1. Creating Practice Based Research Networks for Global Health
JESSIE
Jessica Evert MD, Executive Director, CFHI
Faculty, UCSF Department of Family and Community Medicine
Kim Kimminau PhD, AAFP National Research Network

2. Practice-based Research Networks
PBRNs are groups of clinicians and practices working together to answer community-based health care questions and translate research findings into practice

4. What are PBRNs’ value?
PBRNs are "new clinical laboratories for primary care research and dissemination”
practices are united by a shared commitment to expand the science base of clinical care through systematic inquiry to better understand the health and health care events that unfold daily in their community practice settings

5. 174 PBRNs, 29,455 practices, 153,736 clinicians, +86M patients

6. What pulls US members together?
Opportunities to participate in developing research agenda/grant submissions (76%)
Opportunities to co-author research presentations/publications (75%)
Training in human subjects protection/research ethics (49%)
Practice facilitators/coaches (39%)
TA for practice transformation (29%)
MOC Part IV (20%)
Data sharing is a challenge, but not insurmountable
Data warehouse capabilities permit pulling electronic data irrespective of HER
If data are not electronic, then its chart abstraction, expense, errors and slow!

7. What pulls US members together?
CME (60%)
Financial compensation for research participation (51%)
Opportunities to participate in learning collaboratives (48%)
Performance evaluation / feedback (43%)
Academic detailing (23%)
Conferences or journal clubs (25%)

8. PBRNs and EHR Use Data sharing is a challenge, but not insurmountable
Data warehouse capabilities permit pulling electronic data irrespective of HER
If data are not electronic, then its chart abstraction, expense, errors and slow!

9. Setting a research agenda
Some PBRNs stick to a short list
Some PBRNs stick to an annually reviewed list
Some focus on one set of conditions – i.e., chronic
Some are opportunistic, and review grant and funding options to select focus

10. 4 International PBRNs
International Federation of Primary Care Research Networks (153 clinicians) – Crete, Greece
Center for Studies in Primary Care (150 clinicians) – Ontario, CA
SAIHP PBRN (17 clinicians) – Orissa, India
Holistic Heathcare and Research Centre (30 clinicians) – Andra Pradesh, India
Theses are the ones registered with AHRQ – suspect there are many more

11. Infrastructure Requirements of PRBN (AHRQ grants)
At least 15 ambulatory practices (devoted to primary care)
Statement of purpose
Direction responsible for administraative, financial, and planning functions
Support staff (at least 1 person)
Mechanism such as community advisory board to get feedback from communities of patients served by clinics
Organizational structure independent of any one study
Communication process (regular newsletter, conference calls, or face-to-tace meetings)

12. Organizational Infrastructure
News-sharing function
2-way communication among member practices
Membership roster
Funds for meetings/virtual meeting platform
Organized way of IRB/human subjects protection
Basic network $69,000 annually (2005)

13. Director Often a physician (or PhD)
Desirable to have research experience
Evaluate projects in light of focus/mission and resources of network
Decision making may lie with BOD, committee or Director (varies)
May or may not be directly involved with the research, but is aware of all projects
Often arranges mentorship of members with research questions

14. Director Outreach and recruitment of new members
Writing press releases
Giving talks/increasing exposure
Leading meetings, if they are held
Personnel and financial management
Minimum 0.2/0.5 FTE

15. Coordinator/Research Manager
Day-to-day operations
Training in healthcare management and/or project administration
Understand both clinical settings and research
3 overlapping goals: research manager, infrastructure manager, assistant to Director
May be attached to an academic department overseeing/coordinating network

16. Research Manager Identifying potential grant opportunities
Assisting in development and submission of grants
Developing project-specific protocols
Hiring/training/supervising other research support staff
Organizing/assisting in work flow of projects
Management of project budgets

17. Research Manager Creating and distributing PBRN newsletter
Organizing and scheduling meetings
Developing and maintaining websites
Setting up/conducting conference calls
Assisting in Director duties

18. One-Way Communication
News-sharing function (newsletter & website)
Celebrate successes
Reinforce contact information
Disseminate schedules
Promotion (website)

19. 2-way Communication Email Listserv Discussion board on websites
Vital for community building

20. Member Roster Varies in formality and how elaborate it is
Roster database
Use to identify practices for specific studies
Support mailing and communication
Provide information/demographics of network

21. Meetings Regular meetings vary in frequency
Often combine presentations of research
Often associated with CME credit
Used for capacity building of research network
Web-based video conferencing for geographically dispersed

22. Human Subjects Protection
Members have to be trained in human subjects protections
Often have to deal with multiple IRB boards

24. Brainstorm about Practice-Based Research Networks for Family Medicine Globally…..