Research ArticleOriginal Research

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

Anna Dania, Zsolt Nagykaldi, Ari Haaranen, Jean W. M. Muris, Philip H. Evans, Pekka Mäntyselkä and Chris van Weel
The Journal of the American Board of Family Medicine July 2021, 34 (4) 762-797; DOI: https://doi.org/10.3122/jabfm.2021.04.200595

Abstract

Purpose: 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.

Introduction

Practice-based research networks (PBRNs) are collaborations of researchers and primary care practitioners who are engaged in conducting health/care research, addressing questions and problems that emerge from daily practice, translating research findings into evidence-based practice, and improving the quality of healthcare.1⇓⇓–4

The seminal idea of PBRNs was planted in the UK in the late 1800s, first by James Mackenzie, and later by Will Pickles and John Fry, who conducted research in their own practices.5 Starting in 1967, this effort became more systematic through the Royal College of General Practitioners Weekly Returns Service in Birmingham, UK, which systematically gathered morbidity data from specific practices.6 In the USA, Curtis G. Hames conducted observational studies in family practice settings in the early 1970s,5 while A. Huygen initiated research activities at first in his practice just after World War II and soon engaged 4 Dutch family practices in the Nijmegen area in1967.7 Since these early experiences, primary care research has expanded to more countries and healthcare settings, and many PBRNs have sprung up worldwide.4,8⇓⇓⇓⇓–13

Through the course of 5 decades, PBRNs developed new scientific knowledge and various health care innovations,14⇓–16 new research methodologies,17⇓–19 innovative Health Information Technology (HIT),20⇓⇓–23 and healthcare improvement programs that were, in some cases, supported by national legislation.24⇓⇓–27

While several publications exist describing the development of individual PBRNs or geographically clustered PBRNs (eg, at the regional or national level), there is a paucity of information about the establishment of PBRNs across the world and over 5 decades. The purpose of this study was to address this gap by conducting a scoping review of the worldwide English literature to synthesize what is known about the establishment of PBRNs and by constructing an overarching thematic framework, which has not been established before. This also allowed us to map the facilitators and barriers of building PBRNs based on the entire discoverable body of PBRN literature.

Due to the extent of our findings, the focus of this article is on the internal environment of PBRNs. Results derived from other domains (eg, the external environment) will be presented in subsequent publications.

Methods

We conducted a scoping review of the literature following a methodological framework described by Arksey and O'Malley,28 which was appropriate to map the key elements that underpin our area of interest, spanning across a broad scale of source data. This method is particularly suitable to examine a comprehensive set of data sources and various types of evidence that may be available, such as electronic databases, reference lists, manual searches of individual journals, online information on existing networks, organizations, and conference proceedings. This allowed us to search across the “universe” of PBRNs and any information that was accessible on their establishment.

We then applied analytic stages suggested by the chosen method: (1) defining the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. The purpose of conducting the scoping review was to identify key elements that were linked to the establishment of PBRNs and to create an overarching thematic framework that contextualizes the facilitators and barriers of this process. Our qualitative scoping review approach did not include a quality assessment of the examined articles, since we intended to incorporate any verifiable information available.

Identifying Relevant Studies and Study Selection

We identified relevant publications in 2 steps. In the first step, we searched the English-language literature systematically and reviewed publications listed in MEDLINE (PubMed), OVID, CINAHL (EBSCOhost), Scopus, and SAGE Premier, using the following search terms: “primary care,” “family practice,” “general practice”; in combination with: “practice-based,” “research,” “network,” “data,” and “infrastructure.” We identified publications that contained information on the establishment of PBRNs between January 1, 1965 and December 31, 2020 to establish a primary group of article abstracts.

One of the authors (AD) reviewed the full-text articles and eliminated duplications and articles that were clearly irrelevant. Subsequently, 3 reviewers (AD, PM, and AH) scrutinized all articles separately to ensure that they were relevant to the research question and applied rigorous inclusion/exclusion criteria. The inclusion/exclusion criteria are presented in Table 1. The selection process yielded a total of 229 publications that included relevant information.

View this table:
Table 1.

Inclusion and Exclusion Criteria for the Scoping Review

In the second step, we searched the “gray literature” for white papers, newsletters, conference abstracts, posters, proceedings, presentations, individual PBRN websites, editorials, and online materials published by national organizations; assessed the references in selected publications; and reviewed additional papers that emerged from bibliographic lists. An extended search was conducted using Google Scholar and public online sources. The lead author (AD) communicated with coauthors and colleagues to clarify ambiguities and bridge remaining gaps.

When there was any doubt about the relevance of a study, it was marked and remained in the list to be evaluated by another reviewer (ZN), who had in-depth understanding of PBRN research on an international scale and maintained professional relationships with many included PBRNs. This helped the authors put information published in the literature into a more granular context and gain a deeper understanding about its relevance and meaning. A more detailed description of the review process is presented in Figure 1.

Figure 1.
Figure 1.

Chart Flow Diagram. Abbreviation: PBRN, practice-based research network.

Charting, Collating, and Summarizing Findings

We explored the first 10 years of each PBRN's trajectory (when available) to capture all discoverable key actors and their attributes (interest, influence, goals), relationships and interactions between them, the nature of their relationships, and the resources contributed and properties of the PBRN that emerged during the establishment process. These key areas of our inquiry were anchored in social network theory.29,30 Four authors (AD, AH, ZN, JWMM) carefully reviewed selected publications, grouped those that referred to the same PBRNs, and implemented an iterative process to sort and characterize the material using a data charting form, including the following information: PBRN name, national affiliation, year of establishment, membership, information about PBRN leadership, geographical location and connection to other PBRNs, mission/purpose/goals/objectives/aims (when available), and narratives that informed us about the distinct groups of main actors (“nodes” of the network) and their contributions (“network resources”), their relationships and interactions (“ties” between the “nodes”), their relationship “features,” “properties” they developed, processes of establishment, and early operations. We considered “actors” to be individuals (eg, academics, clinician practitioners, practice facilitators) or groups (eg, PBRN members, boards of directors) who were interacting with each other.29⇓–31

An inductive thematic analysis approach32⇓–34 was implemented to identify key elements gleaned from the literature to generate themes and subthemes related to the establishment of PBRNs.

Our iterative content analysis yielded converging observations (analytic components). These basic components were grouped according to their relevance to already known specific activities or functions that were foundational to the establishment of PBRNs (eg, recruitment, membership, governance, communication, learning environment, and so forth). This process yielded the conceptualization of 57 key elements. These key elements were then linked to 12 subthemes based on higher-level similarities. The subthemes captured the distinct groups of main “actors” (or “nodes”) that contributed to the establishment of PBRNs.

We then developed the final theme structure in relation to specific environmental domains where the subthemes most fittingly belonged. Our analysis defined 3 themes, including the external, the internal, and the boundary between external and internal environments. This article focuses on the theme of the “Internal Environment,” which consists of 25 key elements that can be grouped into 4 subthemes.

Some of the components from our review were then conceptualized as facilitators and barriers to establishing PBRNs, although not all components mapped to facilitators and barriers. In summary, our analytic pathway from data gathering to theme development can be described as follows:

Gathering original narratives from papers (relevant quotations)→Structuring and grouping narratives→ Developing components (eg, “Characteristics of a PBRN Leader”)→Grouping components→Developing key elements from groups of relevant components (eg, “Organizational Leadership”)→Grouping key elements→Developing subthemes from groups of relevant key elements (eg, “Network Infrastructure and Operations”)→Grouping subthemes→Coalescing themes (eg, “Internal Environment”)

Two examples of the methodological approach in synthesizing key elements, subthemes, and themes from the quotation level are presented in Appendix Tables 5 and 6. An illustration of the subthemes and their connections to the themes is presented in Figure 2.

Figure 2.
Figure 2.

The Thematic Structure of PBRN Establishment. Abbreviation: PBRN, practice-based research network.

Results

Our database search identified 2160 publications. A further search of references and the “gray literature” resulted in 378 additional publications. Of these sources, 229 met the inclusion/exclusion criteria. Information gleaned about PBRNs was often variable across publications and individual PBRNs. Included PBRNs and related literature are presented in Table 2.

View this table:
Table 2.

Included Practice-Based Research Networks, Peer-Reviewed Articles, and Review Sources

Ninety-three PBRNs from 15 countries met the inclusion criteria from publications spanning a period of more than 50 years. We evaluated 37 PBRNs from the USA, 15 from the UK, 10 from Australia, 4 from Belgium (of which 2 were pilot projects), 6 from the Netherlands, 3 from Ireland, 2 from Switzerland, 2 from New Zealand, 2 from Canada, and 1 PBRN from Finland, Germany, Italy, Singapore, South Africa, and Sweden. ASPN and e-PCRN were binational and were established with contributors from the USA/Canada,35⇓–37 and USA/UK,23,38⇓–40 respectively and 4 were international networks.41⇓⇓⇓–45 PBRNs could be characterized as local, regional, statewide, interstate, national, or international.

The synthesis of our results yielded 3 main themes, 12 subthemes, and 57 key elements (see Table 3). In this article, we present 25 key elements that constructed the 4 subthemes that are linked to the theme of “Internal Environment.” An overarching thematic framework and thematic connections between its components are presented in Table 3.

View this table:
Table 3.

Overarching Thematic Framework for the Establishment of Practice-Based Research Networks Focusing on the Theme of the Internal Environment Described in This Article

Foundation

We found 1 key element linked to the subtheme of “Foundation” that we analyze below (see also Table 3).

Most PBRNs articulated their core mission, goals, objectives, and aims at the time of their establishment. Sentinel surveillance and the study of population morbidity patterns were often in the focus in early networks.7,46⇓⇓–49 Real-world problems emerging in primary care settings, and improving clinical practice and health care through practice-based evidence were central to the interest of most PBRNs.9,35,36,50⇓⇓⇓⇓⇓⇓⇓⇓–59 These suggest that PBRNs have a widely shared focus and mission for evidence-based practice and quality improvement (QI) of healthcare services. In addition, numerous PBRNs aimed at the enhancement of practitioner knowledge.36,52⇓⇓–55,61,70,76⇓–78 This pattern has been consistent across academia-initiated and practitioner-driven activities by members who recognize the importance of practice-based research, which improves primary care practice. Furthermore, the UK and Australian networks explicitly stated the specific purpose of research capacity building in primary care.51,52,60⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓–75 Later-generation PBRNs demonstrated more specific goals at their establishment, which defined their aims and partnerships.79⇓⇓⇓–83 We present PBRN goals and aims in Appendix Table 2.

As the PBRNs worked toward accomplishing their mission, they developed “ties” and “properties” that helped sustain their internal environment, but they also encountered a number of barriers and challenges, some of them were incidental, while some others were structural. These facilitators and barriers were mapped in relationship to specific key elements and are presented in the following and also summarized in Table 4.

View this table:
Table 4.

List of Facilitators and Barriers

Practitioner Participation and Motivation

We found the following 5 key elements to be linked to the subtheme of “Practitioner Participation and Motivation” (see also Table 3). Most PBRNs were established on a core of research-motivated and experienced clinician members. Especially in the early networks, volunteer practitioner (“bottom-up”)7,84 support was instrumental.

The recruitment of members followed various paths. Some networks recruited a decisively selective group of practices, others tended to create either a representative or a convenience sample. Some sought specific practice or practitioner characteristics or PBRN-related criteria, especially in relation to research experience or interest in a specific research topic. In general, membership brought a set of benefits and obligations, which in some networks were more binding, while others applied a flexible membership model. The idea of providing value-added benefits to members was at the heart of most networks.

PBRN member recruitment often leveraged prior relationships with academia through training or research, relationships within professional organizations, connections established via social or professional venues, and various incentives.

Across the board, PBRN membership typically encompassed either general practitioners (GPs)/family physicians (FPs) or other primary care professionals, separately or together with GPs/FPs. Since the 1990s, numerous networks engaged multiple types of primary care disciplines, including allied health professionals and various levels of expertise.63,70,85,86 In the early years, mainly individual practices were involved, while later, membership was expanded to larger healthcare organizations.87⇓–89

Our analysis suggested 5 levels of member engagement on the research participation continuum: (1) practitioner-research leaders, who initiated, designed, and drove research; (2) champion members, who were active participants in all/most steps of research; (3) regular collaborators, who participated in research that was initiated, designed, and driven by others; (4) research advisors, who interacted with researchers and/or contributed data without conducting research; and (5) informed research users, who were interested in using research results without participating or contributing.

Common barriers for practitioner engagement and participation included lack of protected time, low interest in research topics, limited research skills, competing priorities, and maintaining practice efficiency.44,46,89⇓⇓⇓⇓–94 Obstacles to recruitment also included previous negative experiences with academic interactions.89,95

Practitioner focus on patient care excellence tended to form the cornerstone of PBRN activities. Practitioners were interested in research topics that were closely related to their daily work and were applicable to real-world conditions.9,18,36,60,69,79,80,92,96⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓–108 As members, they aimed to contribute to new knowledge, implement research findings, and engage in healthcare policy or advocacy.

Member motivation was associated with the presence of a research culture in the clinic and the appreciation for research that members considered highly important in general practice.50,60,79,89,109 PBRN membership was perceived as professionally stimulating, increasing job satisfaction, supporting collegiality and peer learning, and facilitating professional development.

Networks that aligned their objectives with the needs of individual practitioners relied more on nonmaterial incentives, eg, a shared vision, participation in a learning community, dissemination of value-added resources, and diffusing knowledge. Such approaches created a solid foundation and strong incentive for PBRN research.39,66,67,69,78,81,82,86,99,105,108,110⇓⇓⇓⇓⇓⇓⇓–118.

