Informatics Management and Ethics (LIME) and Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - John Øvretveit
- Department of Learning Informatics Management and Ethics (LIME) and Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - Johan Hansson
- Department of Learning Informatics Management and Ethics (LIME) and Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
7
|
Riley-Behringer M, Davis MM, Werner JJ, Fagnan LJ, Stange KC. The Evolving Collaborative Relationship between Practice-Based Research Networks (PBRNs) and Clinical and Translational Science Awardees (CTSAs). J Clin Transl Sci 2017; 1:301-309. [PMID: 29503735 PMCID: PMC5828176 DOI: 10.1017/cts.2017.305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/27/2017] [Accepted: 10/19/2017] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Clinical and Translational Science Awards (CTSAs) and Practice-based Research Networks (PBRNs) have complementary missions. We replicated a 2008 survey of CTSA-PBRN leaders to understand how organizational relationships have evolved. METHODS We surveyed 60 CTSA community engagement (CE) Directors and 135 PBRN Directors and analyzed data using between and within-group comparisons. RESULTS Forty-three percent of CTSA CE Directors (26/60) and forty-two percent of PBRN Directors (57/135) responded. Quantitative responses revealed growing alignment between CTSA/PBRN perceptions, with a few areas of discordance. CE Directors noted declining financial support for PBRNs. PBRN Directors identified greater CTSA effectiveness in PBRN engagement, consultation, and collaborative grant submissions. Qualitative data revealed divergent experiences across CTSA/PBRN programs. CONCLUSIONS Relationships between CTSAs and PBRNs are maturing; for some that means strengthening and for others a growing vulnerability. Findings suggest a mutual opportunity for PBRNs and CTSAs around applied research. Studies to characterize exemplar CTSA-PBRN collaborations are needed.
Collapse
Affiliation(s)
| | - Melinda M. Davis
- Oregon Rural Practice-Based Research Network, Family Medicine (School of Medicine) and Community Health (OHSU-PSU School of Public Health), Oregon Health & Science University, Portland, OR, USA
| | - James J. Werner
- Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - L. J. Fagnan
- Department of Family Medicine and Director of Oregon Rural Practice-Based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - Kurt C. Stange
- Center for Community Health Integration, Departments of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, The Case Comprehensive Cancer Center, Cleveland, OH, USA
| |
Collapse
|
8
|
Poggenburg S, Reinisch M, Höfler R, Stigler F, Avian A, Siebenhofer A. General practitioners in Styria - who is willing to take part in research projects and why? : A survey by the Institute of General Practice and Health Services Research. Wien Klin Wochenschr 2017; 129:823-834. [PMID: 28795257 PMCID: PMC5676841 DOI: 10.1007/s00508-017-1244-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
Increasing recognition of general practice is reflected in the growing number of university institutes devoted to the subject and Health Services Research (HSR) is flourishing as a result. In May 2015 the Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, initiated a survey of Styrian GPs. The aim of the survey was to determine the willingness to take part in HSR projects, to collect sociodemographic data from GPs who were interested and to identify factors affecting participation in research projects. Of the 1015 GPs who received the questionnaire, 142 (14%) responded and 135 (13%) were included in the analysis. Overall 106 (10%) GPs indicated their willingness to take part in research projects. Factors inhibiting participation were lack of time, administrative workload, and lack of assistance. Overall, 10% of Styrian GPs were willing to participate in research projects. Knowledge about the circumstances under which family doctors are prepared to participate in HSR projects will help in the planning of future projects.
Collapse
Affiliation(s)
- Stephanie Poggenburg
- Institute of General Practice and Health Services Research, Medical University of Graz, Auenbruggerplatz 20/III, 8036, Graz, Austria.
