System-Based Participatory Research in Health Care: An Approach for Sustainable Translational Research and Quality Improvement

Schmittdiel, Grumbach, and Selby describe the importance of health systems engaging in collaborative partnerships and building on existing community strengths and investing in long-term relationships to promote translational research.[1] Health systems understand population-based health approaches to improving community health. Health systems will benefit from building on the long-term relationships that practice-based research networks (PBRNs) have with their member clinicians, and communities. PBRNs have built their organizations on recruitment, engagement and retention of their members. This is a long-term process that involves trust and a focus on mutual benefit. Improving community health often involves interventions to implement new models to deliver preventive health and chronic illness care. PBRNs have recognized the importance of linking with community and promote research as a community asset.[2] Blending community health development with community-based participatory research is a model promoted by several PBRNs including the Oregon Rural Practice-based Research Network (ORPRN).[3] PBRNs have an increasingly strong relationship with the T2 research community. PBRNs are a key component of the Clinical Translational Science Awards funded by the National Institutes of Health and this linkage is important to both the PBRN and the affiliated academic health center.[4] Schmittdiel and colleagues appropriately highlight the need for rapid quality improvement and translational research.[1] Communities are action oriented and do not tolerate the long process of traditional research. This is where PBRNs with an emphasis on being nimble with rapid project turnaround are effective in contrast to health systems and academic organizations.

It is important that health systems and PBRNs look for synergy in translational research and quality improvement efforts as resources are limited. These resources include funding and research capacity. The basic infrastructure for PBRNs has been described; yet, support for the basic infrastructure to support PBRNs is limited.[5] An effort to avoid duplicating the infrastructure required to perform CBPR in communities is desirable. Health systems will be more likely to succeed in promoting community health by providing financial and technical support to existing PBRNs and their practices. The “band-width” of practices to participate in community-based research is limited and PBRNs and health systems should work together to identify research that can be translated into community benefit.

1. Schmittdiel JA, Grumbach K, Selby JV. System-based participatory research in health care: an approach for sustainable translational research and quality improvement. Ann Fam Med. May-Jun 2010;8(3):256-259.
2. Westfall JM, Fagnan LJ, Handley M, et al. Practice-based research is community engagement. J Am Board Fam Med. Jul-Aug 2009;22(4):423-427.
3. McGinnis P HM, Davis M, Smith J, Beamer B, Hastings D. Transitioning from CHIP to CHIRP, Blending Community Health Development with Community-Based Participatory Research. Family & Community Health. 2010;33(3):228-237.
4. Fagnan LJ, Davis M, Deyo RA, Werner JJ, Stange KC. Linking practice-based research networks and Clinical and Translational Science Awards: new opportunities for community engagement by academic health centers. Acad Med. Mar 2010;85(3):476-483.
5. Green LA, White LL, Barry HC, Nease DE, Jr., Hudson BL. Infrastructure requirements for practice-based research networks. Ann Fam Med. May-Jun 2005;3 Suppl 1:S5-11.

Competing interests:   None declared