Practice-Based Research Networks: Nursing Centers and Communities Working Collaboratively to Reduce Health Disparities
Section snippets
Community nursing centers as primary health care research sites
Nursing centers traditionally have served the health and illness needs of diverse populations of vulnerable urban and rural residents who are at risk for limited health care access and poor health outcomes [7]. CNCs provide a nontraditional model of primary health care delivery that has been developed over a 30-year period. CNCs frequently embrace the World Health Organization (WHO) definition of primary health care, which includes an emphasis on primary prevention, health promotion, and
Establishing a nursing practice-based research network
PBRNs use the experience and insight of practicing clinicians to identify and frame research questions whose answers can improve the health outcomes of many populations, including the most vulnerable. They also provide a mechanism to produce research findings that are immediately relevant to clinicians and more easily assimilated into every day practice. The Committee on the Future of Primary Care, convened by the Institute of Medicine [15], has underscored the importance of PBRNs and described
The Midwest Nursing Centers Consortium Research Network
The Midwest Nursing Centers Consortium Research Network (MNCCRN) was funded by a grant from AHRQ in 2002 to begin developing a collaborative program of participatory community-focused research with vulnerable populations across multiple CNC sites. This research network began with 20 CNCs that had been in operation from 3 to 17 years and represented thirteen Midwestern universities (Lundeen, unpublished data, 2002). Several members were recruited into the network over the past 2 years.
Methods: creating a research infrastructure for the Midwest Nursing Centers Consortium Research Network
The process of creating a research infrastructure for the MNCCRN was built upon work established by the Midwest Nursing Centers Consortium (MNCC), a consortium of nursing centers located in the Midwest and established in 2001 with the purpose of collaborating on advocacy and research efforts. 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
A Midwest Nursing Centers Consortium Research Network research study exemplar: prescription for health, wellness for a lifetime
The Robert Wood Johnson Foundation's Prescription for Health initiative provided funding for the MNCCRN's first research study. This study, Wellness for a Lifetime, took place in eight community nursing centers at seven universities in five states. The primary purposes of this research were to evaluate the outcomes of an accessible, culturally and educationally appropriate physical activity and nutritional intervention for high-risk, low-income, ethnically diverse clients of CNCs. A secondary
Major findings
Self-reported behavior changes included increased movement or physical activity, and intake of a more balanced diet that included less junk food and more fruits and vegetables. In addition, APN assessment of physical activity and nutritional promotion increased. The following items highlight the major findings:
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Twenty-one APNs participated. Chart audits before and after the study found that APN assessment of physical activity levels (32.9% versus 47.5%) and nutritional status (30.5% versus
Research network infrastructures: lessons learned
There are significant challenges that must be addressed to sustain a synergistic, collaborative network for research. There must be a commitment to collaborative work across the network to articulate and implement programs of research. Ideally, priorities for research should be established and a clear assessment undertaken of the capabilities of each site and the network as a whole.
There must be constant vigilance maintained to identify research network funding opportunities. AHRQ-designated
Summary
The evidence from the first MNCCRN study suggests that a shift in the level of wellness in a large percentage of the population of the nation may depend upon the ability to create new models of health care and promotion that merge the traditional model of primary care delivery with a public health approach to primary prevention and health promotion. Nurses can and must enter the field of CBPR using the power of community partnerships inherent in practice to integrate these principles into
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This work was supported by grant award # 5R21HS013573-02 from the Agency for Healthcare Research and Quality and grant #049051 from the Robert Wood Johnson Foundation.