242682 Assessing research skills and training needs of primary care providers within a public health care integrated system

Sunday, October 30, 2011

Shalini Tendulkar, ScD, ScM , Institute for Community Health, Cambridge, MA
Ruth Hertzman-Miller, MD MPH , Department of Medicine, Cambridge Health Alliance, Cambridge, MA
Donna Rusinak , Department of Population Medicine, Harvard Medical School, Boston, MA
Nazmim Bhuiya, MPH , Institute for Community Health, Cambridge, MA
Leroi Hicks, MD, MPH , Division of Hospital Medicine, University of Massachusetts, Worcester, MA
Freeman Changamire, MD, PhD , Family Medicine, Cambridge Health Alliance, Cambridge, MA
Monica DeMasi, MD , Family Medicine, Cambridge Health Alliance, Cambridge, MA
Jonathan A. Finkelstein, MD MPH , Regional Medicine-Public Health Education Centers, Harvard Medical School, Boston, MA
Brian Herrick, MD , Family Medicine, Cambridge Health Alliance, Cambridge, MA
Judith Klickstein , Information Technology, Cambridge Health Alliance, Cambridge, MA
Alice Knowles, MS , Institute for Community Health, Cambridge, MA
Robert Meyer, MD , Pediatrics, Cambridge Health Alliance, Cambridge, MA
Somava Stout, MD MPH , Medicine and Pediatrics, Cambridge Health Alliance, Revere, MA
Karen Hacker, MD MPH , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Background: Building practice-based research networks (PBRNs) may enhance patient care by improving generalizability of findings derived within a practice-based setting and facilitating the translation of research into clinical practice. The development of these networks necessitates increased provider research capacity, particularly in settings that care for the underserved. In an effort to build this capacity, we conducted a needs assessment of primary care providers in a network of 18 primary care sites affiliated with the Cambridge Health Alliance (CHA).

Methods: We surveyed all of the 162 primary care physicians and non-physicians in the network of primary care sites at CHA. A 19 item survey instrument was developed including both closed and open-ended questions. We ascertained skills and needs related to both quality improvement (QI) and clinical research given assumptions that that research could develop from engagement in QI. The following dimensions were assessed: respondent demographics, previous involvement in clinical research and QI, research priorities, interest in participating in clinical research/QI, training in research methods, leadership as a PI or co-PI, funding and dissemination experience in clinical research/QI and barriers and resources to involvement in clinical research/QI. Frequencies of provider responses to quantitative items were calculated and key themes from the open-ended items were extracted.

Results: Of the 162 primary care physicians and non-physicians surveyed, 72 MDs (58%) responded to the survey as well as 4 non-MDs (11%). Approximately 37% of respondents reported previous involvement in quality improvement efforts, and 20% of respondents reported involvement in clinical research. In contrast, 66% (50) of respondents reported interest in participating in clinical research or QI efforts. Among those expressing interest, only 32% reported prior research methods training, 44% reported leadership of a research or QI project, and 20% reported publishing clinical research or a QI project in a peer-reviewed journal. Barriers to engagement in clinical research or QI were identified as lack of protected time (54%), funding (28%), and research skills (30%). Participants also identified a need for training in research skills, mentoring and protected (paid) time for research.

Conclusions: A large proportion of these providers in a safety net community health center system would like to engage in clinical research or QI but have limited experience in this type of work. In order to facilitate provider involvement in research in such systems, it will be critical to address barriers identified here, and engage in partnerships with expertise in research methods and training.

Learning Areas:
Public health or related research

Learning Objectives:
Describe the benefits of building primary care provider research capacity. Discuss the barriers and resources to primary care provider participation in research within one primary care setting.

Keywords: Primary Care, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a primary care provider and integrally involved with the Harvard Catalyst safety net initiative.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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