No Longer Simply a Practice-based Research Network (PBRN): Health Improvement Networks

Williams, Robert L.; Rhyne, Robert L.

doi:10.3122/jabfm.2011.05.110102

Cited by 30 publications

(27 citation statements)

References 20 publications

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“…Some authors advocate that essential components of community involvement in research are shared decision making, developing appropriate research priorities, cultural competence, and building and maintaining trust between the community and researchers. 7,12,13,[15][16][17][18] To implement these components in a sustainable fashion, the infrastructure barriers that come from the piecemeal or study-specific funding of most PBRNs need to be overcome.…”

Section: Discussionmentioning

confidence: 99%

Use of Community Engagement Strategies to Increase Research Participation in Practice-based Research Networks (PBRNs)

Spears

Tsoh

Potter

et al. 2014

The Journal of the American Board of Family Medicine

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Purpose: Practice-based research networks (PBRNs) are increasingly encouraged to use community engagement approaches. The extent to which PBRNs engage clinic and community partners in strategies to recruit and retain participants from their local communities (specifically racial/ethnic communities) is the focus of this study.Methods: The design was a cross-sectional survey of PBRN directors in the United States. Survey respondents indicated whether their research network planned for, implemented, and has capacity for activities that engage clinic and community partners in 7 recommended strategies organized into study phases, called the cycle of trust. The objectives of the national survey were to (1) describe the extent to which PBRNs across the United States routinely implement the strategies recommended for recruiting diverse patient groups and (2) identify factors associated with implementing the recommended strategies.Results: The survey response rate was 63%. Activities that build trust often are used more with clinic partners than with community partners. PBRNs that adopt engagement strategies when working with clinic and community partners have less difficulty in recruiting diverse populations. Multivariate analysis showed that the targeting racial/ethnic communities for study recruitment, Clinical and Translational Science Award affiliation, and planning to use community engagement strategies were independent correlates of PBRN implementation of the recommended strategies. In recent years, policymakers and researchers have expressed concern that the medical research system produces new knowledge that may not be incorporated effectively into clinical practice.1,2 Acquisition of much of the evidence base of health careThis article was externally peer reviewed.

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Section: Discussionmentioning

confidence: 99%

Use of Community Engagement Strategies to Increase Research Participation in Practice-based Research Networks (PBRNs)

Spears

Tsoh

Potter

et al. 2014

The Journal of the American Board of Family Medicine

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“…11,12 PBRNs are continuing to increase their capacity to investigate questions of importance to clinical practice, to disseminate results, and to implement evidence-based strategies. By blending research design and community practice experience, PBRNs provide research findings that are recognized as relevant by primary care clinicians.…”

Section: Assessing the Future Of Pbrns And Practice-based Researchmentioning

confidence: 99%

Supporting Better Science in Primary Care: A Description of Practice-based Research Networks (PBRNs) in 2011

Peterson

Lipman

Lange

et al. 2012

The Journal of the American Board of Family Medicine

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“…CBPPR is difficult to create and sustain in the absence of management support from local, affiliated hospitals and health systems' (italics added). Almost echoing Williams and Rhyne, 155 Teal et al 149 suggest that it might be useful to frame CBPPR as 'quality enhancement' rather than 'research'. They also note several ways in which the research network of the NCI had in fact actively engaged with the chief executives of participating hospitals and health-care systems to provide support.…”

Section: Limitations and The Potential Importance Of Contextmentioning

confidence: 99%

Engagement in research: an innovative three-stage review of the benefits for health-care performance

Hanney

Boaz

Jones

et al. 2013

Health Services and Delivery Research

160

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BackgroundThere is a widely held assumption that research engagement improves health-care performance at various levels, but little direct empirical evidence.ObjectivesTo conduct a theoretically and empirically grounded synthesis to map and explore plausible mechanisms through which research engagement might improve health services performance. A review of the effects on patients of their health-care practitioner's or institution's participation in clinical trials was published after submission of the proposal for this review. It identified only 13 relevant papers and, overall, suggested that the evidence that research engagement improves health-care performance was less strong than some thought. We aimed to meet the need for a wider review.MethodsAn hourglass review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves health care; and (3) a wider (but less systematic) review of papers identified during the two earlier stages. Studies were included inthe focused review if the concept of ‘engagementinresearch’ was an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were identified through the database searches, and 159 from other sources. A further relevance and quality check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an explanatory matrix was developed to help characterise the circumstances in which research engagement might improve health-care performance and the mechanisms that might be at work, identifying two main dimensions along which to categorise the studies:the degree of intentionalityandthe scope of the impact.ResultsOf the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in relation to the question of whether or not research engagement improves health-care performance. Five papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some improvement in health outcomes. For the rest, the improved care took the form of improved processes of care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review demonstrated, for example, how collaborative and action research can encourage some progress along the pathway from research engagement towards improved health-care performance. There is also evidence that organisations in which the research function is fully integrated into the organisational structure out-perform other organisations that pay less formal heed to research and its outputs. The focused and wider reviews identified the diversity in the mechanisms through which research engagement might improve health care: there are many circumstances and mechanisms at work, more than one mechanism is often operative, and the evidence available for each one is limited.LimitationsTo address the complexities of this evidence synthesis of research we needed to spend significant time mapping the literature, and narrowed the research question to make it feasible. We excluded many potentially relevant papers (though we partially addressed this by conducting a wider additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted pieces of research could be difficult to interpret without full knowledge of the context.ConclusionsDrawing on the focused and wider reviews, it is suggested that when clinicians and health-care organisations engage in research there is the likelihood of a positive impact on health-care performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved health-care performance. Further explorations are required of research networks and schemes to promote the engagement of clinicians and managers in research. Detailed observational research focusing on research engagement within organisations would build up an understanding of mechanisms.Study registrationPROSPERO: CRD42012001990.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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No Longer Simply a Practice-based Research Network (PBRN): Health Improvement Networks

Cited by 30 publications

References 20 publications

Use of Community Engagement Strategies to Increase Research Participation in Practice-based Research Networks (PBRNs)

Use of Community Engagement Strategies to Increase Research Participation in Practice-based Research Networks (PBRNs)

Supporting Better Science in Primary Care: A Description of Practice-based Research Networks (PBRNs) in 2011

Engagement in research: an innovative three-stage review of the benefits for health-care performance

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