Appendix Table 5.

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

SubthemesKey ElementsComponentsRelated Quotations
Network infrastructure and operationsRelationship building between academia and practitionersLong-term relationships“This entire recruitment process involves relationship building, not just for CaRESS [study] but also for KAN. This defining feature of a PBRN, the long-term relationship with the clinicians, is the context for all our contact and decisions with the practices.” (Love et al 2006)
“The organizational model developed for the MNCCRN is one that builds on long-standing relationships with community groups, other health care providers, and organizational linkages that will facilitate trust, increase communication, maximize the use of limited resources, and enhance the dissemination of new knowledge generated to multiple constituencies, including consumers, health professionals, and policy makers.” (Anderko et al 2005)
Development of common identity“ASPN conducts an annual convocation of its practices. The primary objectives of this meeting are to get acquainted; share information; develop an “esprit de corps” among network members; review, modify, and approve studies; and generate new study ideas.” (Iverson et al 1988)
“We have two meetings a year, because—unlike WReN—we have a very tightly knit group. The doctors and nurses and their support staffs know that they are in UPRNet, and therefore most UPRNet practices participate in most UPRNet studies…we are, after all, a small, regional, highly committed group.” (Pearls of Research 1998, p. 72)
“Appropriate resources should be identified for face-to-face meetings/teleconferences and annual events, since getting to know fellow researchers within a network helps to attract commitment and a sense of common purpose and camaraderie. An interactive (rather than didactic) approach to training a multilingual group worked well.” (Nuttall 2011)
“What is not captured in this description of the formal program is the value of WReN members meeting as a group, this is much better reflected in the many compliments received from participants.” (Smith and Dunleavey 1996)
“establish annual network meetings, which will provide a sense of ‘family’ of like-minded practitioners with a common purpose to network members.” (Deshefy-Longhi et al 2002)
Based on common mission“CHCs [community health centers] are ideal partners with whom to conduct patient-centered outcomes research because they engage in quality improvement and evaluation with a mission to provide efficient and effective care that advances health and reduces disparities.” (Likumahuva et al 2013)
Collaborative philosophy“The collaborative nature of ASPN means that the results are not the property of any one center or any one individual but belong to all involved and should be published under the aegis of ASPN.” (Green et al 1984)
Matching practitioners and researchers with common interests“‘Matchmaking’ providers and researchers with common research interests using as liaisons the PBRN coordinators, community research liaisons to build personal relationships. Likewise, clinic champions operated as liaison for their clinic.” (Likumahuva et al 2013)
Building research relationships upon the enthusiasm of researchers and practitioners“building upon the enthusiasm of researchers and clinicians at the geographically dispersed sites will be key, so as to assure that these busy professionals with competing priorities remain engaged over time.” (Frayne et al 2013)
Collaboration across various disciplines and levels of seniority“Of particular note is the heartening and consistent multidisciplinary mix of all WeLReN activities but the difference between the doctor:nurse ratio in Theme Group and Expert-Led projects is noteworthy (2:1 vs 6:1). The WeLReN approach facilitates team working across traditional boundaries and across different levels of seniority which may make it easier for research activity to be enhancing of local education and service development activity, through the desirable development of informal inter-organizational connections.” (Thomas and While 2001)
Mutual appreciation between practitioners and academics“While a motivating factor of other PBRNs, our two ‘different worlds’ do not always understand each other, possibly because our PBRN is based in the community rather than an academic setting. Building cohesion among PBRN clinicians and researchers required time to develop relationships so that our clinicians and researchers better appreciate each others' worlds.” (DeVoe et al 2012)
Strong bonds between academia and practitioners“Its success is mainly contributable to the participating GPs' strong academic bonds, to its relatively small size, and to its consistent emphasis on completeness of data and, by organizing monthly meetings, on the assurance of data validity.” (Schers 2008)
Constructive relationship between practitioners and academics“The objective of the first set of clinical and management studies presented in the preceding section were to do the following: (1) form a constructive relationship between medical school faculty and community physicians.” (Nelson et al 1981, Part 2)
Relationships with key practitioners and practice managers“Other ways that ISPRN has developed relationships over time in the organization and implementation of projects has been through establishing a dual relationship with the practice manager and key GPs involved in the project.” (Dijkmans-Hadley et al 2015)