Other nonmaterial incentives included simple projects at the start-up period, professional and practice benefits, and research assistance. Material incentives included training opportunities,61,63,65,66,69,73,78,86,111,119,120 small research grants,10,52,61,63,65,73,78,86,121⇓⇓⇓–125 and professional credits.46,78,80,125⇓⇓⇓⇓–130

Member financial support/remuneration has been applied broadly;60,61,65,73⇓–75,80,92,93,99,108,121,122,131⇓⇓⇓–135 however, in some cases professional credits proved to be enticing126 or preferable.46,73,80,102,125,127,129,130

Ongoing mentorship combined with practitioner empowerment built strong personal relationships, even when these were established through a “top-down approach,” and member compensation was limited.7,9,65,66,136

Academic Participation and Attitudes

Seven key elements were linked to the subtheme of “Academic Participation and Attitudes” (see Table 3).

The development of PBRNs was linked strongly to the development of academic centers of excellence in general practice/family medicine and coevolving with the primary care profession.6,7,47,56,70,137⇓⇓–140 Many networks were initiated and hosted by academic institutions, in part, by leveraging past professional relationships. A number of PBRNs also received infrastructure and technology support (financial and in kind) from academic organizations. In some countries, especially in the UK and Australia, most networks were developed based on national strategies and were supported by academic departments.51,63,65⇓–67,73,136,141⇓–143

A few networks included only academic professionals, while nonacademic practitioners had a minimal role, at least initially.129,140,144 However, some early networks expressed unease with strictly academically propagated PBRNs.54,145

Our study confirmed the notion that the history of PBRNs is inseparable from the development of family medicine/general practice as a distinct discipline. In countries where PBRNs were developed earlier (eg, UK and the Netherlands), these networks emerged together with the academic family medicine discipline.6,7 Based on our data, it seems that in those countries where the discipline was developed at a later stage, research that was able to inform the expansion of family medicine/general practice was also delayed.89,146 Likewise, in some countries where the discipline was not well supported until more recently, the development of PBRNs also seemed to have lagged significantly.76

Academic professionals recognized the importance of practice-based research for the discipline, professional growth, academic education, and careers and have often encouraged the work of PBRNs. They were also inspired and skillful leaders who contributed to the organization, expertise, research quality, reputation, and funding of networks. Academic expertise had a palpable influence on the prioritization of research as well.9,46⇓–48,57,60,66,75,86,90,91,119,122,125,136,137,140,144,147⇓–149

Academically supported PBRN databases allowed the management of a broader research portfolio and more focus on high-impact health conditions7,23,95,106,126,140,147,148,150⇓⇓–153 or facilitated increasing sophistication in primary care research, resulting in a definitive effect on practice improvement.7,21,93,109,126,129,140,147,149,152⇓–154

Academic educators frequently linked medical and resident training with PBRN activity, instilling research skills into future members. Through QI cycles and quality assurance in patient care, academics fostered an environment of excellence and facilitated knowledge transfer to learners, contributing to the growth of practitioners.50,52,93,109,112,130,137,154⇓–156

Academic departments benefited from working with PBRNs by increasing their publication output, strengthening professional training, acquiring grants, establishing fellowships, using or generating PBRN data for scholarly research, and making academic research more community focused and more relevant to primary care.6,47,57,108,124,137,140,157

Network Infrastructure and Operations

We found 12 key elements linked to the subtheme of “Infrastructure and Operations” presented in the following in groups, according to their relevance (see also Table 3).

Initial Partnerships to Establish PBRNs and Centers of Operations

In most PBRNs, academic institutions provided the backbone of network infrastructure, and they also became the center of operation. However, in some cases, professional organizations played this pivotal role.46,84,120,124,144,158⇓–160 Some PBRNs were affiliated with research institutes,47,76,158,161 some developed as community-based associations,81,107,110 in 1 case, without academic affiliation.111 Other PBRNs had more than 1 linkage,23,75,90,108,126 of which 1 was a HIT vendor.91 Some operated as affiliates of other PBRNs96,112,162 or developed as networks of PBRNs,21,60,75,108,126,163 or as subsets of networks,152 or incorporated previous PBRNs,164 or established multiple linkages combining the above affiliations.144 The maturity of PBRNs was clearly associated with more sophisticated research infrastructure development,21,39,60,75,133,153 including federated or “meta” networks (networks of networks).60,75,87,108,126,153,162,165 Information about various organizations that initiated and supported PBRNs is presented in Appendix Table 1.

Key Activities at Establishment, Infrastructural Funding

PBRNs were established through specific key activities that defined the nature of their network. Key activities at the establishment of PBRNs included those that initiated the formation of the network and transformed ideas and mission statements into activities. Some PBRNs followed a common pathway/approach to start their operations, eg, conducting a survey to establish the profile of their practices and practitioners or the routine collection of data in their practices. Representative key activities are illustrated with quotes from the literature in Appendix Table 3.

PBRNs received infrastructural funding from a variety of external sources; however, the most common infrastructural support came from hosting academic institutions.10,18,46,52,66,113,124,125,140 In some countries (eg, Australia and the UK), strategic infrastructural investments and enduring research capacity-building programs originated from national entities.6,52,63,66,69,73⇓–75,100 In some PBRNs, member dues and other in-kind contributions added to the infrastructure.35,52,84,124,130,166

Many networks recognized funding instability as a major challenge to sustainability. This compelled a number of PBRNs to develop business models to support their infrastructure longitudinally. We identified some business models that networks developed within the first decade following their establishment and during the time frame of our cross-sectional review. These models varied from contracting with external researchers who had long-term projects that ensured payments to practitioners or practices involved in these projects,78,124,167 to developing a diversified research portfolio60,115 or contributing with intellectual capital and infrastructure on a cost-recovery basis, to projects sponsored by major funding organizations.52,66 We also encountered more sophisticated business models that provided access to “big data” or other research data resources, which generated revenues for the network.153

Relationship Building between Academics and Practitioners in the Field

PBRNs based relationship building on the need to establish a shared identity among their members. Networks typically aimed at building long-term, constructive, collaborative, and reciprocal relationships and fostering collegiality, respect, trust, and mutual appreciation between academics and practitioners.

Synergistic relationships, which became pivotal for the long-term development of PBRNs, were implemented through all types of interactions between academic professionals and network members. Further, “conveners” that sustained the ties between them, such as practice facilitators, research coordinators, and assistants, were actively involved in these relationships. Thus, interpersonal multidirectional relationships were shown to be fundamentally important to the development of PBRNs. PBRN relationship-building activities are presented in Appendix Table 5, along with the steps of synthesizing this key element.

PBRNs reinforced relationships through training and education, applying multidisciplinary approaches and engaging key practitioners, practice managers, clinician champions,45,92,108 research assistants, and practice facilitators.168 Practice facilitation became a key component of many PBRN projects, supporting multidirectional communication between practices and network leadership and providing value-added assistance.

Dynamic practitioner–academic interactions fostered the emergence of a new model of primary care where research and QI are integral to the practice.9 This new model and vision of primary care, which has been developing since the early 2000s in some PBRNs,51,52,60,61,68⇓⇓⇓⇓⇓⇓–75 was expressed in a recent survey.89

Governance, Leadership, Communication

Strong leadership, multidirectional communication, and participatory governance that produces reciprocal benefits for all members were linked to PBRN growth already at the network establishment phase.43,60,90,92,124,125,153,157,167,169 The initial governance structure and multidirectional relationships leaders developed have influenced the network structure, how the network evolved in the following years, and the very first activities they engaged in.

Our data suggested that many networks were established around a recognized “research-enthusiast” and committed leader, with interest in improving primary care practice, developing new knowledge, and, in some cases, influencing policy. Leaders were either professionals73 who had senior academic positions169 and/or clinicians with long track records.67,124 Some also had previous PBRN experience with other networks.115,125 The components of key element “Organizational Leadership” are presented in Appendix Table 6 together with the steps of synthesizing this key element.

PBRNs used various pathways of a/synchronous communication to meet their goals for intellectual exchange, research capacity building, research prioritization, translation and dissemination of research results, and relationship building. On-site visits and personal communication were considered the most effective and motivating for research engagement. Conferences were used to generate new ideas and discuss their implementation.

Early PBRNs typically implemented an informal and low-cost governance model. We encountered a few networks with minimally structured governance, which were led by a director,84 while large single, international or federated networks and networks of PBRNs incorporated a more sophisticated and extensive leadership structure.41,43,44,60,75,92,96,108,126,132,153

Some networks operated as (semi)independent or nonprofit organizations, but there was limited information regarding their relationship to host organizations and how independently they operated.

Based on available data, PBRN governance models could be characterized as top-down, bottom-up, or a mixed model that engaged the entire organization, which some referred to as a “whole system approach.”66,86

Governing bodies of PBRNs tended to incorporate a mixture of member-practitioners, academics, or solely academic professionals, depending on their structure.

Typically, governance consisted of a leadership group with research expertise, which offered guidance to research proposals, and/or an oversight group, which contributed to planning and monitoring. In larger networks, subgroups/committees were established to attend to larger-scale issues. Administrative structures and day-to-day operations varied in size and complexity, depending on the robustness of the network.

Methodology of Prioritizing the Research Agenda and Topics of PBRN Research

We found that governance type was also linked to idea generation and research prioritization activities. Competing agenda was indicated by statements stressing that practitioner priorities were important.9,35,96,111,112,122,170⇓–172 In some publications, we also found information about leadership processes for cocreating the research agenda,81,83,86,99,110,125,132,173 data-driven research,21,90,153 evidence reviews,47,72,130 and the ranking of project ideas based on network priorities.35,99,110,115,132 Networks reported challenges when there were gaps between the interests of research funders and PBRN stakeholders, including divergence between the goals of granting agencies and interests of PBRNs.

We identified 5 levels of research outcomes based on the subjects of interest—patient-level, clinician-level, practice/health system-level, community/population-level, and PBRN-level—including work on the research capacity of the network. Many PBRN studies incorporated multiple levels of outcomes,52,60,84,94,116,130 which were closely linked to the types of data PBRNs collected.

Data Gathered from Networks, Data Management, and QI Activities

Some publications contained information about research data sources, data governance practices and ownership, data use and purpose, scope and representativeness, value (including capacity of data), and information about infrastructure for data management support, database development, warehousing, and interoperability. Ensuring data quality through ongoing improvement efforts was fundamental for PBRNs to operate as “real-world” research laboratories producing knowledge and resources that could be disseminated widely in primary care settings. Aggregation and systematic analyses of data emanating from large collaborations, eg, federated or “meta” networks, contributed to the generalizability of results and deeper research innovations.23,36,55,80,92,96,125,126,153

The issue of representativeness of the network was a concern in many PBRNs from the start. To prevent variations from national standards, some PBRNs developed confirmatory surveys to measure the external validity of their research,3,97,122,127,132,140,155,156,174⇓⇓⇓⇓⇓⇓–181 while some smaller/local networks were representative of the patient population of their area,152,156,182,183 or their data allowed extrapolation to a national population.129,137

QI was among the main objectives of many PBRNs, even before the year 2000.52,112 Our results indicate that QI has been a significant incentive for participation, and it was leveraged to improve clinical guideline implementation, stimulated the development of new methodologies,112,184 such as “best practices research,” played an important role in the translation of research into practice, helped identify research topics relevant to gaps in practice, and was also linked to collaborative learning.

PBRNs reported that QI activities enhanced the quality of healthcare in network practices.7,18,51,53,106,112 Numerous networks applied HIT to facilitate QI activities, such as quality feedbacks, clinical decision tools, and learning communities, and had a robust effect on QI implementations and QI capacity.21,74,95,103,105,133,185

Learning Environment

The learning environment was an integral part of the infrastructure and operation of PBRNs. Many findings indicate that colearning helped build a primary care research culture among PBRNs, especially through training/education7,52,55,63,66,69,70,73,75,78,79,81,109,111,179,186,187 or learning community activities.13,39,67,86,88,90,99,153,188

General training included educational courses, continuing medical education, annual training programs, higher degree education, and using interactive teaching methods, such as workshops, courses, and webinars. Mentoring, advising, research assistance, and QI training were frequently provided in the context of specific projects.7,38,43,46,51,52, 66,74,76,78,86,99,101,106,109,111,112,115,120,132,139,160,169,171,189

Training activities were targeted mainly to primary care practitioners interested in research, but they were also provided for emerging academic researchers. Residency and practitioner training programs linked to PBRN activities represented other components of the learning environment.

Research capacity building activities were pronounced among the priorities of UK and Australian networks and varied from simple research training courses to degree credits and higher-level education, allowing the more widespread use of clinical evidence gleaned from practice-based research.9,52,59,61,63,69,70,75,78,100 An example of research training is presented in Appendix Table 4.

More recent networks tended to emphasize the learning community aspect of PBRNs and considered it fundamental to the network's operation, but the seminal idea was rooted in early networks.54,111⇓–113 The function involved sharing resources and peer learning and the dissemination of best practices and QI methods based on facilitated member interaction.

Discussion

This article presents the findings of a seminal scoping review across the widest possible geographical and temporary scope, and it maps key elements contributing to the establishment of PBRNs in primary care settings. Our study examined a wide variety of publications spanning 5 decades. Our approach allowed us to explore key elements of establishing PBRNs, but it did not aim at a deep analysis of the underlying reasons.

Our synthesis yielded 57 key elements (see Table 3), of which 25 are discussed in this article. These belong to the subthemes of “Foundation,” “Practitioner Participation and Motivation,” “Academic Participation and Attitudes,” and “Network Infrastructure and Operations” and are linked to the theme of “Internal Environment of PBRN.” Our lists of facilitators and barriers were distilled from knowledge we derived from our synthesis, and they may be useful for those who plan to build PBRNs in the future.

