Designing a framework for primary health care research in Canada: a scoping literature review

Abstract

BackgroundDespite significant investments to improve primary health care (PHC) delivery in Canada, provincial health care systems remain fragmented and uncoordinated. Canada’s commitment to strengthening PHC should be driven by robust research and evaluation that reflects our health policy priorities and responds to the needs of the population. One challenge facing health services researchers is developing and sustaining meaningful research priorities and agendas in an overburdened, complex health care system with limited capacity for PHC research and support for clinician researchers.MethodsA scoping review of the literature was conducted to examine PHC research priorities in Canada. We compared national research priorities for PHC to research priorities being considered in the province of Alberta. Our scoping review was guided by the following questions: (1) What are the research priorities for PHC in Canada?; and (2) What process is used to identity PHC research priorities?ResultsSix key theme areas for consideration in setting a PHC research agenda were identified: research in practice, research on practice, research about practice, methods of priority setting, infrastructure, and the intersection of PHC and population/public health. These thematic areas provide a new framework for guiding PHC research in Canada. It was developed to generate best practices and new knowledge (i.e., innovation), transform PHC clinical practice or support quality improvement (i.e., spread), and lead to large-scale health care system transformation (i.e., scale).ConclusionsPriority-driven research aims to answer questions of key importance that are likely to have a significant impact on knowledge or practice in the short to medium term. Setting PHC research priorities ensures funded research has the greatest potential population health benefit, that research funding and outputs are aligned with the needs of practitioners and decision makers, and that there is efficient and equitable use of limited resources with less duplication of research effort. Our findings also suggest that a common research priority framework for PHC research in Canada would ensure that research priority-setting exercises are grounded in an evidence-based process.

A national research centre for the evaluation and implementation of person‐centred care: Content from the first interventional studies

“…However, based on the present findings, together with those from other projects such as the collaborative action for person‐centred coordinated care initiative, 45 the introduction of PCC into the healthcare systems needs to be carefully followed and evaluated to identify effective practices. A priority‐driven research agenda has been suggested and may be useful to the GPCC to support healthcare decision‐making while using resources effectively 46 …”

Scoping Review of Climate Change and Health Research in the Philippines: A Complementary Tool in Research Agenda-Setting

“…Since scoping reviews can be an arduous, yet transparent method for mapping research areas, some recently used it as either a stand-alone or supplementary tool in agenda-setting in various fields in health research [6,7,8,9]. Montesanti et al used it as a sole tool in generating key research themes in primary health care in Canada to contribute to the efficient and equitable use of limited funding, and possibly reduced duplication [6]. Alternatively, Ajumobi et al used a scoping review in developing introductory materials to guide the consultative process in setting Nigeria’s national malaria operational research agenda [7].…”

Key informants perspectives on creating a high impact research department in family and community medicine: a qualitative project

“…All participants viewed research in primary care as critical as most patient care occurs in this setting. This is supported by the literature that primary care is about relationships among physicians, patients, families, and communities; it is the backbone of the health system, and primary care research is needed to inform policy that sustain healthcare delivery and the commitment to improving population health (9,37,(43)(44)(45). Our project ndings, supported by other studies, suggest that it was important to foster an overarching culture that values and supports primary care research through the establishment of strong funding policies by government and funding institutions (38,44,(46)(47)(48)(49).…”

“…Lastly, emerging issues such as planetary health and primary care provider wellness are also important topics of research. Therefore, the future agenda for primary care is sophisticated and needs an interdisciplinary scientist workforce equipped to address identi ed gaps at clinical and policy levels to improve outcomes for populations served (5)(6)(7)(8)(9)(10). To that end, university primary care academic departments must support the development of primary care clinician scientist workforce and research production (11)(12)(13).…”