Maintenance of Certification Part 4 Credit and Recruitment for Practice-Based Research

Abstract

BACKGROUND: Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. METHODS: Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months. Field note review revealed that many physicians declined enrollment, stating that they prioritized MOC Part 4 projects over research studies. A QI curriculum meeting standards for MOC Part 4 Credit was developed and added to the study protocol as an enrollment incentive. Enrollment rates and characteristics of practitioners enrolled pre- and post-MOC were compared. RESULTS: Pre-MOC enrollment contributed 48% of practices in 22 months; post-MOC enrollment contributed 49% of practices in 6 months. An average of 3.5 practices enrolled per month pre-MOC, compared with 13.1 per month post-MOC (P < .001). Clinicians in pre- and post-MOC groups were similar in age, gender, race, and time spent on patient care; practices enrolled post-MOC were more likely to be located in federally designated Medically Underserved Areas than those enrolled pre-MOC (28.6% vs 12%, P = .03). CONCLUSIONS: Addition of MOC Part 4 Credit increased recruitment success and increased enrollment of pediatricians working in underserved areas. Including QI initiatives meeting MOC Part 4 criteria in practice-based research protocols may enhance participation and aid in recruiting diverse practice and patient populations.

Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm

“…Our findings that behavioral problems were associated with lower developmental scores were consistent with those found in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) [13] that followed 8,000 children born term and preterm. The ECLS-B study found that those children with cognitive delay at 9 and 24 months (defined by scores on the Bayley Short Form) had significantly more behavioral problems by 4 and 5 years, with SES associated with worse behavior problems.…”

Reducing Head CT Use for Children With Head Injuries in a Community Emergency Department

“…Other studies have shown that offering MOC credit can increase participation for QI projects in community settings. 29 MOC was established by the American Board of Medical Specialties to encourage ongoing improvement in physicians' knowledge, and improvement in medical practice to evidencebased care. 30 In part IV of the MOC requirements, physicians participate in approved QI projects.…”

“…30 In part IV of the MOC requirements, physicians participate in approved QI projects. 29 However, MOC requirements have been criticized because they do not always fulfill practice-specific needs, and they provide minimal benefit if not tailored to the practice of the physician, 30 and so valuable MOC projects are needed. 31 We demonstrate that regional children's hospitals can use MOC requirements to help community hospitals adopt evidence-based best practices and improve important outcomes.…”

Adapting Practice-Based Intervention Research to Electronic Environments: Opportunities and Complexities at Two Institutions

“…Unfortunately, demands for increased efficiency in office practice dictated by such factors as payment pressures and increased patient complexity have reduced time for practitioner involvement in research. 17 Combined, these trends pose the question: What are the challenges and efficiencies related to implementing an effective, minimally demanding practice-based intervention in a fully electronic environment, as compared with the environment in years past?…”