RT Journal Article
SR Electronic
T1 Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP S115
OP S123
DO 10.1370/afm.1549
VO 11
IS Suppl 1
A1 Andrada Tomoaia-Cotisel
A1 Debra L. Scammon
A1 Norman J. Waitzman
A1 Peter F. Cronholm
A1 Jacqueline R. Halladay
A1 David L. Driscoll
A1 Leif I. Solberg
A1 Clarissa Hsu
A1 Ming Tai-Seale
A1 Vanessa Hiratsuka
A1 Sarah C. Shih
A1 Michael D. Fetters
A1 Christopher G. Wise
A1 Jeffrey A. Alexander
A1 Diane Hauser
A1 Carmit K. McMullen
A1 Sarah Hudson Scholle
A1 Manasi A. Tirodkar
A1 Laura Schmidt
A1 Katrina E. Donahue
A1 Michael L. Parchman
A1 Kurt C. Stange
YR 2013
UL http://www.annfammed.org/content/11/Suppl_1/S115.abstract
AB PURPOSE We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. RESULTS The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. CONCLUSIONS These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.