| | - Manuel Reinisch
- Institute of General Practice and Health Services Research, Medical University of Graz, Auenbruggerplatz 20/III, 8036, Graz, Austria
| | - Reinhild Höfler
- Institute of General Practice and Health Services Research, Medical University of Graz, Auenbruggerplatz 20/III, 8036, Graz, Austria
| | - Florian Stigler
- Institute of General Practice and Health Services Research, Medical University of Graz, Auenbruggerplatz 20/III, 8036, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Andrea Siebenhofer
- Institute of General Practice and Health Services Research, Medical University of Graz, Auenbruggerplatz 20/III, 8036, Graz, Austria
- Institute of General Practice, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
9
|
Lin CP, Guirguis-Blake J, Keppel GA, Dobie S, Osborn J, Cole AM, Baldwin LM. Using the diffusion of innovations theory to assess socio-technical factors in planning the implementation of an electronic health record alert across multiple primary care clinics. JOURNAL OF INNOVATION IN HEALTH INFORMATICS 2016; 23:450-8. [PMID: 27348488 PMCID: PMC5072363 DOI: 10.14236/jhi.v23i1.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 12/07/2015] [Accepted: 01/04/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Adverse drug events (ADEs) are a leading cause of death in the United States. Patients with stage 3 and 4 chronic kidney disease (CKD) are at particular risk because many medications are cleared by the kidneys. Alerts in the electronic health record (EHR) about drug appropriateness and dosing at the time of prescription have been shown to reduce ADEs for patients with stage 3 and 4 CKD in inpatient settings, but more research is needed about the implementation and effectiveness of such alerts in outpatient settings. OBJECTIVE To explore factors that might inform the implementation of an electronic drug-disease alert for patients with CKD in primary care clinics, using Rogers' diffusion of innovations theory as an analytic framework. METHODS Interviews were conducted with key informants in four diverse clinics using various EHR systems. Interviews were audio recorded and transcribed. results Although all clinics had a current method for calculating glomerular filtration rate (GFR), clinics were heterogeneous with regard to current electronic decision support practices, quality improvement resources, and organizational culture and structure. CONCLUSION Understanding variation in organizational culture and infrastructure across primary care clinics is important in planning implementation of an intervention to reduce ADEs among patients with CKD.
Collapse
Affiliation(s)
- Ching-Pin Lin
- Institute of Translational Health Sciences, University of Washington, Seattle, Washington, USA.
| | - Janelle Guirguis-Blake
- Institute of Translational Health Sciences, University of Washington, Seattle, Washington, USA.
| | - Gina A Keppel
- Department of Family Medicine, University of Washington, Seattle, Washington, USA.
| | - Sharon Dobie
- Department of Family Medicine, University of Washington, Seattle, Washington, USA.
| | - Justin Osborn
- Department of Family Medicine, University of Washington, Seattle, Washington, USA.
| | - Allison M Cole
- Department of Family Medicine, University of Washington, Seattle, Washington, USA.
| | - Laura-Mae Baldwin
- Department of Family Medicine, University of Washington, Seattle, Washington, USA.
| |
Collapse
|
10
|
Popolin MP, Touso MM, Yamamura M, Rodrigues LBB, da Cunha Garcia MC, Arroyo LH, Ramos ACV, Berra TZ, Santos Neto M, de Almeida Crispim J, Chiaravalotti Neto F, Pinto IC, Palha PF, da Costa Uchoa SA, Lapão LV, Fronteira I, Arcêncio RA. Integrated health service delivery networks and tuberculosis avoidable hospitalizations: is there a relation between them in Brazil? BMC Health Serv Res 2016; 16:78. [PMID: 26931507 PMCID: PMC4774126 DOI: 10.1186/s12913-016-1320-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is also one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. The purpose of this study is to consider which attributes and which territories have shown the most significant progress in Primary Health Care, in terms of coordination of Health Care Networks, and also check if those areas of Primary Health Care that are most critical regarding coordination, there were more or less cases of avoidable hospitalizations for tuberculosis. METHODS This is an ecological study that uses primary and secondary data. For analysis, coropletic maps were developed through the ArcGIS software, version 10.2. There was also the calculation of gross annual and Bayesian rates for hospitalizations for tuberculosis, for each Primary Health Care territory. RESULTS There were satisfactory results for attributes such as Population (n = 37; 80.4 %), Primary Health Care (n = 43; 93.5 %), Support System (n = 45; 97.8 %); the exceptions were Logistics System (n = 32; 76.0 %) and Governance System, with fewer units in good condition (n = 31; 67.3 %). There is no evidence of any connection between networks' coordination by Primary Health Care and tuberculosis avoidable admissions. CONCLUSION The results show that progress has been made regarding the coordination of the Health Care Networks, and a positive trend has been shown, even though the levels are not excellent. It was found no relationship between the critical areas of Primary Health Care and tuberculosis avoidable hospitalizations, possibly because other variables necessary to comprehend the phenomena.