Collaborative relationship focused on practitioner interest“The first premise is that COOP Project aims to meet the educational, managerial, and research interests of primary care physicians. It is a collaborative effort involving a medical school, community practices, and policy makers, but the direction of the COOP Project is determined by interest of the physicians.” (Nelson et al 1981, Part 1)
Maintaining respectful and trusting relationships“the core tenet of successful PBRNs is developing and maintaining respectful and trusting long-term relationships that continue beyond research studies.” (Hayes et al 2011)
“Over the course of years, members of the disabilities and service communities slowly developed trusting relationships with a small cadre of physicians who demonstrated expertise and commitment to this population. Mutual respect and understanding further developed between members of these 3 communities through collaborative management of complex client situations in which extensive communication and problem-solving between groups were required.” (Tyler and Werner 2014)
Networking and interaction“In addition to opportunities to increase knowledge and skills in clinical and managerial areas, CDN's conferences and workshops also provide opportunities for professional peer networking and interaction. According to CDN activists, sharing experiences and ideas with colleagues who work in similar organizational environments and respond to the needs of similar patient populations helps to enrich professional life.” (Sardell 1996)
Efforts to increase trust“Strong leadership and frequent communication meant that NNCs [National Network Coordinators] and NNFs [National Network Facilitators] got to know well and grew to trust the GRACE-01 coordinating team.” (Nuttall 2011)
Development of trust and boundaries about data sharing“Building a PBRN with a common EHR, or the ability to merge data from multiple EHRs into a common repository, requires that trust and boundaries around data sharing be established.” (DeVoe et al 2012)
Sharing experiences“This unit provided a forum for general practitioners interested in the epidemiology of common infectious diseases to share experiences about the spread and the impact of conditions diagnosed and treated in their practices.” (Fleming 1999)
Leveraging personal relationships“Another advantage of regional networks is that a more personal relationship with physicians, office staff, and patients is possible. Physicians and their office staff members generally know the PPRG staff personally.” (LeBailly 2003)
Fostering collegiality“Fostering ongoing research relationships and a sense of camaraderie that advances the cause of child research and invigorates participating clinicians.” (Slora and Wasserman 2010)
“A shared sense of the importance of the research questions to improving clinical care was the foundation for establishing a common purpose and a spirit of camaraderie.” (Nuttall 2011)
Support the links between practice and research“The 3 networks expressed the need to support routine practice, do research, and, at the same time, raise the quality of care in the network. An integral relationship between practice and research is apparent in each of the networks.” (van Weel 2000)
Leveraging the prior relationships with academia“Two rural practices with residency graduates of the University of Missouri expressed an interest in collaborating. In addition, the Department of Family and Community Medicine sponsors two rural satellite practices which are used as educational bases for residents.” (Williamson et al 1998)
Leveraged relationships with teaching practices“The network is both a research and teaching network. Interestingly enough, however, we have done more research than teaching.” (Pearls of Research 1988, p. 72)
Collaborative relationship based on the strengths of each part“The combination of a central university faculty, which has an understanding of research methods and design, statistical analysis, and grant writing, with rural practitioners, who have “real world” practices, values, and clinical institutions, is a good one. This type of collaboration is professionally satisfying and is likely to result in valuable new primary care knowledge.” (Williamson et al 1998)
Synergies developed during training“Since beginning collaborative working in 2002, a synergy has developed between CumbReN and HRDNoW [Health R&D North West] that has helped build research capacity at an individual and organizational level within the North Cumbria PCTs.” (Robertson et al 2005)
Synergy and collaboration developed during research process“The network enables primary care practitioners with interesting clinical questions to work with expert researchers. From this synergy have developed large R&D projects of national importance.” (Smith and Dunleavey 1996)
“The investigator and one provider then engaged another physician, both of whom were not previously involved with research. Collaboratively, they developed a project to address clinical questions they had encountered in practice.” (Likumahuva et al 2013)
Synergy developed through bidirectional collaboration“WH-PBRN…represents a long-term partnership of clinicians and researchers who together strive to improve the health and health care of women Veterans. Powerful synergies arise from this bi-directional collaboration, which aligns the perspectives and experience of clinicians and researchers.” (Frayne et al 2013)