The key elements presented in this review are in line with a study published in 2005 on infrastructural requirements of PBRNs in the American context.190 They are also coherent with network dimensions that create social and intellectual capital that were presented in an evaluation tool/kit by Harvey et al in 2000,191 although this article applies a different nomenclature. Harvey's study also underscores the existence of common features among PBRNs across all geographies.

In the subtheme “Foundation,” we linked mission, purpose, goals, objectives, and aims; however, not all PBRNs communicated their vision and goals clearly in discoverable publications, which does not imply a lack of goals. In this review, we did not investigate whether networks modified their mission during their trajectory or if they became incorporated into larger networks, but their continuity suggests that they may have reached at least some of their initial goals.

Our review suggests that network member profiling surveys,44,89,98,122,140,155,156,169 gauging practitioner motivation51,55,56,78,79,102,127,138,145 or training needs,63,67,69,70,100 and assessing the external validity of research97,179⇓–181 were common in the early phase of networks, underscoring the importance of membership and/or population characteristics, practitioner motivation, and the research capacity of the network.

We found a shift in later-generation PBRNs toward more specific goals articulated at their establishment, which expressed their partnership interests.79⇓⇓⇓–83 These trends indicate an increasing sophistication of PBRNs, either through broadening their membership, which reflects their transformation in the primary healthcare environment, or through research specialization.13,85,192 The evolution of the goals of new networks over time may indicate that PBRNs adjusted to the emerging needs of communities for better primary healthcare practice.

Specific network objectives and pathways of starting networks were dependent on available resources that fostered PBRN activity in each country and network. Most of these resources were influenced by external factors, which in turn could alter resources that are internal to the PBRNs. These connections will be reviewed in a subsequent article.

The development of large networks often incorporated an objective to ensure the viability of emerging PBRN partners.21,75,96,108,126 These networks had access to a variety of populations, leveraged wider interests, engaged in multiple types of research, and focused on research topics that were broadly generalizable. This trend seems to have developed around 2010, and it is consistent with the findings of other studies that show that there is a tendency toward multinetwork collaborations, especially when they leverage advanced HIT.13,133 As a further expansion of PBRNs, the establishment of PBRN “meta-networks” led to a transformation into “communities of solutions”193 supported by Centers for Primary Care Practice-Based Research and Learning (P30 Centers), in the USA,194 and the extension of the clinical research network approach to all healthcare, in the UK.195

In these transformations, the focus of the research partnership was gradually extended from individual practitioner to practice, then clinic, and finally to the broader PBRN membership even in the early phases of PBRN development. These seem to parallel a similar methodological evolution, which progressed from studies addressing existing knowledge gaps of primary care to more sophisticated comparative effectiveness research based on large primary care data sets. This transition was anchored in increased research capacity and technological innovations that enabled additional functions, such as accredited evaluations,126,153 advanced clinical decision support,93,95,96,153 and learning communities.88,90,153 In many PBRNs, practitioners seemed to be more poised to improve the quality of care than to do academic research. These findings are in line with a recent survey.196

Importance of Communication, Learning Environment, and Relationship Building

Our analyses, which were anchored in social network theory,29,197 indicated the highest levels of associations in the following areas: (1) communication; (2) learning environment; and (3) relationship building between academics and practitioners in the field. These key elements included numerous components describing facilitators as well. The first and second areas indicate that PBRNs evolved as learning organizations applying multidimensional communication, which enabled them to shorten the time of spreading innovations among stakeholders, underscoring that research is not the only activity in the scope of PBRNs.198,199 The third area in the internal environment of PBRNs was linked to key elements for relationship building between academics and practitioners in the field and reflects features of these relationships that propagated the establishment of PBRNs.

Our findings are also convergent with previous studies that present key elements of high-quality practice organizations in primary care.200,201 This may indicate that practices engaged in PBRN activity are endowed with properties that enable them to improve care quality or that QI is organically linked to PBRN activity. The richness of data related to communication, learning environment, and relationship building in PBRNs, using multidirectional and multiple means communication, suggests more intense interactions and knowledge exchange among PBRN members.

The Impact of PBRNs on Primary Care Practice and Professionals

Our findings demonstrate a reciprocal relationship between the development of PBRNs and the generation of new knowledge for primary healthcare improvement, the enhancement of the discipline of primary care, and the acceleration of primary care practice reform through transformative collaborations. Although our review suggests that practices that participate in PBRN research may be somewhat different, and therefore may not be representative of primary care in general,41,97,122,148,174,181,202 in some networks, participation seemed to enable the implementation of care innovations. Through their broader impact on healthcare, policy, and education, members may have also accelerated innovation transfer to other practices.203⇓⇓⇓–207

Based on our findings, we formulated 5 levels of member engagement on the research participation continuum (see Table 3), including literature-concordant “research leaders,” “network champions,” “regular collaborators,” “advisors,” and “informed research-product users.” The latter describes practitioners who are influenced by PBRN activity passively (“listeners”).69,100,208,209 This may be noteworthy, since academic funders typically do not support the dissemination and “consumption,” only the “production,” of knowledge and resources.

Our findings indicate that the 50-year development of PBRNs gave rise to a new thinking and way of practicing general medicine, which gradually integrated research into community practice. This notion might be called “researcher-in-community,” which describes practitioners who pose questions emerging from daily practice to a dedicated network of like-minded colleagues, supported by academic researchers. Their aim is to answer practical questions through practice-based research by bringing the university to community practice and incorporating the community into academia.

This is analogous to the model of “researcher-in-residence,”210⇓–212 an arrangement that may provide additional benefits through broader cross-pollination, learning, and diffusion of healthcare innovations.19,203,213

Governance Models

Our analyses indicated “top-down,” “bottom-up” or mixed (“whole system”) governance models in PBRNs.66,142 We found other typologies for PBRN governance in a study from the UK214 and in a publication from Institute for Health Policy Studies (IHPS), in the UK.215 There was limited information on governance models PBRNs adopted over the period of their establishment. Some articles suggest that a mixed-type model tended to develop in most networks over time. For example, the Nijmegen Family Practice Academic Network started as a top-down network, but practitioner empowerment resulted in stronger bottom-up governance.9,10

Reciprocal Benefits between PBRN Practices and Academic Departments

The key elements “Learning Environment” and “Academic Contribution to PBRNs” reflected strong support academicians provided to facilitate the professional growth of primary care practitioners.

Our synthesis established 6 key elements that describe the contributions of academia and 1 element that points to benefits that academic institutions received from PBRNs (see Table 3). It is important to note that this is not a quantitative measure of academic benefits, which included publications, enhanced graduate education, grants supported by PBRN data, excellence in teaching medical students and training residents, and better proximity to community, which were facilitated by working with PBRNs. This reflects the reciprocity between academician and practitioner benefits from PBRN participation.

Business Models of Supporting the Work of PBRNs

Financial instability was another significant challenge for PBRNs. Prior research has underscored the importance of infrastructural and research funding for PBRN operation.11,190,216⇓–218 To address ongoing infrastructural support, some networks developed a business model at the time of their establishment52,66,82,124,153 or later.172 The PBRN infrastructure has been promoted in the USA through training and technical assistance provided by the Agency for Healthcare Research and Quality,219 while in the UK, a diverse research portfolio elicited by the needs of academia and industry has been driving research in primary care settings.75

Geographical Variations in PBRN Development in the Internal Environment

We have not seen substantial geographical variations in the “Internal Environment” of PBRNs (the focus of this article) by region or country. However, we observed a clear and strong thrust toward research capacity building in primary care settings among the UK and Australian networks. These networks tended to attribute similar importance to practice-based evidence and evidence-based practice in family medicine/general practice and primary care, compared with networks from other countries. Dutch networks were characterized by the development of registries of data recorded by FPs. Data collection capacity and modalities defined the use of study methodologies in different countries. Examples include sentinel surveillance networks and relevant studies in the UK, Australia, Belgium, the Netherlands, or the Dutch registries and their observational studies, and card studies plus flow charts in American networks.

International networks shared similar infrastructural problems with large national networks in the USA and UK, including study coordination, network logistics, challenges with the management of large data sets, and the costs of big-scale activity. In addition, international networks encountered other problems that emerged from differences between the local and/or national environment (eg, different ethical and regulatory frameworks across different countries); interpretation bias (eg, local differences in understanding of key research concepts); and challenges from different structures of member networks depending on varying levels of development and organization.

In the UK, Dutch, Canadian, and Australian networks, we observed more top-down PBRN governance, although it was not always communicated explicitly. In the American networks, there was more emphasis on practitioner engagement and empowerment (participatory networks). Various governance types defined pathways of practitioner empowerment as well. In this way, top-down networks more commonly implemented audit cycles, educational and degree courses, and academic appointments, whereas more bottom-up type networks more frequently promoted shared resources and learning communities. However, top-down networks also developed learning communities, eg, through the audit cycle sessions of the Dutch networks, and, vice versa, bottom-up networks in the USA promoted the professional development of their members through degree programs.

Financial incentives showed similar patterns. In the UK and Australia, providing PBRN member financial incentives was more common practice, but this type of incentive expanded over time, together with professional credits. Typically, the use of financial incentives seemed more common where top-down governance was prevalent, while the importance of intellectual exchange and development of new knowledge was a superior motivator in bottom-up networks. The use of financial incentives expanded in the last category of networks over time, underscoring the value of the time and effort of practitioners and also indicating a movement from single-practitioner practices, where the practitioner's membership was based on personal motivation, to larger organizations where financial motivators may play a greater role.

Suggestions for Developing New PBRNs

Our review indicated a clear emphasis on specific activities and practices that led to the development of new PBRNs. We summarize these in Table 5.

View this table:
Table 5.

Suggestions for Developing New PBRNs

Limitations

According to our knowledge, this is a seminal and novel scoping review and a mapping of what can be gleaned from the international literature about the establishment of PBRNs in primary care across multiple countries and over a period of more than 50 years. Our ongoing work may be a foundation for future studies on the development of PBRNs; however, this article was limited to the key elements of the main theme “Internal Environment.” Future studies will explore other domains, including the external environment and those spanning the internal and external environments.

We relied only on English-language sources since our team did not have the capacity to review scientific papers in several languages. However, most of the PBRN literature is in English, which favors our approach.

Our decision to review up to 10 years of each network's development can be challenged, since some networks may not need 10 years to develop a mature operation. However, we observed that some pioneer networks developed more gradually without well-tried templates, so we wanted to ensure that we can capture this important process.

The list of PBRNs that met our inclusion criteria is more limited than those identified in the USA,220 Australia,221 the UK,70 and Canada222 and in sources that refer only to specific PBRN activities. We excluded articles that did not contain sufficient information on PBRN establishment. We also omitted data that we found exclusively on PBRN websites without any supporting literature. In some cases, our search of the “gray literature” was extended by communicating with key informants or authors. This approach may result in the omission of some less accessible information.

Scoping reviews may carry some bias of various kinds because a critical appraisal of the included literature's quality is often beyond their scope. Selection bias may occur, if not all available data on a topic are identified or included. In this study, we implemented an inductive thematic analysis methodology. Themes, subthemes, and key elements emerged from the data. However, we purposefully leveraged some well-established a priori knowledge about PBRNs that had a guiding effect on the development of our thematic model.

Conclusions

PBRNs have emerged through reciprocal relationships and interactions between academicians and primary care professionals. They evolved not only as research communities but also as learning organizations with multidirectional communication that shares the new knowledge and best practice innovations across the membership. They had a marked impact on the landscape of primary healthcare of the academic disciplines and became an integral part of primary healthcare practice in their countries. Although there are country- and PBRN-specific features, most facilitators and barriers of developing PBRNs, as viewed from their internal environment, are shared throughout the world and over 5 decades.

Appendix

View this table:
Appendix Table 1.

Types of Organizations That Initiated and Supported PBRNs at Their Establishment and Relevant Quotations

View this table:
Appendix Table 2.

Identical PBRN Missions, Purposes, Goals/Focuses, Objectives, Aims, and Relevant Quotations

View this table:
Appendix Table 3.

Key Activities at Establishment and Relevant Quotations

View this table:
Appendix Table 4.

Example of Practice-Based Research Network Research Training

View this table:
Appendix Table 5.

Example of Synthesis of Key Element “Relationship Building between Academics and Practitioners in the Field”

View this table:
Appendix Table 6.

Example of Synthesis of Key Element “Organizational Leadership”

Notes

  • Received for publication November 16, 2020.
  • Revision received February 9, 2021.
  • Accepted for publication February 10, 2021.

