Challenges and Opportunities for Family Medicine in the Research Process
| Research Process Components | Challenges | Opportunities |
|---|---|---|
| NIH = National Institutes of Health; AHRQ = Agency for Healthcare Quality and Research; PBRN = practice-based research network; IRB = Institutional Review Board; HIPPA = Health Insurance Portability and Accountability Act; EHR = electronic health record. | ||
| Identifying knowledge gaps | Understanding what is already known and identifying gaps in important knowledge from a generalist perspective and relevant to the health of people, families, communities, and health care in a family medicine setting | Making known the tremendous complementarities between the NIH roadmap and the family medicine research approach |
| Hypothesis generation | Posing and focusing the right questions | Engaging clinicians and communities in networks and participatory approaches |
| Acquiring funding | Lack of funding for primary care, noncategorical, research;study sections unfamiliar with practice-based, community participatory and integrative research | Billionizing AHRQ; advocating for participation in review and leadership roles; promoting PBRNs;supporting Grant Generating Project |
| Creating and maintaining research laboratories | Supply of family medicine investigators with research skills and committed time; creation of family medicine patient cohorts | Developing PBRN capacity; research centers for primary care health |
| Executing studies | Competing clinical demands with inadequate infrastructure and funding; research coordination across dispersed sites; IRB challenges; HIPAA | Lobbying for funding; helping AHRQ advocate for central PBRN IRB and HIPAA authorization |
| Analyzing data | Sophistication of family medicine investigators in data analysis and qualitative research methods | Research centers for primary care health; practice-and community-based research, and dissemination networks |
| Dissemination | Scarcity of scientific meetings for primary care research;underdeveloped mechanisms for engaging patients,communities, clinicians, and policymakers in knowledge generation and use | Practice- and community-based research and dissemination networks; advancing support of Annals; support of mentoring projects |
| Implementation | Doing research in the setting (and from the perspective) in which findings will be applied to reduce the problem of translation into practice | PBRNs; EHRs |
| Identifying knowledge gaps | The cycle starts again. (There are other iterative loops within the cycle). | Work toward a culture of inquiry throughout family medicine |