Cycles of collaborative activityThe cycle can itself be viewed as participatory action research in that collaborative cycles of reflection, inquiry, feedback and action occur in each project and throughout the network.” (Thomas and While 2001)
Collaboration with other research interested groups out of primary health care“NoReN's activities are geared towards research training, mentoring and fostering collaborative research. Specific activities during 1997 included…Providing an interface with other local groups, eg, hospital research committees.” (Carter 1998, p. 80–1)
Collaboration among all stakeholders“Collaboration is the key to ACORN's success, relying on strong partnerships with practices, health systems, other universities and PBRNs, community organizations, businesses, insurers, and public health entities. Our relationships help to inform study ideas, carry out interventions, interpret and disseminate findings, and ensure that positive transformative methods found are implemented into practice.” (ACORN, accessed June 28, 2020)
Partnering for shared learning and best practices implementation“Partnering with OCHIN, researchers, and payers, many practices are organizing themselves as Patient-Centered Medical Homes. We envision a synergy between practice transformation and research activities, strengthened by a ‘learner’s bridge' that provides opportunities for community partners to learn the skills for implementing and evaluating practice interventions…This type of partnership ensures that meaningful activities will be documented and will contribute to the growing fund of knowledge about evidence-based, best practices in primary care. Further, engaging learners in this partnership further strengthens the benefit for spread of innovation and sustainable future change.” (DeVoe et al 2011)
Development of relationships with vendors (or HIT stakeholders) and members“Our system architecture design was a result of partnerships between multiple stakeholders including our CTSA, community practices and tribal partners, and national research communities. Developing the LC Data QUEST data sharing architecture involved significant time and effort in creating and sustaining relationships among all partners involved and required an iterative process to allow stakeholders to give valuable input into system requirements.” (Stephens et al 2012)
The relationship with the network is beneficial for the members“Maintaining an engaged and productive network that is able to provide high reliability research activities and attract potential investigators requires a skilled and committed central organizing body to facilitate collaboration, to lessen the burden of research participation for practices, and to govern the network such that that all members receive benefits from participation.” (Pace et al 2014)
Linking through research assistants, research facilitators, clinician championsClinician champions: “Members of the clinician committee, who are physician champions from participating clinics, may vary from project to project. Physician champions inform their colleagues about the study and help solve logistical problems that arise during the project.” (Kuo 2008)
Coinvestigators: “To ensure consistency of intervention and reliability and validity of data, there must be a seasoned coinvestigator at each site who is ultimately responsible for each research study, in collaboration with CNC clinicians.” (Anderko et al 2005)
Research assistants/facilitators for research: “These assistants identify and exchange ideas, methods, questions, and challenges between practices within their pod and, through the central office, to the rest of the network; facilitate QI; and assist practices to participate in network-wide projects and for the research results implementation in practice.” (Mold and Peterson 2005)
“…the Oklahoma Physicians Resource/ Research Network (OKPRN) uses five full-time equivalent (FTE) facilitators, called practice enhancement assistants (PEAs). The PEAs help member practices participate in individual and network-wide research and quality improvement projects. Initial PEA training includes a comprehensive introduction program followed by project-specific training.” (Nagykaldi et al 2005
Relationship brokering“Since our network would not be able to depend on much income, it should serve primarily a brokering function, bringing together researchers and interested practitioners for specific studies that are financially supported by the researchers.” (Solberg et al 1986)
“In research linking primary care practitioners and hospital-based consultants, complementary strengths can be linked, thereby improving the potential for understanding the natural history of disease.” (Christoffel et al 1988)
Key tips for relationship building, mentorship, and leadership“Cultivate and support; Leaders and collaboration; Share resources; Build bridges and partnerships; Add value in multiple differing spheres.” (DeVoe et al 2012)
Challenges deriving from practice comparisons“PBRNs must take precautions to avoid group comparisons so that ‘low performers’ are not embarrassed or jeopardized.” (Kuo 2008)
Challenges related to relationships maintenance“Maintenance and updating of contact information on cohort [patient] members requires ongoing effort.” “There are, however, challenges involved in this type of infrastructure development. They include involvement of practitioners, minimization of selection bias, and maintenance of funding to support the network and cohort infrastructure.” (Sloan et al 2006)