References

  1. 1.↵
    Agency for Healthcare Research and Quality [Internet]. Practice-based research networks; 2016. Available from: https://pbrn.ahrq.gov.
  2. 2.↵
    1. Mold JW,
    2. Pasternak A,
    3. McCaulay A
    , Practice-Based Research Subcommittee of North American Primary Care Research Group Committee on Advancing Science of Family Medicineet al. Definitions of common terms relevant to primary care research. Ann Fam Med 2008;6:570–1.
    OpenUrlFREE Full Text
  3. 3.↵
    1. Robinson G,
    2. Gould M
    . What are the attitudes of general practitioners towards research? Br J Gen Pr 2000;50:390–2.
    OpenUrl
  4. 4.↵
    1. Thomas P,
    2. Griffiths F,
    3. Kai J,
    4. O'Dwyer A
    . Networks for research in primary health care. Br Med J 2001;322:588–90.
    OpenUrlFREE Full Text
  5. 5.↵
    1. Green LA,
    2. Hickner J
    . A short history of primary care practice-based research networks: from concept to essential research laboratories. J Am Board Fam Med 2006;19:1–10.
    OpenUrlFREE Full Text
  6. 6.↵
    1. Fleming DM,
    2. Norbury CA,
    3. Crombie DL
    . Annual and seasonal variation in the incidence of common diseases. Occas Pap R Coll Gen Pract 1991;1–24.
  7. 7.↵
    1. Van Weel C
    . The continuous morbidity registration Nijmegen: background and history of a Dutch general practice database. Eur J Gen Pract 2008;14(Suppl. 1):5–12.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Smith H
    . The Federation of Primary Care Research Networks: a national initiative to enhance networking locally. Prim Heal Care Res Dev 2000;1:3–4.
    OpenUrl
  9. 9.↵
    1. Van Weel C,
    2. Smith H,
    3. Beasley JW
    . Family practice research networks: experiences from 3 countries. J Fam Pract 2000;49.
  10. 10.↵
    1. Gunn JM
    . Should Australia develop primary care research networks? Med J Aust 2002;177:62–6.
    OpenUrlPubMed
  11. 11.↵
    1. Pirotta M,
    2. Temple-Smith M
    . Practice-based research networks. Aust Fam Physician 2017;46:793–5.
    OpenUrl
  12. 12.↵
    1. Van Weel C
    . General practice research networks: gateway to primary care evidence. Med J Aust 2002;177:62–3.
    OpenUrlPubMed
  13. 13.↵
    1. Rhyne RL,
    2. Fagnan LJ
    . Practice-based research network (PBRN) engagement: 20+ years and counting. J Am Board Fam Med 2018;31:833–9.
    OpenUrlFREE Full Text
  14. 14.↵
    1. Willis CD,
    2. Riley BL,
    3. Herbert CP,
    4. Best A
    . Networks to strengthen health systems for chronic disease prevention. Am J Public Health 2013;103:e39–e48.
    OpenUrlCrossRef
  15. 15.↵
    1. Kennedy ED,
    2. Chester P,
    3. Majeed A,
    4. Wallace P,
    5. Matthews DR
    . Networks offer new opportunities for diabetes research. Prim Care Diabetes 2010;4:3–8.
    OpenUrl
  16. 16.↵
    1. Tapp H,
    2. Dulin M
    . The science of primary health-care improvement: potential and use of community-based participatory research by practice-based research networks for translation of research into practice. Exp Biol Med 2010;235:290–9.
    OpenUrlCrossRefPubMed
  17. 17.↵
    1. Dusek JA,
    2. Abrams DI,
    3. Roberts R,
    4. et al
    . Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER) of the BraveNet practice-based research network: study protocol. BMC Complement Altern Med 2015;16.
  18. 18.↵
    1. Baldwin LM,
    2. Keppel GA,
    3. Davis A,
    4. Guirguis-Blake J,
    5. Force RW,
    6. Berg AO
    . Developing a practice-based research network by integrating quality improvement: challenges and ingredients for success. Clin Transl Sci 2012;5:351–5.
    OpenUrlPubMed
  19. 19.↵
    1. Gaglioti AH,
    2. Werner JJ,
    3. Rust G,
    4. Fagnan LJ,
    5. Neale AV
    . Practice-based research networks (PBRNs) bridging the gaps between communities, funders, and policymakers. J Am Board Fam Med 2016;29.
  20. 20.↵
    1. Krist AH,
    2. Green LA,
    3. Phillips RL
    , NAPCRG Health Information Technology Working Groupet al. Health information technology needs help from primary care researchers. J Am Board Fam Med 2015;28:306–10.
    OpenUrlAbstract/FREE Full Text
  21. 21.↵
    1. Pace WD,
    2. Cifuentes M,
    3. Valuck RJ,
    4. Staton EW,
    5. Brandt EC,
    6. West DR
    . An electronic practice-based network for observational comparative effectiveness research. Ann Intern Med 2009;151:338.
    OpenUrlCrossRefPubMed
  22. 22.↵
    1. Nagykaldi Z,
    2. Fox C,
    3. Gallo S,
    4. et al
    . Improving collaboration between primary care research networks using Access Grid technology. Inform Prim Care 2008;16:51–8.
    OpenUrlPubMed
  23. 23.↵
    1. Peterson KA,
    2. Fontaine P,
    3. Speedie S
    . The electronic Primary Care Research Network (ePCRN): a new era in practice-based research. J Am Board Fam Med 2006;19:93–7.
    OpenUrlAbstract/FREE Full Text
  24. 24.↵
    1. Booth M,
    2. Hill G,
    3. Moore MJ,
    4. Dalla D,
    5. Moore MG,
    6. Messenger A
    . The new Australian Primary Health Networks: how will they integrate public health and primary care? Public Heal Res Pract 2016;26.
  25. 25.↵
    Australian Government Department of Health and Ageing. Primary Health Care Research, Evaluation and Development (PHCRED) strategy phase three: 2010–2014; 2010.
  26. 26.↵
    1. Westfall JM,
    2. Mold J,
    3. Fagnan L
    . Practice-based research—“blue highways” on the NIH roadmap. JAMA 2007;297:403–6.
    OpenUrlCrossRefPubMed
  27. 27.↵
    Department for Health. Best research for best health: introducing a new national health research strategy; 2006.
  28. 28.↵
    1. Arksey H,
    2. O'Malley L
    . Scoping studies: towards a methodological framework. Int J Soc Res Methodol Theory Pract 2005;8.
  29. 29.↵
    1. Binstock R,
    2. et al
    1. Moren-Cross J,
    2. Lin N
    . Social networks and social integration. In: Binstock R, et al. editors. Handbook of aging and the social sciences. Academic Press; 2006. p. 111–5.
  30. 30.↵
    1. Thomas P,
    2. Graffy J,
    3. Wallace P,
    4. Kirby M
    . How primary care networks can help integrate academic and service initiatives in primary care. Ann Fam Med 2006;4:235–9.
    OpenUrlAbstract/FREE Full Text
  31. 31.↵
    1. Brass DJ,
    2. Galaskiewicz J,
    3. Greve HR,
    4. Tsai W
    . Taking stock of networks and organizations: a multilevel perspective. Acad Manag J 2004;47.
  32. 32.↵
    1. Braun V,
    2. Clarke V
    . Using thematic analysis in psychology. Qual Res Psychol 2006;3.
  33. 33.↵
    1. Maguire M,
    2. Delahunt B
    . Doing a thematic analysis: a practical, step-by-step guide for learning and teaching scholars. All Irel J Teach Learn High Educ 2017;8.
  34. 34.↵
    1. Vaismoradi M,
    2. Turunen H,
    3. Bondas T
    . Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Heal Sci 2013;15.
  35. 35.↵
    1. Green LA,
    2. Wood M,
    3. Becker L,
    4. et al
    . The Ambulatory Sentinel Practice Network: purpose, methods, and policies. J Fam Pract 1984;18.
  36. 36.↵
    1. Iverson DC,
    2. Calonge N,
    3. Miller RS,
    4. Niebauer LJ,
    5. Reed FM
    . The development and management of a primary care research network. Fam Med 1988;20:1978–87.
    OpenUrl
  37. 37.↵
    1. Rosser WW,
    2. Green L
    . Update from ASPN. Can Fam Physician 1989;35.
  38. 38.↵
    1. Fontaine P,
    2. Mendenhall TJ,
    3. Peterson K,
    4. Speedie SM
    . The “Measuring Outcomes of Clinical Connectivity” (MOCC) trial: investigating data entry errors in the electronic Primary Care Research Network (ePCRN). J Am Board Fam Med 2007;20.
  39. 39.↵
    1. Delaney BC,
    2. Peterson KA,
    3. Speedie S,
    4. Taweel A,
    5. Arvanitis TN,
    6. Richard HF
    . Envisioning a learning health care system: the electronic primary care research network, a case study. Ann Fam Med 2012;10.
  40. 40.↵
    1. Peterson KA,
    2. Delaney BC,
    3. Arvanitis TN,
    4. et al
    . A model for the electronic support of practice-based research networks. Ann Fam Med 2012;10.
  41. 41.↵
    1. Culpepper L,
    2. Froom J
    . The international primary care network: purpose, methods, and policies. Fam Med 1988;20.
  42. 42.↵
    1. Butler CC,
    2. Hood K,
    3. Verheij T,
    4. et al
    . Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries. BMJ 2009;338:b2242.
    OpenUrlAbstract/FREE Full Text
  43. 43.↵
    1. Nuttall J,
    2. Hood K,
    3. Verheij TJ,
    4. et al
    . Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries. BMC Fam Pract 2011;12.
  44. 44.↵
    1. del Torso S,
    2. van Esso D,
    3. Gerber A,
    4. et al
    . European Academy of Paediatrics Research in Ambulatory Setting Network (EAPRASnet): a multi-national general paediatric research network for better child health. Child Care Health Dev 2010;36.
  45. 45.↵
    1. Lamont R,
    2. Fishman T,
    3. Sanders PF,
    4. ‘Ofanoa M,
    5. Goodyear-Smith F
    . View from the canoe: co-designing research Pacific style. Ann Fam Med 2020;18:172–5.
    OpenUrlAbstract/FREE Full Text
  46. 46.↵
    1. Clothier HJ,
    2. Fielding JE,
    3. Kelly HA
    . An evaluation of the Australian Sentinel Practice Research Network (ASPREN) surveillance for influenza-like illness. Commun Dis Intell 2005;29.
  47. 47.↵
    1. Schweikardt C,
    2. Verheij RA,
    3. Donker GA,
    4. Coppieters Y
    . The historical development of the Dutch Sentinel General Practice Network from a paper-based into a digital primary care monitoring system. J Public Heal 2016;24.
  48. 48.↵
    1. Volmink JA,
    2. Furman SN
    . The South African Sentinel Practitioner Research Network Organization, Objectives, Policies and Methods; 1991.
  49. 49.↵
    1. Fleming DM
    . Weekly returns service of the Royal College of General Practitioners. Commun Dis Public Heal 1999;2:96–100.
    OpenUrl
  50. 50.↵
    1. Cooke J,
    2. Nancarrow S,
    3. Dyas J,
    4. Williams M
    . An evaluation of the “designated research team” approach to building research capacity in primary care. BMC Fam Pract 2008;9.
  51. 51.↵
    1. Abbott S,
    2. Gunnell C
    . Developing R&D capacity in primary care nursing: report of a research project. Prim Health Care Res Dev 2005;6:95–100.
    OpenUrl
  52. 52.↵
    1. Carter Y
    . Research opportunities in primary care. Radcliffe Medical Press; 1998.
  53. 53.↵
    1. Anderko L,
    2. Lundeen S,
    3. Bartz C
    . The Midwest Nursing Centers Consortium Research Network: translating research into practice. Policy Polit Nurs Pract 2006;7:101–9.
    OpenUrlCrossRefPubMed
  54. 54.↵
    1. Nelson EC,
    2. Kirk JW,
    3. Bise BW,
    4. et al
    . The cooperative information project: part 2: some initial clinical, quality assurance, and practice management studies. J Fam Pract 1981;13.
  55. 55.↵
    1. Wasserman R,
    2. Serwint JR,
    3. Kuppermann N,
    4. Srivastava R,
    5. Dreyer B
    . The APA and the rise of pediatric generalist network research. Acad Pediatr 2011;11:195–204.
    OpenUrlCrossRefPubMed
  56. 56.↵
    1. Solberg LI,
    2. Cole PM,
    3. Seifert MH
    . The Minnesota Academy of Family Physicians' Research Network: a vehicle for practice-based research. Minn Med 1986;69.
  57. 57.↵
    1. Middelkoop BJC,
    2. Bohnen AM,
    3. Duisterhout JS,
    4. Hoes AW,
    5. Pleumeekers HJCM,
    6. Prins A
    . Rotterdam General Practitioners Report (ROHAPRO): a computerised network of general practices in Rotterdam, The Netherlands. J Epidemiol Community Health 1995;49:231–3.
    OpenUrlAbstract/FREE Full Text
  58. 58.↵
    1. Davies J,
    2. Heyman B,
    3. Bryar R,
    4. et al
    . The research potential of practice nurses. Heal Soc Care Community 2002;10:370–81.
    OpenUrl
  59. 59.↵
    1. Davies J,
    2. Heyman B,
    3. Bryar R,
    4. et al
    . Building practice nurse research capacity. Pract Nurs 2002;13:449–53.
    OpenUrl
  60. 60.↵
    1. Sullivan F,
    2. Hinds A,
    3. Pitkethly M,
    4. Treweek S,
    5. Wilson P,
    6. Wyke S
    . Primary care research network progress in Scotland. Eur J Gen Pract 2014;20.
  61. 61.↵
    1. Hannay DR
    . Evaluation of a primary care research network in rural Scotland. Prim Heal Care Res Dev 2006;7.
  62. 62.↵
    1. Comino E,
    2. Zwar NA,
    3. Hermiz OH
    . PHReNet: a general practice research network in South Western Sydney, Australia; 2002.
  63. 63.↵
    1. Waters RL,
    2. Weston KM,
    3. Farmer E
    [Internet]. Linking primary health care researchers in South Australia: a network strategy; 2004. Available from: https://ro.uow.edu.au/cgi/viewcontent.cgi?article=1564&context=medpapers.