Collapse
Affiliation(s)
- Marcela Paschoal Popolin
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Michelle Mosna Touso
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Mellina Yamamura
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Ludmila Barbosa Bandeira Rodrigues
- Institute for Health Sciences, Federal University of Mato Grosso, Av Alexandre Ferronato 1200, Reserve 35, 78550-000, Sinop, Mato Grosso, Brazil.
| | - Maria Concebida da Cunha Garcia
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Luiz Henrique Arroyo
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Antônio Carlos Vieira Ramos
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Thais Zamboni Berra
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Marcelino Santos Neto
- Centre of Social Sciences, Health and Technology of the Federal University of Maranhão (UFMA), Rua Turqueza, 65900-410, Imperatriz, Maranhão, Brazil.
| | - Juliane de Almeida Crispim
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Francisco Chiaravalotti Neto
- Department of Epidemiology, Faculty of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, 01246-904, São Paulo, São Paulo, Brazil.
| | - Ione Carvalho Pinto
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Pedro Fredemir Palha
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| | - Severina Alice da Costa Uchoa
- Department of Group Health, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Rio Grande do Norte, 59078-970, Natal, Brazil.
| | - Luís Velez Lapão
- WHO Collaborating Centre for Health Workforce Policy and Planning, International Public Health and Biostatistics, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua Junqueira 100, Lisbon, P-1349-008, Portugal.
| | - Inês Fronteira
- International Public Health and Biostatistics, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua Junqueira 100, Lisbon, P-1349-008, Portugal.
| | - Ricardo Alexandre Arcêncio
- Maternal-Infant and Public Health Nursing Department, College of Nursing of Ribeirão Preto, University of São Paulo, Av dos Bandeirantes 3900, 14040-902, Ribeirão Preto, São Paulo, Brazil.
| |
Collapse
|
11
|
A mixed-methods study of research dissemination across practice-based research networks. J Ambul Care Manage 2015; 37:179-88. [PMID: 24594566 DOI: 10.1097/jac.0000000000000018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Practice-based research networks may be expanding beyond research into rapid learning systems. This mixed-methods study uses Agency for Healthcare Research and Quality registry data to identify networks currently engaged in dissemination of research findings and to select a sample to participate in qualitative semistructured interviews. An adapted Diffusion of Innovations framework was used to organize concepts by characteristics of networks, dissemination activities, and mechanisms for rapid learning. Six regional networks provided detailed information about dissemination strategies, organizational context, role of practice-based research network, member involvement, and practice incentives. Strategies compatible with current practices and learning innovations that generate observable improvements may increase effectiveness of rapid learning approaches.
Collapse
|
12
|
Cole A, Keppel GA, Linares A, Alto W, Kriegsman W, Reed A, Holmes J, Mohanachandran M, Baldwin LM. Evaluating the Development, Implementation and Dissemination of a Multisite Card Study in the WWAMI Region Practice and Research Network. Clin Transl Sci 2015; 8:764-9. [PMID: 26177880 DOI: 10.1111/cts.12312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Practice-based research networks (PBRNs) promote the conduct of research in real-world settings by engaging primary care clinicians as champion research collaborators. Card studies are brief surveys administered to patients or clinicians at the point of care. The objective of this paper is to describe the design and evaluation of a card study methodology that the WWAMI Region Practice and Research Network (WPRN) used to develop research partnerships across multiple member sites. METHODS We used a collaborative model to develop, implement and disseminate the results of a network-wide card study to assess patient preferences for weight loss in primary care. After the card study data collection was completed, we conducted individual and focus group interviews and a brief survey of participating practice champions. RESULTS Increased research engagement and personal and professional developments were the primary motivators for participating in the development of the card study. Increasing research activity at practices and learning information about patients were motivators for implementing the study. Their participation resulted in champions reporting increased confidence in collaborating on research projects as well as the development of new clinical services for patients. DISCUSSION This collaborative model positively influenced research capacity in the WPRN and may be a useful strategy for helping PBRNs conducted translational research.
