Research ArticleOriginal Research

A Review of 50 Years of International Literature on the External 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 2022, 35 (4) 762-792; DOI: https://doi.org/10.3122/jabfm.2022.04.210411

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Chart flow diagram of the process of systematic selection of articles. Abbreviation: PBRNs, Practice Based Research Networks.

  • Figure 2.
    Figure 2.

    An example of the methodological approach in synthesizing components, key elements, subthemes, and themes from the quotations.

  • Figure 3.
    Figure 3.

    The world map of Practice-Based Research Networks (PBRNs).

  • Figure 4.
    Figure 4.

    Stakeholders influencing the development of Practice-Based Research Networks (PBRNs). Abbreviation: HIT, Health Information Technology.

Tables

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  • Table 1.

    Inclusion and Exclusion Criteria for the Scoping Review

    Inclusion Criteria

    1. Peer-reviewed journal articles published between 1/1/1965 and 12/31/2020 in English language that refer to one or more primary care PBRNs and include information about their establishment.

    2. Articles that refer to research projects conducted by PBRNs that also provide information about their establishment.

    3. Reports, editorials, letters, commentaries, conference papers and web pages that may provide complementary information on an already identified PBRN.

    4. Information on PBRN establishment was included after defining primary care-linked PBRNs based on the scope of primary care in each particular region or country.

    Exclusion Criteria

    1. Articles that focus on specific research studies, data collection or database/technology development in PBRN settings, without providing information about the PBRN's establishment.

    2. Articles in which the identity of the PBRN can't be determined (eg, due to blinding).

    • Abbreviation: PBRNs, Practice-Based Research Networks.

  • Table 2.

    Overarching Thematic Framework for the Establishment of Practice-Based Research Networks (PBRNs) Focusing on the Themes of the External Environment and Stakeholders at the Intersection between the Internal and External Environment Described in This Article

    ThemeSubthemeKey Elements
    (i) Internal Environment of PBRN(i) Foundation

    1. Setting up mission, purposes, goals, objectives and aims

    (ii) Practitioner Participation and Motivation

    1. Recruitment

    2. Membership

    3. Levels of member engagement

    4. Intrinsic motivators to participate and benefits for practitioners

    5. Extrinsic motivators to participate and benefits for practitioners

    (iii) Academic Participation and Attitudes

    1. Type of affiliation and advantages – disadvantages of affiliation

    2. The role of academics and academic departments in developing, hosting and sustaining the network

    3. Academic contribution to governance and leadership

    4. Contribution of academic research expertise

    5. Academic support for research culture development and practitioner empowerment

    6. Academic initiative to link medical students and residents to PBRN activity

    7. Benefits for academia from PBRN collaboration

    (iv) Network Infrastructure and Operations

    1. Initial Partnerships to Establish PBRNs and Centers of Operations

    2. Infrastructural Funding

    3. Key Activities at Establishment

    4. Relationships Building Between Academics and Practitioners in the Field

    5. Governance

    6. Organizational Leadership

    7. Methodology of prioritizing the Research Agenda

    8. Topics of PBRN research

    9. Data gathered from networks & Data management

    10. Quality improvement (QI) activities

    11. Learning environment

    12. Communication

    (ii) Stakeholders at the intersection between the internal and external environment(i) Patients and Community Stakeholders

    1. Patient-centeredness and community engagement in PBRNs

    2. Relationship building with patient or community groups as an essential part of research

    3. Quality improvement activities guided by patient feedback

    4. Involving patients or community members in PBRN governance

    5. Integrating CBPR methodology into PBRN research

    6. Community Engaged Research methodology in PBRN research

    7. Motivation of community members for research participation

    8. Community engagement in health policymaking through PBRN activity

    (ii) Other Healthcare Stakeholders

    1. Identification, engagement and contribution of healthcare stakeholders

    2. Relationship building with healthcare stakeholders

    3. Other aspects of working with healthcare stakeholders

    (iii) External environment(i) National Health System

    1. The impact of primary health care structure on PBRN development

    (ii) Institutional/Governmental Support, National/State Policy and Regulatory Environment

    1. Decision-makers

    2. National policy

    3. Regulatory environment

    4. Interaction with policymaking

    5. Community impact on public health policymaking through PBRN

    (iii) Professional Organizations

    1. National professional organization contribution and support

    2. International professional organizations contribution

    (iv) External Funders

    1. External funders contributions

    (v) Leveraging Previous Research and PBRN Experience and Interacting with Other Networks

    1. International experience

    2. National experience

    3. Leveraging previous research expertise

    4. Leveraging PBRN practice models

    5. Leveraging experience from peer networks

    6. Interacting with other networks

    7. Developing networks of PBRNs

    (iv) HIT and HIT Vendors

    1. HIT applications sustain the infrastructure

    2. HIT applications facilitating or supporting the PBRN operation

    3. HIT vendors contribute to sustainability

    4. HIT vendor in the partnership of the network

    5. Challenges from the variety of EHR systems

    • Note: In this Table, the shadowed part corresponds to themes, sub-themes, and key elements presented in a previous study.

    • Abbreviation: EHR, Electronic Health Records; HIT, Health Information Technology.

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