  64. 64.↵
    1. Ried K,
    2. Farmer EA,
    3. Weston KM
    . Setting directions for capacity building in primary health care: a survey of a research network. BMC Fam Pract 2006;7.
  65. 65.↵
    1. Ried K,
    2. Farmer EA,
    3. Weston KM
    . Bursaries, writing grants and fellowships: a strategy to develop research capacity in primary health care. BMC Fam Pract 2007;8:13.
    OpenUrlPubMed
  66. 66.↵
    1. Soós M,
    2. Temple-Smith M,
    3. Gunn J,
    4. Johnston-Ata'Ata K,
    5. Pirotta M
    . Establishing the Victorian primary care practice based research network. Aust Fam Physician 2010;39.
  67. 67.↵
    1. Dijkmans-Hadley B,
    2. Bonney A,
    3. Barnett SR
    . Development of an Australian practice-based research network as a community of practice. Aust J Prim Health 2015;21.
  68. 68.↵
    1. Robertson S,
    2. Hornby C,
    3. Jones R
    . Joint working to develop R&D capacity in three rural primary care trusts. Prim Health Care Res Dev 2005;6:1–4.
    OpenUrl
  69. 69.↵
    Trent Focus Group. For the promotion of research and development in primary health care: annual report 1996–97; 1997.
  70. 70.↵
    1. Comino E
    [Internet]. The Winston Churchill Memorial Trust of Australia Churchill Fellowship 2002: primary health care research (networks) in the United Kingdom. Available from: http://nswcfa.churchilltrust.com.au/media/fellows/Comino_Elizabeth_2002-1.pdf.
  71. 71.↵
    1. Cooke J,
    2. Owen J,
    3. Wilson A
    . Research and development at the health and social care interface in primary care: a scoping exercise in one National Health Service region. Heal Soc Care Community 2002;10.
  72. 72.↵
    1. Graffy J,
    2. Hines M,
    3. Fosam H
    . Annual Report for ELENoR; 2002.
  73. 73.↵
    1. Pitkethly M,
    2. Sullivan F N
    . Four years of TayRen, a primary care research and development network. Prim Heal Care Res Dev 2003;4.
  74. 74.↵
    1. Porcheret M,
    2. Hughes R,
    3. Evans D,
    4. et al
    . Data quality of general practice electronic health records: the impact of a program of assessments, feedback, and training. J Am Med Informatics Assoc 2004;11.
  75. 75.↵
    1. Sullivan F,
    2. Butler C,
    3. Cupples M,
    4. Kinmonth AL
    . Primary care research networks in the United Kingdom. Br Med J 2007;334:1093–4.
    OpenUrlFREE Full Text
  76. 76.↵
    1. Visentin GR
    . The multiple meaning of a research project in general practice. Eur J Clin Nutr 2005;59:S89–S92.
    OpenUrl
  77. 77.↵
    1. Okkes IM,
    2. Groen A,
    3. Oskam SK,
    4. Lamberts H
    . Advantages of long observation in episode-oriented electronic patient records in family practice. Methods Inf Med 2001;40:229–35.
    OpenUrlPubMed
  78. 78.↵
    1. Smith HD,
    2. Dunleavey J
    . Wessex primary care research network: a report on two years progress. Southampt Heal J 1996;3:43–7.
    OpenUrl
  79. 79.↵
    1. Duggan A,
    2. Minkovitz CS,
    3. Chaffin M,
    4. et al
    . Creating a national home visiting research network. Pediatrics 2013;132:S82–S89.
    OpenUrlAbstract/FREE Full Text
  80. 80.↵
    1. Adams J,
    2. Steel A,
    3. Moore C,
    4. Amorin-Woods L,
    5. Sibbritt D
    . Establishing the ACORN National Practitioner Database: strategies to recruit practitioners to a national practice-based research network. J Manipulative Physiol Ther 2016;39:594–602.].
    OpenUrl
  81. 81.↵
    1. Tyler CV,
    2. Werner JJ
    . Community-engagement strategies of the Developmental Disabilities Practice-Based Research Network (DD-PBRN). J Am Board Fam Med 2014;27.
  82. 82.↵
    1. Frayne SM,
    2. Carney DV,
    3. Bastian L,
    4. et al
    . The VA women's health practice-based research network: amplifying women veterans' voices in VA research. J Gen Intern Med 2013;28:504–9.
    OpenUrlPubMed
  83. 83.↵
    1. Jensen IB,
    2. Brämberg EB,
    3. Wåhlin C,
    4. et al
    . Promoting evidence-based practice for improved occupational safety and health at workplaces in Sweden: report on a practice-based research network approach. IJERPH 2020;17:5283–15.
    OpenUrl
  84. 84.↵
    1. Dovey SM,
    2. Tilyard MW
    . The computer research network of the Royal New Zealand College of General Practitioners: an approach to general practice research in New Zealand. Br J Gen Pract 1996;46.
  85. 85.↵
    1. Pickstone C,
    2. Nancarrow SA,
    3. Cooke JM,
    4. et al
    . Building research capacity in the allied health professions. Evid Policy 2008;4:53–68.
    OpenUrlCrossRef
  86. 86.↵
    1. Thomas P,
    2. While A
    . Increasing research capacity and changing the culture of primary care towards reflective inquiring practice: the experience of the West London research network (WeLReN). J Interprof Care 2001;15.
  87. 87.↵
    1. Lieberman MI
    [Internet]. Medical Quality Improvement Consortium (MQIC) presentation; 2006. Available from: https://www.amia.org/sites/amia.org/files/2006-Policy-Meeting-Medical-2006-Policy-Meeting-Quality-Improvement-Consortium.pdf.
  88. 88.↵
    1. Sills MR
    [Internet]. SAFTINet overview for EDRC: presented to the Emergency Department Research Committee, Department of Pediatrics, University of Colorado School of Medicine; 2015 [cited 2020 June 29]. Available from: https://www.slideshare.net/MarionSills/saftinet-overview-for-edrc.
  89. 89.↵
    1. O'Regan A,
    2. Hayes P,
    3. O'Connor R,
    4. et al
    . The University of Limerick Education and Research Network for General Practice (ULEARN-GP): practice characteristics and general practitioner perspectives. BMC Fam Pract 2020;21:25.
    OpenUrlCrossRefPubMed
  90. 90.↵
    1. DeVoe JE,
    2. Gold R,
    3. Spofford M,
    4. et al
    . Developing a network of community health centers with a common electronic health record: description of the Safety Net West Practice-Based Research Network (SNW-PBRN). J Am Board Fam Med 2011;24.
  91. 91.↵
    1. Ornstein SM,
    2. Jenkins RG
    . The Practice Partner Research Network: description of a novel national research network of computer-based patient records users. Carolina Heal Serv Policy Rev 1997;4:145–51.
    OpenUrl
  92. 92.↵
    1. DeVoe JE,
    2. Likumahuwa S,
    3. Eiff MP,
    4. et al
    . Lessons learned and challenges ahead: report from the OCHIN Safety Net West Practice-Based Research Network (PBRN). J Am Board Fam Med 2012;25:560–4.
    OpenUrlAbstract/FREE Full Text
  93. 93.↵
    1. Kwan BM,
    2. Sills MR,
    3. Graham D,
    4. et al
    . Stakeholder engagement in a patient-reported outcomes (PRO) measure implementation: a report from the SAFTINet practice-based research network (PBRN). J Am Board Fam Med 2016;29:102–15.
    OpenUrlAbstract/FREE Full Text
  94. 94.↵
    1. Rodnick JE,
    2. Francisco S
    . Papers by family physicians that have influenced the way i practice. J Fam Pract 1999; 48. Available from: https://www.mdedge.com/familymedicine/article/183548/papers-family-physicians-have-influenced-way-i-practice.
  95. 95.↵
    1. Stephens KA,
    2. Lin C-P,
    3. Baldwin L-M,
    4. et al
    . LC Data QUEST: a technical architecture for community federated clinical data sharing. AMIA Jt Summits Transl Sci 2012;2012:57–62.
    OpenUrl
  96. 96.↵
    1. Slora EJ,
    2. Wasserman RC
    . PROS: a research network to enhance practice and improve child health. Pediatr Ann 2010;39:352–61.
    OpenUrlCrossRefPubMed
  97. 97.↵
    1. McCloskey B,
    2. Grey M,
    3. Deshefy-Longhi T,
    4. Grey LJ
    . APRN practice patterns in primary care. Nurse Pract 2003;28:39–44.
    OpenUrlPubMed
  98. 98.↵
    1. Pearce KA,
    2. Love MM,
    3. Barron MA,
    4. Matheny SC,
    5. Mahfoud Z
    . How and why to study the practice content of a practice-based research network. Ann Fam Med 2004;2.
  99. 99.↵
    1. Kuo GM,
    2. Steinbauer JR,
    3. Spann SJ
    . Conducting medication safety research projects in a primary care physician practice-based research network. J Am Pharm Assoc 2008;48.
  100. 100.↵
    1. Ried K,
    2. Farmer EA,
    3. Weston KM
    . Setting directions for capacity building in primary health care: a survey of a research network. BMC Fam Pract 2006;7:1–11.
    OpenUrlCrossRefPubMed
  101. 101.↵
    1. Vessey JA
    . A practice-based research network to improve the quality of school nursing practice. J Sch Nurs 2007;23.
  102. 102.↵
    1. Gibson K,
    2. Szilagyi P,
    3. Swanger CM,
    4. et al
    . Physician perspectives on incentives to participate in practice-based research: a Greater Rochester practice-based research network (GR-PBRN) study. J Am Board Fam Med 2010;23.
  103. 103.↵
    1. Liaw ST,
    2. Taggart J,
    3. Dennis S,
    4. Yeo A
    . Data quality and fitness for purpose of routinely collected data—a general practice case study from an electronic practice-based research network (ePBRN). AMIA Annu Symp Proc 2011;2011:785–94.
    OpenUrlPubMed
  104. 104.↵
    1. Green LA,
    2. Hames CG,
    3. Nutting PA
    . Potential of practice-based research networks: experiences from ASPN. J Fam Pract 1994;38.
  105. 105.↵
    1. Kwan BM,
    2. Graham D,
    3. Sills M,
    4. et al
    . SAFTINet: Scalable Architecture for Federated Translational Inquiries Network methods for the collection of patient reported outcomes in a safety net-oriented practice based research network: a SAFTINet demonstration project patient—reported outcome; 2015.
  106. 106.↵
    1. Boydell L,
    2. Grandidier H,
    3. Rafferty C,
    4. McAteer C,
    5. Reilly P
    . General practice data retrieval: The Northern Ireland project. J Epidemiol Community Health 1995;49:22–5.
    OpenUrlAbstract/FREE Full Text
  107. 107.↵
    1. Dulin MF
    . The creation of PBRN to study health care delivery to a transitioning community (HS16023); 2005.
  108. 108.↵
    1. Likumahuwa S,
    2. Song H,
    3. Singal R,
    4. et al
    . Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report. J Am Board Fam Med 2013;26.
  109. 109.↵
    1. Metsemakers JFM,
    2. Hoppener P,
    3. Knottnerus JA,
    4. Kocken RJJ,
    5. Limonard CBG
    . Computerized health information in the Netherlands: a registration network of family practices. Br J Gen Pract 1992;42.
  110. 110.↵
    1. DeVoe JE,
    2. Sears A
    . The Ochin community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village. J Am Board Fam Med 2013;26:271–8.
    OpenUrlAbstract/FREE Full Text
  111. 111.↵
    1. Sardell A
    . Clinical networks and clinician retention: the case of CDN. J Community Health 1996;21:437–51.
    OpenUrlCrossRefPubMed
  112. 112.↵
    1. Mold JW,
    2. Peterson KA
    . Primary care practice-based research networks: working at the interface between research and quality improvement. Ann Fam Med 2005;3.
  113. 113.↵
    1. Mold JW,
    2. Barton ED
    . OAFP starts practice-based resource/research network. J Okla State Med Assoc 1996;89.
  114. 114.↵
    1. Serwint JR
    . Multisite survey of pediatric residents' continuity experiences: their perceptions of the clinical and educational opportunities. Pediatrics 2001;107:e78.
    OpenUrlAbstract/FREE Full Text
  115. 115.↵
    1. Fagnan LJ
    . ORPRN “Blue Highways” reflections; 2018.
  116. 116.↵
    1. Libby AM,
    2. Pace W,
    3. Bryan C,
    4. et al
    . Comparative effectiveness research in DARTNet primary care practices: point of care data collection on hypoglycemia and over-the-counter and herbal use among patients diagnosed with diabetes. Med Care 2010;48(Suppl.).
  117. 117.↵
    1. Cole AM,
    2. Stephens KA,
    3. Keppel GA,
    4. Lin CP,
    5. Baldwin LM
    . Implementation of a health data-sharing infrastructure across diverse primary care organizations. J Ambul Care Manage 2014;37:164–70.
    OpenUrl
  118. 118.↵
    1. Koskela TH
    . Building a primary care research network—lessons to learn. Scand J Prim Health Care 2017;35.
  119. 119.↵
    1. Davies J,
    2. Heyman B,
    3. Bryar R,
    4. et al
    . Building practice nurse research capacity. Pract Nurs 2002;13.
  120. 120.↵
    1. Graham DG,
    2. Spano MS,
    3. Stewart TV,
    4. Staton EW,
    5. Meers A,
    6. Pace WD
    . Strategies for planning and launching PBRN research studies: a project of the Academy of Family Physicians National Research Network (AAFP NRN). J Am Board Fam Med 2007;20.
  121. 121.↵
    1. Burge SK,
    2. Hill JH
    . The medical student summer research program in family medicine. Fam Med 2014;46:45–8.
