Conducting research in general practice: lessons learnt from experience

James, Erica; Talbot, Lyn

doi:10.1071/he05041

Cited by 15 publications

(8 citation statements)

References 40 publications

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“…9 However, HRECs can offer many services, such as an independent review process that examines potential risk to participants and service providers, and possible benefits of the research or evaluations, ensuring these are evidence-informed and methodologically robust. 10,11 For those conducting health promotion, which must be ethically justifiable, formal ethics approval should be an integral consideration. 8,9 Historically, HRECs have been attached to academic institutions, health departments and large teaching hospitals.…”

Section: Introductionmentioning

confidence: 99%

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations

Reilly

Crawford

Lobo

et al. 2016

Health Promot J Austr

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Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

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Section: Introductionmentioning

confidence: 99%

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations

Reilly

Crawford

Lobo

et al. 2016

Health Promot J Austr

View full text Add to dashboard Cite

show abstract

“…Problems we experienced with the recruitment and retention of participants, coupled with low return rates were limitations of this study that are common in general practice research 26,27 …”

Section: Discussionmentioning

confidence: 99%

Australian rural remote registered nurses' experiences of learning to provide antenatal services in general practice: A pilot study

Mills

Birks

Francis

et al. 2010

Int J of Nursing Practice

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This article reports on a pilot vocational study program for provision of antenatal services in the general practice environment. The concurrent evaluation study assessed practice nurse' experiences of undertaking the pilot program, the level and applicability of the content, and the mode of delivery. General practitioners' understanding of the role of the nurse in providing antenatal services, and the actual and potential impact of this new role on models of service delivery and care were also investigated. Women receiving care from practice nurses within this new model of service delivery and care were also of interest in this study. Findings showed that the current role of the general practice nurse in caring for pregnant women is restricted to assisting the general practitioner to complete their assessment of clients.Organising clinical placement with a midwife was a major barrier to completing the pilot program.

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“…All practices were invited by telephone to participate. In line with recommendations for conducting research in primary care [ 33 ], primary recruitment was conducted by a practicing GP (Chief Investigator Ewald) who had clinical credibility with the target group. CI Ewald attended a practice meeting at interested clinics to describe the aims of the study and the requirements of participating practices.…”

Section: Methodsmentioning

confidence: 99%

“…To maintain the method most closely resembling real world practice and to ensure a genuine GP referral pathway, situating a research assistant in the waiting room for recruitment was not employed in the current trial. This pragmatic approach needed to be balanced with limiting the amount of time required by GPs or other practice staff to undertake patient screening (that related to the research trial and would not be necessary in usual practice for a referral scheme) [ 33 ]. For this reason, following identification and referral of the potentially eligible patient, a study-specific research assistant undertook all study screening and consent-related activities during a scheduled appointment at the practice rooms.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)

et al. 2014

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BackgroundPhysical inactivity is fourth in the list of risk factors for global mortality. General practitioners are well placed to offer physical activity counseling but insufficient time is a barrier. Although referral to an exercise specialist is an alternative, in Australia, these allied health professionals are only publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. Accordingly, this trial aims to determine the efficacy of GP referral of insufficiently active patients (regardless of their chronic disease status) for physical activity counseling (either face-to-face or predominately via telephone) by exercise specialists, based on patients’ objectively assessed physical activity levels, compared with usual care. If the trial is efficacious, the equivalence and cost-effectiveness of face-to-face counseling versus telephone counseling will be assessed.MethodsThis three arm pragmatic randomized trial will involve the recruitment of 261 patients from primary care clinics in metropolitan and regional areas of New South Wales, Australia. Insufficiently active (less than 7000 steps/day) consenting adult patients will be randomly assigned to: 1) five face-to-face counseling sessions, 2) one face-to-face counseling session followed by four telephone calls, or 3) a generic mailed physical activity brochure (usual care). The interventions will operationalize social cognitive theory via a behavior change counseling framework. Participants will complete a survey and seven days of pedometry at baseline, and at three and 12 months post-randomization. The primary analyses will be based on intention-to-treat principles and will compare: (i) mean change in average daily step counts between baseline and 12 months for the combined intervention group (Group 1: face-to-face, and Group 2: telephone) and usual care (Group 3); (ii) step counts at 3 months post-randomization. Secondary outcomes include: self-reported physical activity, sedentary behavior, quality of life, and depression.DiscussionIf referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12611000884909.

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Conducting research in general practice: lessons learnt from experience

Cited by 15 publications

References 40 publications

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations

Australian rural remote registered nurses' experiences of learning to provide antenatal services in general practice: A pilot study

Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)

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