The Grant Generating Project: Giving Primary Care Researchers Tools to Succeed

As noted by McWhinney as early as the 1960s, one of the critical criteria for the ongoing development of an academic discipline, such as primary care, is an active area of research.¹ Added to this is the long-standing premise that it is essential for primary care evidence to be generated by primary care researchers with primary care physicians with and for primary care patients.^2,3 This has been the core tenet of NAPCRG since its founding in 1972,⁴ and one of the reasons the Committee on Building Research Capacity launched the Grant Generating Project (GGP).⁵ The 1-year “fellowship without walls” was developed to support researchers with consultation, technical assistance, and peer review for grant applications—resources that researchers often lacked in their academic environments.⁶ Supported by the various organizations such as the American Academy of Family Physicians’ Plan to Enhance Family Practice Research, NAPCRG’s Committee on Building Research Capacity, the Society of Teachers of Family Medicine, and the Foundation of the American Academy of Family Physicians, the program successfully met research and scholarship capacity-building needs in primary care for over 20 years.⁷

During this time, research complexity steadily increased⁸ and the number of grant applications being submitted more than doubled (NIH Data Book 2023) with success rates dropping from over 30% in 1998 to near 20% in 2022. Accompanying these challenging trends were innovative advances in andragogy through blended learning, active teaching, and improvements in education technology. With this shifting landscape, in 2017, NAPCRG took full responsibility for the GGP and committed to reimagining the program. As Chair of Committee for the Advancement of the Science of Family Medicine and having developed several primary care graduate degrees at McGill University,⁹ I volunteered to lead the transition of GGP into a full blended-learning program. With the help of Dr Tamara Carver on the education technology front and GGP Alumni Dr Nancy Elder and Dr Douglas Archibald, this superannuated course that was taught during 4 in-person sessions over the course of a year was completely overhauled within 6 weeks. The program was turned into a cutting-edge blended-learning experience with tuition. The extensive online materials with 12 modules were complemented by 2 in-person sessions supported by 3 virtual classrooms. As part of this course, 1 module is dedicated to dissemination and implementation science as well as how to do community-partnered research. For the online curriculum, materials were developed that addressed both the United States’ and Canadian funding contexts. Fellows from this program came from diverse backgrounds, with differing levels of experience and health care contexts. Building on earlier success of the program, the restructured version of GGP has continued to help new researchers to achieve funding success in the US and Canadian context. With the success in relaunching this important education initiative, several partner associations including STFM, ABFM, and the College of Family Physicians of Canada have committed to providing annual scholarships. With the relaunch in 2017 with 16 Fellows, we have created an annual cohort of learners who have developed enduring professional collaborations and successful grant applications. This year the GGP will see the addition of focus on primary care researchers applying for Artificial Intelligence/Machine Learning (AI/ML) grants through the generous support of the Gordon and Betty Moore Foundation.

While primary care has been identified as a critical component for the delivery of high-quality health care and for the improvement of global health,¹⁰ we also live in an environment of rapidly changing health care systems with increasing expectations, knowledge, and involvement of patients, families, and communities. There is a growing preoccupation with cost and performance leading government or other decision makers to intervene, control, and reform. Finally technological developments such as artificial intelligence, big data and machine learning along with the genomics have created new hopes and expectations for primary care.¹¹ The advent and progression of a global pandemic only intensified these issues. All these factors lead to the conclusion that to improve health care, a strong evidence base for primary care is essential. To do this, we must prepare our researchers to be competitive in the funding application arena. GGP is one effort to ensure this happens.

• © 2023 Annals of Family Medicine, Inc.