    OpenUrl
  122. 122.↵
    1. Kavanagh KE,
    2. O'Brien N,
    3. Glynn LG,
    4. Vellinga A,
    5. Murphy AW
    . WestREN: a description of an Irish academic general practice research network. BMC Fam Pract 2010;11.
  123. 123.↵
    Trent Focus Group. For the promotion of research and development in primary health care: annual report 2000-2001; 2001.
  124. 124.↵
    1. Beasley JW,
    2. Cox NS,
    3. Livingston BT
    . Development and operation of the Wisconsin Research Network. Wis Med J 1991;90.
  125. 125.↵
    Pearls of Research [Internet]. American Academy of Family Physicians. Practice-based research networks in the 21st century; 1998. Available from: https://www.aafp.org/dam/AAFP/documents/patient_care/nrn/pearlsofresearch.pdf.
  126. 126.↵
    1. Birtwhistle R,
    2. Keshavjee K,
    3. Lambert-Lanning A,
    4. et al
    . Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward. J Am Board Fam Med 2009;22.
  127. 127.↵
    1. Croughan-Minihane MS,
    2. Thom DH,
    3. Petitti DB
    . Research interests of physicians in two practice-based primary care research networks. West J Med 1999;170:19–24.
    OpenUrlPubMed
  128. 128.↵
    IPCRN [Internet]. Irish Primary Care Research Network [cited 2017 May 17]. Available from: http://www.ipcrn.ie/.
  129. 129.↵
    1. Sayer GP,
    2. McGeechan K,
    3. Kemp A,
    4. et al
    . The general practice research network: the capabilities of an electronic patient management system for longitudinal patient data. Pharmacoepidemiol Drug Saf 2003;12.
  130. 130.↵
    1. Nelson EC,
    2. Kirk JW,
    3. Bise BW,
    4. et al
    . The Cooperative Information Project: part 1: a sentinel practice network for service and research in primary care. J Fam Pract 1981;13.
  131. 131.↵
    1. Williamson HA,
    2. Hector MG,
    3. LeFevre M,
    4. White RD
    . Establishing a rural family practice research network. Fam Med 1988;20.
  132. 132.↵
    1. Wasserman RC,
    2. Slora EJ,
    3. Bocian AB,
    4. et al
    . Pediatric Research in Office Settings (PROS): a national practice-based research network to improve children's health care. Pediatrics 1998;102:1350–7.
    OpenUrlAbstract/FREE Full Text
  133. 133.↵
    1. Peterson KA,
    2. Lipman PD,
    3. Lange CJ,
    4. Cohen RA,
    5. Durako S
    . Supporting better science in primary care: a description of practice-based research networks (PBRNs) in 2011. J Am Board Fam Med 2012;25.
  134. 134.↵
    1. Love MM,
    2. Pearce KA,
    3. Williamson MA,
    4. Barron MA,
    5. Shelton BJ
    . Patients, practices, and relationships: challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial. J Am Board Fam Med 2006;19:75–84.
    OpenUrlAbstract/FREE Full Text
  135. 135.↵
    National Institute for Health Research, Clinical Research Network. LCRN guidance suite: provision of infratsructure support for research delivery in primary care settings. Vol V2.0.; 2014.
  136. 136.↵
    1. Laurence CO,
    2. Beilby JJ,
    3. Marley JE,
    4. Newbury J,
    5. Wilkinson D,
    6. Symon B
    . Establishing a practice based primary care research network: the University Family Practice Network in South Australia. Aust Fam Physician 2001;30.
  137. 137.↵
    1. Schers H,
    2. Bor H,
    3. van den Hoogen H,
    4. van Weel C
    . What went and what came? Morbidity trends in general practice from the Netherlands. Eur J Gen Pract 2008;14:13–24.
    OpenUrlCrossRefPubMed
  138. 138.↵
    1. Osborn EH,
    2. Petitti DB
    . Physician interest in collaborative research. J Am Board Fam Pract 1988;1.
  139. 139.↵
    1. Anderko L,
    2. Bartz C,
    3. Lundeen S
    . Practice-based research networks: nursing centers and communities working collaboratively to reduce health disparities. Nurs Clin North Am 2005;40.
  140. 140.↵
    1. Sloane PD,
    2. Callahan L,
    3. Kahwati L,
    4. Mitchell CM
    . Development of a practice-based patient cohort for primary care research. Fam Med 2006;38.
  141. 141.↵
    Trent Focus Group. For the promotion of research and development in primary health care: annual report 1999–2000; 1999.
  142. 142.↵
    1. Thomas P,
    2. Griffiths F,
    3. Kai J,
    4. O'Dwyer A
    . Primary care networks for research in primary health care. Br Med J 2001;322:588–90.
    OpenUrlFREE Full Text
  143. 143.↵
    1. Magin PJ,
    2. Marshall MJ,
    3. Goode SM,
    4. Cotter GL,
    5. Pond CD,
    6. Zwar NA
    . How generalisable are results of studies conducted in practice-based research networks? A cross-sectional study of general practitioner demographics in two New South Wales networks. Med J Aust 2011;195.
  144. 144.↵
    1. De Clercq E,
    2. Vandenberghe H,
    3. Jonckheer P,
    4. Bastiaens H,
    5. Lafontane MF,
    6. Van Gasteren V
    . Assessment of a three-year experience with a Belgian primary care data network. Stud Health Technol Inform 2002;93.
  145. 145.↵
    1. Marley J
    . Establishing a rural research network. Med J Aust 1992;156.
  146. 146.↵
    1. Volmink J
    . SASPREN—a new development in family practice research in South Africa. South African Med J 1996;86.
  147. 147.↵
    1. Truyers C,
    2. Goderis G,
    3. Dewitte H,
    4. Akker MV,
    5. Buntinx F
    . The Intego database: background, methods and basic results of a Flemish general practice-based continuous morbidity registration project. BMC Med Inform Decis Mak 2014;14.
  148. 148.↵
    1. Carsley S,
    2. Borkhoff CM,
    3. Maguire JL,
    4. et al
    . Cohort profile: the Applied Research Group for Kids (TARGet Kids!). Int J Epidemiol 2015;44.
  149. 149.↵
    1. Morinis J,
    2. Maguire J,
    3. Khovratovich M,
    4. McCrindle BW,
    5. Parkin PC,
    6. Birken CS
    . Paediatric obesity research in early childhood and the primary care setting: the TARGet Kids! research network. IJERPH 2012;9:1343–54.
    OpenUrl
  150. 150.↵
    1. Laux G,
    2. Koerner T,
    3. Rosemann T,
    4. Beyer M,
    5. Gilbert K,
    6. Szecsenyi J
    . The CONTENT project: a problem-oriented, episode-based electronic patient record in primary care. Inform Prim Care 2005;13.
  151. 151.↵
    1. Metsemakers JFM,
    2. Knottnerus JA,
    3. Van Schendel GJ,
    4. Kocken RJJ,
    5. Limonard CBG
    . Unlocking patients' records in general practice for research, medical education and quality assurance: the Registration Network Family Practices. Int J Biomed Comput 1996;42:1–2.
    OpenUrlCrossRefPubMed
  152. 152.↵
    1. Taggart J,
    2. Liaw ST,
    3. Dennis S,
    4. et al
    . The University of NSW electronic practice based research network: disease registers, data quality and utility. Stud Heal Technol Inform 2012;178.
  153. 153.↵
    1. Pace WD,
    2. Fox C,
    3. White T,
    4. Graham D,
    5. Schilling LM,
    6. West DR
    . The DARTNet Institute: seeking a sustainable support mechanism for electronic data enabled research networks. eGEMs 2014;2:6.
    OpenUrl
  154. 154.↵
    1. Dillon P,
    2. O'Brien KK,
    3. McDonnell R,
    4. et al
    . Prevalence of prescribing in pregnancy using the Irish primary care research network: a pilot study. BMC Pregnancy Childbirth 2015;15.
  155. 155.↵
    1. Boffin N,
    2. Bossuyt N,
    3. Vanthomme K,
    4. Van Casteren V
    . Readiness of the Belgian network of sentinel general practitioners to deliver electronic health record data for surveillance purposes: results of survey study. BMC Fam Pract 2010;11.
  156. 156.↵
    1. Fagnan LJ,
    2. Morris C,
    3. Shipman SA,
    4. Holub J,
    5. King A,
    6. Angier H
    . Characterizing a practice-based research network: Oregon rural practice-based research network (ORPRN) survey tools. J Am Board Fam Med 2007;20.
  157. 157.↵
    1. Dulin MF,
    2. Tapp H,
    3. Smith HA,
    4. Urquieta D. H B,
    5. Furuseth OJ
    . A community based participatory approach to improving health in a Hispanic population. Implement Sci 2011;6.
  158. 158.↵
    1. Fleming DM,
    2. Crombie DL
    . The incidence of common infectious diseases: the weekly returns service of the Royal College of General Practitioners. Health Trends 1985;17.
  159. 159.↵
    1. Birtwhistle RV
    . Canadian Primary Care Sentinel Surveillance Network: a developing resource for family medicine and public health. Can Fam Physician 2011;57.
  160. 160.↵
    1. Wasserman RC,
    2. Croft CA,
    3. Brotherton SE
    . Preschool vision screening in pediatric practice: a study from the Pediatric Research in Office Settings (PROS) network. Pediatrics 1992;89:834–8.
    OpenUrlAbstract/FREE Full Text
  161. 161.↵
    1. Lobet MP,
    2. Stroobant A,
    3. Mertens R,
    4. et al
    . Tool for validation of the network of sentinel general practitioners in the Belgian health care system. Int J Epidemiol 1987;16:612–8.
    OpenUrlCrossRefPubMed
  162. 162.↵
    AAFP [Internet]. Affiliated PBRNs–National Research Network [cited 2020 Aug 13]. Available from: https://www.aafp.org/patient-care/nrn/nrn/pbrns.html.
  163. 163.↵
    PBRN Resource Center A. Centers for Primary Care Practice-Based Research and Learning: nurture partnerships, method development, and trans-network collaborations; n.d.
  164. 164.↵
    1. Lindbloom EJ,
    2. Ewigman BG,
    3. Hickner JM
    . Practice-based research networks: the laboratories of primary care research. Med Care 2004;42(Suppl).
  165. 165.↵
    1. Schilling LM,
    2. Kwan BM,
    3. Drolshagen CT,
    4. et al
    . Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) Technology Infrastructure for a Distributed Data Network. eGEMs 2013;1:11.
    OpenUrl
  166. 166.↵
    1. Vessey JA
    , the Founding Oversight Board Members of MASNRN. Development of the Massachusetts School Nurse Research Network (MASNRN): a practice-based research network to improve the quality of school nursing practice. J Sch Nurs 2007;23:65–72.
    OpenUrlCrossRefPubMed
  167. 167.↵
    1. LeBailly S,
    2. Ariza A,
    3. Bayldon B,
    4. Binns HJ
    . The origin and evolution of a regional pediatric practice-based research network: practical and methodological lessons from the Pediatric Practice Research Group. Curr Probl Pediatr Adolesc Health Care 2003;33.
  168. 168.↵
    1. Nagykaldi Z,
    2. Mold JW,
    3. Aspy CB
    . Practice facilitators: a review of the literature. Fam Med 2005;37:581–8.
    OpenUrlPubMed
  169. 169.↵
    1. Deshefy-Longhi T,
    2. Swartz MK,
    3. Grey M
    . Establishing a practice-based research network of advanced practice registered nurses in southern New England. Nurs Outlook 2002;50:127–31.
    OpenUrlCrossRefPubMed
  170. 170.↵
    1. Christoffel KK,
    2. Binns HJ,
    3. Stockman JA,
    4. et al
    . Practice-based research: opportunities and obstacles. Pediatrics 1988;82.
  171. 171.↵
    1. Solberg LI,
    2. Mayer TR,
    3. Seifert M,
    4. Cole PM
    . The Minnesota AFP research panel: a model for collaborative practicing family physician research. Fam Med 1983;15:139–42.
    OpenUrl
  172. 172.↵
    1. Hayes H,
    2. Parchman ML,
    3. Howard R
    . A logic model framework for evaluation and planning in a primary care practice-based research network (PBRN). J Am Board Fam Med 2011;24.
  173. 173.↵
    1. Williams RL,
    2. McPherson L,
    3. Kong A,
    4. Skipper B,
    5. Weller N
    . Internet-based training in a practice-based research network consortium: a report from the primary care multiethnic network (PRIME Net). J Am Board Fam Med 2009;22.
  174. 174.↵
    1. Volmink J,
    2. Laubscher J,
    3. Furman S
    . The SASPREN primary care survey—who consults the family doctor? South African Med J 1996;86.
  175. 175.↵
    1. Serwint JR,
    2. Thoma KA,
    3. Dabrow SM
    , for the CORNET Investigators, et al. Comparing patients seen in pediatric resident continuity clinics and National Ambulatory Medical Care Survey practices: a study from the Continuity Research Network. Pediatrics 2006;118:e849–e858.
    OpenUrlAbstract/FREE Full Text
  176. 176.↵
    1. Selby K,
    2. Cornuz J,
    3. Senn N
    . Establishment of a representative practice-based research network (PBRN) for the monitoring of primary care in Switzerland. J Am Board Fam Med 2015;28.
  177. 177.↵
    1. Galliher JM,
    2. Bonham AJ,
    3. Dickinson LM,
    4. Staton EW,
    5. Pace WD
    . Representativeness of PBRN physician practice patterns and related beliefs: the case of the AAFP National Research Network. Ann Fam Med 2009;7:547–54.
    OpenUrlAbstract/FREE Full Text
  178. 178.↵
    1. Slora EJ,
    2. Thoma KA,
