A qualitative study examining healthcare managers and providers’ perspectives on participating in primary care implementation research

Abstract

BackgroundPrimary care reforms should be supported by high-quality evidence across the entire life cycle of research. Front-line healthcare providers play an increasing role in implementation research. We recently evaluated two interventions for people with type 2 diabetes (T2D) in partnership with four Primary Care Networks (PCNs) in Alberta, Canada. Here, we report healthcare professionals perspectives on participating in primary care implementation research.MethodsGuided by the RE-AIM framework, we collected qualitative data before, during, and after both interventions. We conducted 34 in-person or telephone interviews with 17 individual PCN professionals. We used content analysis to identify emerging codes and concepts.ResultsTwo major themes emerged from the data. First, healthcare managers were eager to conduct implementation research in a primary care setting. Second, regardless of willingness to conduct research, there were challenges to implementing experimental study designs for both interventions. PCN professionals presumed the interventions were better than usual care, expressed role conflict, and reported administrative burdens related to research participation. Perceptions of patient vulnerability and an obligation to intervene exacerbated these issues.ConclusionsHealthcare professionals with limited practical research experience might not foresee the challenges in implementing experimental study designs in primary care settings to generate high-quality evidence. These issues are intensified when healthcare professionals perceive target patient populations as vulnerable and in need of intervention based on the presenting illness. Possible solutions include further research training, involving healthcare professionals in study design development, and using non-clinical staff to conduct research activities, particularly among acutely unwell patient populations.

Acceptability of the POWERPLAY Program: A Workplace Health Promotion Intervention for Men

“…A tension existed in this regard because the support of workplace leads was crucial to men's participation, but the actual time required to organize, host, and promote the program had significant sustainability challenges. Other research has revealed similar feasibility concerns wherein "in house" organization of a program in addition to participation might be deemed too much for some workplaces ("administrative burden") (Wozniak et al, 2016). A defined partnership between program leads and outside representatives is an essential element in program sustainability.…”

A “Patient Preference” Model of Recruitment for Research from Primary-Care-Based Memory Clinics: A Promising New Approach

“…The discussions undertaken at our stakeholder meeting, particularly related to the research scenarios reviewed, highlighted the dilemma faced by memory clinic teams when they are approached about recruiting participants from their clinic. In removing the responsibility from physicians to determine eligibility and explain studies, the MINT Memory Clinic Research Match Program addresses the health professional-related barriers that impede research recruitment, such as concern about risks and burden to patients and potential for perceived conflict of interest, time restraints, and limited understanding of and experience with research and skills to introduce research (Lee, Locklin, et al, 2022;Mason et al, 2007;Wozniak et al, 2016). This approach is essentially a registry of patient preferences for research, not the typical volunteer registry of clinical information used to determine eligibility criteria.…”

Implementing a mHealth intervention to increase colorectal cancer screening among high-risk cancer survivors treated with radiotherapy in the Childhood Cancer Survivor Study (CCSS)

“…The burden to understand the effectiveness of the mHealth intervention requires robust participation among the PCPs of enrolled patients and their interest in reviewing the study materials and completing the questionnaires and interviews. While PCPs generally value research and consider it an important pathway towards the generation of useful clinical knowledge, they also find it to be administratively burdensome [ 49 ]. Based on feedback from our PCP Advisory Board on how to best address this potential issue, we have ensured that all PCP study materials are concise, have included a gift card for participation in each study component, and have developed a structured follow-up plan to collect any missing data.…”