A Review of 50-Years of International Literature on the Internal Environment of Building Practice-Based Research Networks (PBRNs)

Abstract

Practice-based research networks (PBRNs) have developed dynamically across the world, paralleling the emergence of the primary care discipline. While this review focuses on the internal environment of PBRNs, the complete framework will be presented incrementally in future publications.Methods: We conducted a scoping review of the published and gray literature. Electronic databases, including MEDLINE (PubMed), OVID, CINAHL (EBSCOhost), Scopus, and SAGE Premier, were searched for publications between January 1, 1965 and December 31, 2020 for English-language articles. Rigorous inclusion/exclusion criteria were implemented to identify relevant publications, and inductive thematic analysis was applied to elucidate key elements, subthemes, and themes. Social network theory was used to synthesize findings.Results: A total of 229 publications described the establishment of 93 PBRNs in 15 countries that met the inclusion criteria. The overall framework yielded 3 main themes, 12 subthemes, and 57 key elements. Key PBRN activities included relationship building between academia and practitioners and development of a learning environment through multidirectional communication.Conclusions: PBRNs across many countries contributed significantly to shaping the landscape of primary health care and became an integral part of it. Many common features within the sphere of PBRNs can be identified that seem to promote their establishment across the world.

Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty

“…NS was also required to re-apply for ethics due to changes in physicians’ EMR systems. Ethical oversight related challenges are reported as barriers to PBRLN work [ 11 ]; we suggest mapping ethics board timelines and having standard block text for components of ethics applications to ensure all team members are clear on the detail and processes of the study. A key lesson learned from these challenges is the need for a protocol for all team members to follow that allows the work to be completed but also allows for a flexible process.…”

“…Each network was required to tailor the data collection protocol to fit with their FPs’ worldviews. Dania et al [ 11 ] report a significant barrier to PBRLN work as being lengthened timelines. Ethical approval across networks is time-consuming.…”

“…Campbell-Voytal et al’s [ 10 ] study involving seven PBRLNs working in collaborative teams to articulate procedures for PBRN Research Good Practices reports the importance of getting through rocky periods with trust, communication, and handling conflict as key factors to successful PBRLN collaboration. Part of multi-jurisdictional work involves working with differing time zones, competing demands of all those involved, and the increased complexity of research coordination [ 11 ]. Efforts were made to ensure that as many team members as possible could attend these meetings; however, this was not always possible.…”

“…Regular communication between team members is a key factor for successful research [ 46 , 47 ] but has been reported as a barrier to PBRLN work due to increased efforts. Dania et al [ 11 ] report a risk for communication and understanding gaps in large networks during research activities, further exacerbated by distance communication. Thus, a key lesson learned for working across networks was to make all possible efforts to maintain communication through the prioritization of regular team meetings with all team members to ensure everyone is aligned in study procedures and timelines.…”

“…Previous research involving PBRLNs demonstrates that team-based research is important to address complex health problems and necessary if primary care is to improve adoption, implementation, and sustainability of clinical practice [ 10 ]. Dania et al’s [ 11 ] recent scoping review reports on 229 publications that describe the establishment of 93 PBRNs in 15 countries. Their review includes articles that refer to research projects conducted by PBRNs that also provide information about their establishment; the authors report on key PBRN activities and themes.…”