    3. Wasserman RC,
    4. Pedlow SE,
    5. Bocian AB
    . Patient visits to a national practice-based research network: comparing pediatric research in office settings with the National Ambulatory Medical Care Survey. Pediatrics 2006;118:e228–e234.
    OpenUrlAbstract/FREE Full Text
  179. 179.↵
    1. De VP
    . Home violence in South Africa: surveillance during 1996 by SASPREN, a sentinel network of general/family practitioners: SASPREN news. South Africa Fam Pract 1998;19.
  180. 180.↵
    1. Green LA,
    2. Miller RS,
    3. Reed FM,
    4. Iverson DC,
    5. Barley GE
    . How representative of typical practice are practice-based research networks? A report from the Ambulatory Sentinel Practice Network Inc (ASPN). Arch Fam Med 1993;2:939–49.
    OpenUrlCrossRefPubMed
  181. 181.↵
    1. Nutting PA,
    2. Baier M,
    3. Werner JJ,
    4. Cutter G,
    5. Reed FM,
    6. Orzano AJ
    . Practice patterns of family physicians in practice-based research networks: a report from ASPN. J Am Board Fam Pract 1999;12:278–84.
    OpenUrlAbstract/FREE Full Text
  182. 182.↵
    1. Van den Akker M,
    2. Buntix F,
    3. Metsemakers JFM,
    4. Roos S,
    5. Knottnerus JA
    . Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 1998;51.
  183. 183.↵
    1. Gourlay ML,
    2. Lewis CL,
    3. Preisser JS,
    4. Mitchell CM,
    5. Sloane PD
    . Perceptions of informed decision making about cancer screening in a diverse primary care population. Fam Med 2010;42:421–7.
    OpenUrlPubMed
  184. 184.↵
    1. Mold J,
    2. Gregory ME
    . Best practices research. Fam Med 2003;35:131–4.
    OpenUrlPubMed
  185. 185.↵
    1. Gill JM,
    2. Chen YX,
    3. Grimes A,
    4. Klinkman MS
    . Using electronic health record-based tools to screen for bipolar disorder in primary care patients with depression. J Am Board Fam Med 2012;25:283–90.
    OpenUrlAbstract/FREE Full Text
  186. 186.↵
    1. Venmans LMAJ,
    2. Hak E,
    3. Gorter KJ,
    4. Rutten GEHM
    . Incidence and antibiotic prescription rates for common infections in patients with diabetes in primary care over the years 1995 to 2003. Int J Infect Dis. 2009;13.
  187. 187.↵
    1. Chmiel C,
    2. Bhend H,
    3. Senn O,
    4. et al
    . The FIRE project: a milestone for research in primary care in Switzerland. Swiss Med Wkly 2011;141:1–7.
    OpenUrl
  188. 188.↵
    1. Pace WD,
    2. West DR,
    3. Valuck RJ,
    4. Cifuentes M,
    5. Staton EW
    . Distributed Ambulatory Research in Theurapeutics Network (DARTNet): summary report; 2009.
  189. 189.↵
    1. Slawson DC,
    2. Herman JM,
    3. Bennett JH
    . Single community research networks: the HARNET experience. Arch Fam Med 1993;2:725–8.
    OpenUrlCrossRefPubMed
  190. 190.↵
    1. Green LA,
    2. White LL,
    3. Barry HC,
    4. Nease DE,
    5. Hudson BL
    . Infrastructure requirements for practice-based research networks. Ann Fam Med 2005;3.
  191. 191.↵
    1. Harvey J,
    2. Fenton E,
    3. Sturt J
    . Evaluation of primary care R&D networks in North Thames region: final report; 2002.
  192. 192.↵
    1. Tierney WM,
    2. Oppenheimer CC,
    3. Hudson BL,
    4. et al
    . A national survey of primary care practice-based research networks. Ann Fam Med 2007;5.
  193. 193.↵
    1. Griswold KS
    . Communities of solution: the Folsom report revisited. Ann Fam Med 2012;10:250–60.
    OpenUrlAbstract/FREE Full Text
  194. 194.↵
    Primary Care MultiEthnic Network (PRIMENet) [Internet]. 2020. [cited 2020 Nov 29]. Available from: http://www.prime-net-consortium.org/.
  195. 195.↵
    1. Darbyshire J,
    2. Sitzia J,
    3. Cameron D,
    4. et al
    . Extending the clinical research network approach to all of healthcare. Ann Oncol 2011;22.
  196. 196.↵
    1. Binienda J,
    2. Neale AV,
    3. Wallace LS
    . Future directions for practice-based research networks (PBRNs): a CERA survey. J Am Board Fam Med 2018;31.
  197. 197.↵
    1. Mayo M,
    2. Meindl JR,
    3. Pastor JC
    . Shared leadership in work teams: a social network approach. In: Shared leadership: reframing the hows and whys of leadership. London: SAGE; 2003.
  198. 198.↵
    1. Burt RS
    . Social contagion and innovation: cohesion versus structural equivalence. Am J Sociol 1987;92.
  199. 199.↵
    1. Liu W,
    2. Sidhu A,
    3. Beacom AM,
    4. Valente TW
    . Social network theory. In: The international encyclopedia of media effects. Hoboken (NJ): Wiley; 2017. p. 1–12.
  200. 200.↵
    1. Crossland L,
    2. Janamian T,
    3. Jackson CL
    . Key elements of high-quality practice organisation in primary health care: a systematic review. Med J Aust 2014;201.
  201. 201.↵
    1. Solberg LI,
    2. Hroscikoski MC,
    3. Sperl-Hillen JAM,
    4. Harper PG,
    5. Crabtree BF
    . Transforming medical care: case study of an exemplary, small medical group. Ann Fam Med 2006;4.
  202. 202.↵
    1. Van Weel C
    . Longitudinal research and data collection in primary care. Ann Fam Med 2005;3.
  203. 203.↵
    1. Beasley JW,
    2. Starfield B,
    3. Van Weel C,
    4. Rosser WW,
    5. Haq CL
    . Global health and primary care research. J Am Board Fam Med 2007;20.
  204. 204.↵
    1. Nagykaldi Z
    . Practice-based research networks at the crossroads of research translation. J Am Board Fam Med 2014;27:725–9.
    OpenUrlAbstract/FREE Full Text
  205. 205.↵
    1. Schwartz A,
    2. Young R,
    3. Hicks PJ,
    4. Learn FA
    . Medical education practice-based research networks: facilitating collaborative research. Med Teach 2016;38.
  206. 206.↵
    1. Werner JJ,
    2. Stange KC
    . Praxis-based research networks: An emerging paradigm for research that is rigorous, relevant, and inclusive. J Am Board Fam Med 2014;27.
  207. 207.↵
    1. Etz RS,
    2. Hahn KA,
    3. Gonzalez MM,
    4. Crabtree BF,
    5. Stange KC
    . Practice-based innovations: more relevant and transportable than NIH-funded studies. J Am Board Fam Med 2014;27.
  208. 208.↵
    1. Del MC.,
    2. Askew D
    . Building family/general practice research capacity. Ann Fam Med 2004;2.
  209. 209.↵
    1. Dwan KM,
    2. Magin PJ
    . The desire for research in general practice. Aust Fam Physician 2008;37:871–3.
    OpenUrlPubMed
  210. 210.↵
    1. Marshall M,
    2. Pagel C,
    3. French C,
    4. et al
    . Moving improvement research closer to practice: the researcher-in-residence model. BMJ Qual Saf 2014;23:801–5.
    OpenUrlAbstract/FREE Full Text
  211. 211.↵
    1. Marshall M,
    2. Eyre L,
    3. Lalani M,
    4. et al
    . Increasing the impact of health services research on service improvement: the researcher-in-residence model. J R Soc Med 2016;109:220–5.
    OpenUrlCrossRefPubMed
  212. 212.↵
    1. Marshall M
    [Internet]. Negotiating evidence; the researcher-in-residence model; 2016. Available from: https://piru.ac.uk/assets/files/Marshall Researcher in Residence.pdf.
  213. 213.↵
    1. Cadwallader JS,
    2. Lebeau JP,
    3. Lasserre E,
    4. Letrilliart L
    . Patient and professional attitudes towards research in general practice: the RepR qualitative study. BMC Fam Pract 2014;15.
  214. 214.↵
    SDO. NHS Service Delivery and Organization, R&D Programme. Key lessons for network management in health care; 2005.
  215. 215.↵
    1. Exworthy M,
    2. Day P,
    3. Robinson R,
    4. Peckham S,
    5. Evans D
    [Internet]. Primary care research networks; 1997 [cited 2020 Oct 13]. Available from: https://uwe-repository.worktribe.com/output/1102793.
  216. 216.↵
    1. Beasley JW,
    2. Starfield B,
    3. Van Weel C,
    4. Rosser WW,
    5. Haq CL
    . Global health and primary care research. J Am Board Fam Med 2007;20:518–26.
    OpenUrlAbstract/FREE Full Text
  217. 217.↵
    1. Beasley JW,
    2. Hahn DL,
    3. Wiesen P,
    4. Plane MB,
    5. Manwell L
    . The cost of primary care research. J Fam Pract 2000;49:985.
    OpenUrlPubMed
  218. 218.↵
    1. Hahn DL
    . Physician opportunity costs for performing practice-based research. J Fam Pract 2000;49.
  219. 219.↵
    Agency for Healthcare Research and Quality PRC [Internet]. Practice-based research network business opportunities with ACOs and other health care systems: training and technical assistance; 2015. Available from: https://pbrn.ahrq.gov/sites/default/files/docs/page/Primer-for-PBRN-Business-Opportunities.pdf.
  220. 220.↵
    Agency for Healthcare Research and Quality [Internet]. PBRN registry, practice-based research networks, Agency for Healthcare Research and Quality; 2019. [cited 2020 Oct 13]. Available from: https://pbrn.ahrq.gov/pbrn-registry.
  221. 221.↵
    APCReN [Internet]. Available from: www.apcren.org.au.
  222. 222.↵
    1. Jones C
    [Internet]. An environmental scan of practice-based research networks; 2006. Available from: https://www.yumpu.com/en/document/read/23017131/an-environmental-scan-of-practice-based-research-networks.
  223. 223.
    1. Van den Bosch WJ
    . Forty years family-based morbidity data in general practice. Scand J Prim Health Care 1993;11:31–2.
    OpenUrlPubMed
  224. 224.
    1. Nelson E
    . Functional health status levels of primary care patients. JAMA 1983;249:3331.
    OpenUrlCrossRefPubMed
  225. 225.
    1. Main DS,
    2. Lutz LJ,
    3. Barrett JE,
    4. Matthew J,
    5. Miller RS
    . The role of primary care clinician attitudes, beliefs, and training in the diagnosis and treatment of depression: a report from the Ambulatory Sentinel Practice Network Inc. Arch Fam Med 1993;2:1061–6.
    OpenUrlCrossRefPubMed
  226. 226.
    1. Boffin N,
    2. Moreels S,
    3. Casteren VV
    [Internet]. The Belgian Network of Sentinel General Practices between 2007 and 2012: a short report; 2013. Available from: https://www.wiv-isp.be/Epidemio/epien/medven/D_2013_2505_40.pdf.
  227. 227.
    1. Ariza AJ,
    2. Binns HJ,
    3. Christoffel KK
    . Evaluating computer capabilities in a primary care practice-based research network. Ann Fam Med 2004;2.
  228. 228.
    1. LaBresh KA,
    2. Lazorick S,
    3. Ariza AJ,
    4. et al
    . Implementation of the NHLBI Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: rationale and study design for Young Hearts, Strong Starts, a cluster-randomized trial targeting body mass index, blood pressure, and tobacco. Contemp Clin Trials 2014;37.
  229. 229.
    1. Froom J,
    2. Culpepper L
    . Otitis media in day-care children: a report from the International Primary Care Network. J Fam Pract 1991;32.
  230. 230.
    1. Okkes IM,
    2. Polderman GO,
    3. Fryer GE,
    4. et al
    . The role of family practice in different health care systems: a comparison of reasons for encounter, diagnoses, and interventions in primary care populations in the Netherlands, Japan, Poland, and the United States. J Fam Pract 2002;51.
  231. 231.
    1. Kljakovic M,
    2. Seddon T,
    3. Reinken J,
    4. McLeod D
    . The rise and fall of a general practice information network. N Z Fam Physician 1992;73–6.
  232. 232.
    1. Leitch S
    . New Zealand needs a practice based research network. J Prim Health Care 2016;8:9.
    OpenUrl
  233. 233.
    1. Shaughnessy AF,
    2. Cincotta JA,
    3. Adelman A
    . Family for the Harrisburg Area Research Network (HARNET). Practice patients' attitudes toward firearm safety as a preventive medicine issue: a HARNET study. J Am Board Fam Pract 1999;12:354–9.
    OpenUrlAbstract/FREE Full Text
  234. 234.
    1. Knottnerus J,
    2. Metsemakers J,
    3. Hoppener P,
    4. Limonard C
    . Chronic illness in the community and the concept of social prevalence. Fam Pract 1992;9:15–21.
    OpenUrlCrossRefPubMed
  235. 235.
    1. de Lusignan S,
    2. van Weel C
    . The use of routinely collected computer data for research in primary care: opportunities and challenges. Fam Pract 2006;23.
  236. 236.
    1. Tilyard MW,
    2. Dovey SM,
    3. Spears GF
    . Biases in estimates from the RNZCGP computer research group. N Z Med J 1995;108.
  237. 237.
    1. Rodnick JE
    . Research fellowships: a road less traveled. Fam Med 1999;31.
  238. 238.
    1. Hall J,
    2. Martin IR
    . The Dunedin RNZCGP Research Unit Computer Research Network: an update to 2003 and beyond. N Z Fam Physician 2003;30:181–5.
    OpenUrl
  239. 239.
    1. Hak E,
    2. Van Essen GA,
    3. Buskens E,
    4. Stalman W,
    5. De MR
    . Is immunising all patients with chronic lung disease in the community against influenza cost effective? Evidence from a general practice based clinical prospective cohort study in Utrecht, The Netherlands. J Epidemiol Community Health 1998;52:120–5.