Collapse
Affiliation(s)
- Allison Cole
- Department of Family Medicine, Institute of Translational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Gina A Keppel
- Department of Family Medicine, Institute of Translational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Adriana Linares
- Division of Family Medicine, Peace Health, Vancouver, Washington, USA
| | - William Alto
- Department of Family Medicine, Swedish Medical Center, Seattle, Washington, USA
| | - William Kriegsman
- Department of Family Medicine, Multicare Health, Tacoma, Washington, USA
| | - Alex Reed
- Department of Family Medicine, University of Colorado, Denver, Colorado, USA
| | - John Holmes
- Department of Family Medicine, Idaho State University in Pocatello, ID, USA
| | | | - Laura-Mae Baldwin
- Department of Family Medicine, Institute of Translational Health Sciences, University of Washington, Seattle, Washington, USA
| |
Collapse
|
13
|
Steel A, Adams J, Sibbritt D. Developing a multi-modality complementary medicine practice-based research network: The PRACI project. ADVANCES IN INTEGRATIVE MEDICINE 2014. [DOI: 10.1016/j.aimed.2014.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14
|
Practice-based research networks (PBRNs) are promising laboratories for conducting dissemination and implementation research. J Am Board Fam Med 2014; 27:759-62. [PMID: 25381072 PMCID: PMC4918907 DOI: 10.3122/jabfm.2014.06.140092] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Dissemination and implementation science addresses the application of research findings in varied health care settings. Despite the potential benefit of dissemination and implementation work to primary care, ideal laboratories for this science have been elusive. Practice-based research networks (PBRNs) have a long history of conducting research in community clinical settings, demonstrating an approach that could be used to execute multiple research projects over time in broad and varied settings. PBRNs also are uniquely structured and increasingly involved in pragmatic trials, a research design central to dissemination and implementation science. We argue that PBRNs and dissemination and implementation scientists are ideally suited to work together and that the collaboration of these 2 groups will yield great value for the future of primary care and the delivery of evidence-based health care.
Collapse
|
15
|
Gorzkowski JA, Klein JD, Harris DL, Kaseeska KR, Whitmore Shaefer RM, Bocian AB, Davis JB, Gotlieb EM, Wasserman RC. Maintenance of Certification Part 4 Credit and recruitment for practice-based research. Pediatrics 2014; 134:747-53. [PMID: 25180282 PMCID: PMC4179094 DOI: 10.1542/peds.2014-0316] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. METHODS Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months. Field note review revealed that many physicians declined enrollment, stating that they prioritized MOC Part 4 projects over research studies. A QI curriculum meeting standards for MOC Part 4 Credit was developed and added to the study protocol as an enrollment incentive. Enrollment rates and characteristics of practitioners enrolled pre- and post-MOC were compared. RESULTS Pre-MOC enrollment contributed 48% of practices in 22 months; post-MOC enrollment contributed 49% of practices in 6 months. An average of 3.5 practices enrolled per month pre-MOC, compared with 13.1 per month post-MOC (P < .001). Clinicians in pre- and post-MOC groups were similar in age, gender, race, and time spent on patient care; practices enrolled post-MOC were more likely to be located in federally designated Medically Underserved Areas than those enrolled pre-MOC (28.6% vs 12%, P = .03). CONCLUSIONS Addition of MOC Part 4 Credit increased recruitment success and increased enrollment of pediatricians working in underserved areas. Including QI initiatives meeting MOC Part 4 criteria in practice-based research protocols may enhance participation and aid in recruiting diverse practice and patient populations.
Collapse
Affiliation(s)
| | | | - Donna L. Harris
- Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; and
| | | | | | - Alison B. Bocian
- Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; and
| | - James B. Davis
- Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; and
| | - Edward M. Gotlieb
- Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; and
| | - Richard C. Wasserman
- Pediatric Research in Office Settings, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; and,Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont
| |
Collapse
|
16
|
Cole AM, Stephens KA, Keppel GA, Lin CP, Baldwin LM. Implementation of a health data-sharing infrastructure across diverse primary care organizations. J Ambul Care Manage 2014; 37:164-70. [PMID: 24594564 PMCID: PMC4065306 DOI: 10.1097/jac.0000000000000029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks.
Collapse
Affiliation(s)
- Allison M Cole
- Department of Family Medicine, and WWAMI region Practice and Research Network, University of Washington, Seattle (Drs Cole and Baldwin and Ms Keppel); and Institute of Translational Health Sciences, and Department of Psychiatry, University of Washington, Seattle (Drs Stephens and Lin)
| | | | | | | | | |
Collapse
|
17
|
Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report. J Am Board Fam Med 2013; 26:579-87. [PMID: 24004710 PMCID: PMC4559143 DOI: 10.3122/jabfm.2013.05.130025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.
Collapse
|