Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression

Evidence-based interventions are often poorly translated into primary care settings due to inadequate integration into organizational cultures and clinical workflows. Study designs that blend evaluation of effectiveness and implementation may enhance uptake of interventions into primary care setting...

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Bibliographic Details
Published in:Family practice 2015-04, Vol.32 (2), p.216-223
Main Authors: Naik, Aanand D, Lawrence, Briana, Kiefer, Lea, Ramos, Katherine, Utech, Anne, Masozera, Nicholas, Rao, Radha, Petersen, Nancy J, Kunik, Mark E, Cully, Jeffrey A
Format: Article
Language:English
Subjects:
Advisory Committees
Community-Based Participatory Research
Depression - prevention & control
Depression - psychology
Diabetes Mellitus - prevention & control
Diabetes Mellitus - psychology
Evidence-Based Medicine
Health Services Research
Humans
Leadership
Models, Organizational
Organizational Culture
Primary Health Care
Program Evaluation
Randomized Controlled Trials as Topic - methods
Telemedicine
Translational Medical Research
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Summary:Evidence-based interventions are often poorly translated into primary care settings due to inadequate integration into organizational cultures and clinical workflows. Study designs that blend evaluation of effectiveness and implementation may enhance uptake of interventions into primary care settings. Community-Based Participatory Research (CBPR) models are useful for developing partnerships between research teams and primary care clinical partners to test blended study designs. We conducted a formative evaluation of partnership building between a health services research team and a primary care community in US Veterans Affairs Health System to conduct a randomized effectiveness trial of an intervention embedded in routine primary care. The formative evaluation used qualitative data drawn from research/clinical partnership meetings. Data were coded and analysed using qualitative framework analysis. The CBPR model guided development of a research/clinical partnership based on a facilitation team consisting of 'external facilitators' (research team), 'internal facilitators' (primary care leadership) and a 'clinical advisory committee' drawn from the primary care community. Qualitative themes focused on: how the intervention components ('evidence') aligned with local clinical cultures, barriers and facilitators to acceptance and adoption of the intervention processes within the context of clinical workflows and identified 'facilitators' of intervention uptake and sustainability. A CBPR model can guide the development of research/clinical partnerships. Partnerships can identify barriers and craft modifications to intervention procedures that promote integration and into primary care workflows. Formative research/clinical partnerships are critical for designing and testing interventions focused on implementation and sustainability of new evidence within routine primary care.
ISSN:0263-2136
1460-2229
DOI:10.1093/fampra/cmu084