    OpenUrlAbstract
  240. 240.
    1. Hak E,
    2. Van Essen GA,
    3. Stalman WAB,
    4. De MR
    . Improving influenza vaccination coverage among high-risk patients: a role for computer-supported prevention strategy? Fam Pract 1998;15:138–43.
    OpenUrlCrossRefPubMed
  241. 241.
    1. Middelkoop BJ,
    2. Bohnen AM,
    3. Duisterhout JS,
    4. Pleumeekers HJ,
    5. Prins A
    . A computerized network of general practices in Rotterdam, The Netherlands. Am J Public Health 1994;84:1852–3.
    OpenUrlPubMed
  242. 242.
    1. Noël PH,
    2. Zeber JE,
    3. Pugh MJ,
    4. Finley EP,
    5. Parchman ML
    . A pilot survey of post-deployment health care needs in small community-based primary care clinics. BMC Fam Pract 2011;12.
  243. 243.
    1. Hayes H,
    2. Burge S
    . Creating a practice-based research network from scratch: where do I begin? Progress in Community Health Partnerships 2012;6:369–80.
    OpenUrlCrossRefPubMed
  244. 244.
    STARNet [Internet]. About STARNet, Institute for Integration of Medicine and Science [cited 2020 June 28]. Available from: https://iims.uthscsa.edu/STARNet/about.
  245. 245.
    1. Nagykaldi Z,
    2. Mold JW,
    3. Robinson A,
    4. Niebauer L,
    5. Ford A
    . Practice facilitators and practice-based research networks. J Am Board Fam Med 2006;19:506–10.
    OpenUrlAbstract/FREE Full Text
  246. 246.
    1. Van Casteren VFA,
    2. Bossuyt NHE,
    3. Moreels SJS,
    4. et al
    . Does the Belgian diabetes type 2 care trajectory improve quality of care for diabetes patients? Arch Public Heal 2015;73.
  247. 247.
    1. Nemeth LS,
    2. Wessell AM,
    3. Jenkins RG,
    4. Nietert PJ,
    5. Liszka HA,
    6. Ornstein SM
    . Strategies to accelerate translation of research into primary care within practices using electronic medical records. J Nurs Care Qual 2007;22:343–9.
    OpenUrlCrossRefPubMed
  248. 248.
    1. Wessell AM,
    2. Liszka HA,
    3. Nietert PJ,
    4. Jenkins RG,
    5. Nemeth LS,
    6. Ornstein S
    . Achievable benchmarks of care for primary care quality indicators in a practice-based research network. Am J Med Qual 2008;23:39–46.
    OpenUrlCrossRefPubMed
  249. 249.
    1. Etz RS,
    2. Keith RE,
    3. Maternick AM,
    4. et al
    . Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial. Implement Sci 2015;10:1–9.
    OpenUrlCrossRefPubMed
  250. 250.
    ACORN [Internet]. ACORN, Department of Family Medicine, VCU School of Medicine [cited 2020 June 28]. Available from: https://familymedicine.vcu.edu/research/family-medicine-research/acorn/.
  251. 251.
    1. Thiru K,
    2. de Lusignan S,
    3. Sullivan F,
    4. Brew S,
    5. Cooper A
    . Three steps to data quality. JHI 2003;11:95–102.
    OpenUrl
  252. 252.
    1. Albright TL,
    2. Parchman M,
    3. Burge SK
    . Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study. Fam Med 2001;33:354–60.
    OpenUrlPubMed
  253. 253.
    1. Hill JH,
    2. Burge S,
    3. Haring A,
    4. Young RA
    . Communication technology access, use, and preferences among primary care patients: from the Residency Research Network of Texas (RRNeT). J Am Board Fam Med 2012;25.
  254. 254.
    RRNET [Internet]. About RRNeT, Institute for Integration of Medicine and Science [cited 2020 June 28]. Available from: https://iims.uthscsa.edu/RRNeT/about.
  255. 255.
    1. Westfall JM,
    2. VanVorst RF,
    3. Main DS,
    4. Herbert C
    . Community-based participatory research in practice-based research networks. Ann Fam Med 2006;4.
  256. 256.
    1. Frew EJ,
    2. Hammersley V,
    3. Wolstenholme J,
    4. Whynes DK
    . Collaborating with a primary care-based research network. J Eval Clin Pract 2001;7:339–42.
    OpenUrlPubMed
  257. 257.
    1. Hammersley VS,
    2. Hippisley-Cox J,
    3. Wilson A,
    4. Pringle M
    . A comparison of research general practices and their patients with other practices—a cross-sectional survey in Trent. Br J Gen Pract 2002;52:463–8.
    OpenUrlAbstract/FREE Full Text
  258. 258.
    Trent Focus Group. For the promotion of research and development in primary health care: annual report 2001–2002; 2002.
  259. 259.
    1. Graffy J
    . News from ELENoR. ELENoR NEWS 2003 (April).
  260. 260.
    1. Hayward RA,
    2. Porcheret M,
    3. Mallen CD,
    4. Thomas E
    . Recruiting patients and collecting data for an observational study using computerised record pop-up prompts: the PROG-RES study. Prim Health Care Res Dev 2013;14:21–8.
    OpenUrl
  261. 261.
    1. Zwar NA,
    2. Weller DP,
    3. McCloughan L,
    4. Traynor VJ
    . Supporting research in primary care: are practice-based research networks the missing link? Med J Aust 2006;185.
  262. 262.
    1. Olsen DP,
    2. Dixon JK,
    3. Grey M,
    4. Deshefy-Longhi T,
    5. Demarest JC
    . Privacy concerns of patients and nurse practitioners in primary care—an APRNet study. J Am Acad Nurse Pract 2005;17.
  263. 263.
    1. Deshefy-Longhi T,
    2. Swartz MK,
    3. Grey M
    . Characterizing nurse practitioner practice by sampling patient encounters: an APRNet study. J Am Acad Nurse Practitioners 2008;20:281–7.
    OpenUrl
  264. 264.
    1. Chuan TN,
    2. Gan GL
    . Primary care research—a blueprint for action for Singapore. Asia Pac J Public Health 2001;13:49–53.
    OpenUrlPubMed
  265. 265.
    1. Trinh L,
    2. Macartney K,
    3. McIntyre P,
    4. Chiu C,
    5. Dey A,
    6. Menzies R
    . Investigating adverse events following immunisation with pneumococcal polysaccharide vaccine using electronic general practice data. Vaccine 2017;35:1524–9.
    OpenUrl
  266. 266.
    1. Sinclair-Lian N,
    2. Rhyne RL,
    3. Alexander SH,
    4. Williams RL
    . Practice-based research network membership is associated with retention of clinicians in underserved communities: a research involving outpatient settings network (RIOS Net) study. J Am Board Fam Med 2008;21.
  267. 267.
    1. Williams RL,
    2. Shelley BM,
    3. Sussman AL
    . The marriage of community-based participatory research and practice-based research networks: can it work? A research involving outpatient settings network (RIOS Net) study. J Am Board Fam Med 2009;22.
  268. 268.
  269. 269.
    1. Mehmet S,
    2. Comino E,
    3. Traynor VJ,
    4. Zwar NA
    . PHReNet: running a primary health care network: issues and challenges; 2004.
  270. 270.
    1. Anderko L,
    2. Bartz C,
    3. Lundeen S
    . Wellness for a lifetime: improving lifestyle behaviors of low-income, ethnically diverse populations. Ann Fam Med 2005;3.
  271. 271.
    1. Ried K,
    2. Farmer EA,
    3. Weston KM
    . Aims and objectives for the SARNet research network. BMC Fam Pract 2006;7.
  272. 272.
    1. Farmer E,
    2. Ried K,
    3. Weston KM
    . Primary Health Care Research Evaluation and Development Program, annual report; 2005.
  273. 273.
    1. Dulin MF,
    2. Ludden TM,
    3. Tapp H,
    4. et al
    . Geographic information systems (GIS) demonstrating primary care needs for a transitioning Hispanic community. J Am Board Fam Med 2010;23.
  274. 274.
    1. Dulin MF,
    2. Tapp H,
    3. Smith HA,
    4. et al
    . A trans-disciplinary approach to the evaluation of social determinants of health in a Hispanic population. BMC Public Health 2012;12.
  275. 275.
    MAPPR [Internet]. Home page [cited 2020 June 28]. Available from: https://www.mapprnc.org/.
  276. 276.
    1. Pulcini J,
    2. Sheetz A,
    3. Desisto M
    . Establishing a practice-based research network: lessons from the Massachusetts experience. J School Health 2008;78:172–4.
    OpenUrlCrossRefPubMed
  277. 277.
    1. De Clercq E,
    2. Van Casteren V,
    3. Jonckheer P,
    4. Burggraeve P
    . Primary healthcare research network: the Belgian ResoPrim recommendations. In: Studies in health technology and informatics. Amsterdam: IOS Press; 2009.
  278. 278.
    Department of Health, Research and Development Directorate. Best research for best health: a new national health research strategy; 2006.
  279. 279.
    National Institute for Health Research, Clinical Research Network. Five year strategic plan for research delivery: 2012–2017; 2012.
  280. 280.
    National Institute for Health Research, Clinical Research Network [Internet]. Income distribution from NIHR CRN industry portfolio studies; 2014.
  281. 281.
    Local Clinical Research Networks [Internet]; 2016. Available from: http://www.nihr.ac.uk/nihr-in-your-area/local-clinical-research-networks.htm.
  282. 282.
    1. Maro JC,
    2. Platt R,
    3. Holmes JH,
    4. et al
    . Design of a national distributed health data network. Ann Intern Med 2009;151:341.
    OpenUrlCrossRefPubMed
  283. 283.
    1. Arkind J,
    2. Likumahuwa-Ackman S,
    3. Warren N,
    4. et al
    . Lessons learned from developing a patient engagement panel: an OCHIN report. J Am Board Fam Med 2015;28:632–8.
    OpenUrlAbstract/FREE Full Text
  284. 284.
    1. Peckham S,
    2. Hutchison B
    . Developing primary care: the contribution of primary care research networks. Healthc Policy 2012;8.
  285. 285.
    1. Coleman N,
    2. Halas G,
    3. Peeler W,
    4. Casaclang N,
    5. Williamson T,
    6. Katz A
    . From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database. BMC Fam Pract 2015;16:11.
    OpenUrlCrossRefPubMed
  286. 286.
    1. Abdullah K,
    2. Thorpe KE,
    3. Mamak E,
    4. et al
    . Optimizing early child development for young children with non-anemic iron deficiency in the primary care practice setting (OptEC): study protocol for a randomized controlled trial. Trials 2015;16.
  287. 287.
    1. Rizza A,
    2. Kaplan V,
    3. Senn O,
    4. et al
    . Age- and gender-related prevalence of multimorbidity in primary care: the Swiss FIRE project. BMC Fam Pract 2012;13:113.
    OpenUrlCrossRefPubMed
  288. 288.
    1. Zellweger U,
    2. Bopp M,
    3. Holzer BM,
    4. Djalali S,
    5. Kaplan V
    . Prevalence of chronic medical conditions in Switzerland: exploring estimates validity by comparing complementary data sources. BMC Public Health 2014;14:1–12.
    OpenUrlCrossRefPubMed
  289. 289.
    1. Gill JM,
    2. Klinkman MS,
    3. Chen YX
    . Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study. J Am Board Fam Med 2010;23:499–508.
    OpenUrlAbstract/FREE Full Text
  290. 290.
    Electronic Practice Based Research Network, Centre for Primary Health Care and Equity [cited 2020 June 28]. Available from: https://cphce.unsw.edu.au/research/informatics-and-ehealth/electronic-practice-based-research-network.
  291. 291.
    1. Kwan BM,
    2. Graham DG,
    3. Sills MR,
    4. et al.
    [Internet]. Methods for the collection of patient reported outcomes in a safety net-oriented practice based research network: a SAFTINet demonstration project. Poster presentation, AcademyHealth Annual Research Meeting, June 24, 2013 [cited 2020 June 29]. Available from: https://www.slideshare.net/MarionSills/academy-health-pro-poster-final-2013-0620.
  292. 292.
    1. Pomernacki A,
    2. Carney DV,
    3. Kimerling R,
    4. et al
    . Lessons from initiating the first Veterans Health Administration (VA) Women's Health Practicebased Research Network (WH-PBRN) study. J Am Board Fam Med 2015;28:649–57.
    OpenUrlAbstract/FREE Full Text
  293. 293.
    1. Cole AM,
    2. Stephens KA,
    3. Keppel GA,
    4. Estiri H,
    5. Baldwin L-M
    . Extracting electronic health record data in a practice-based research network: processes to support translational research across diverse practice organizations. eGEMs 2016;4:1206.
    OpenUrl
  294. 294.
    1. Galvin S,
    2. Callan A,
    3. Cormican M,
    4. et al
    . Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study. BMC Fam Pract 2015;16.
  295. 295.
    1. Adams J,
    2. Steel A,
    3. Chang S,
    4. Sibbritt D
    . Helping address the national research and research capacity needs of Australian chiropractic: introducing the Australian Chiropractic Research Network (ACORN) project. Chiropr Man Ther 2015;23.
  296. 296.
    1. Adams J,
    2. Peng W,
    3. Steel A,
    4. et al
    . A cross-sectional examination of the profile of chiropractors recruited to the Australian Chiropractic Research Network (ACORN): a sustainable resource for future chiropractic research. BMJ Open 2017;7:e015830.e015830.
    OpenUrlAbstract/FREE Full Text
Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section

Keywords