Background: Despite ongoing efforts to utilize electronic infrastructure and thereby limit reliance on clinicians, research conducted in the context of healthcare delivery requires the engagement of practicing clinicians. However, we know surprisingly little about how clinicians perceive their roles in comparative effectiveness and patient-centered outcomes research (CER/PCOR). The proposed project will provide an opportunity for the research community to hear directly from clinicians regarding their perspectives on research engagement.
Proposed Solution: The plan for this project includes three phases: 1) review of the literature and funded projects to identify the range of clinician roles in research and factors that might influence engagement; 2) focus groups with clinicians to understand their opinions regarding clinician engagement in CER/PCOR and solicit feedback on facilitators of engagement in different research scenarios; and 3) key informant interviews with investigators and clinicians participating in two different pragmatic clinical trials to assess approaches to clinician engagement.
Objectives: Our long-term objective is to develop guidance regarding effective strategies for partnering with clinicians to conduct CER/PCOR in the context of healthcare delivery. We will achieve this objective via three specific aims: 1) define the range of roles clinicians play in CER/PCOR conducted in clinical settings; 2) evaluate the conditions or factors at the personal, practice setting, and health system level that are most likely to influence clinician participation across a range of possible roles in CER/PCOR; and 3) develop a framework defining strategies and facilitators to promote clinician participation according to potential roles in CER/PCOR.
Activities: Project activities will include review and summary of previous work; small focus group discussions with physicians, nurses, and other clinical staff; and one-on-one interviews with investigators and clinicians participating in the ADAPTABLE (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness) trial and one other pragmatic clinical trial.
Projected Outcomes: Anticipated outcomes from the proposed project include: 1) evidence pertaining to clinician perceptions of their role in CER/PCOR and factors likely to influence their participation in different types of studies; 2) a conceptual framework that will assist researchers as they plan to engage clinicians in CER/PCOR studies; and 3) a preliminary engagement rubric outlining important elements of effective clinician engagement.
Patient and Stakeholder Engagement Plan: In addition to the clinician stakeholders who participate in focus groups, we will engage a project advisory committee (PAC) that includes experts in CER/PCOR, practicing physicians and nurses, patient representatives, and representatives from participating healthcare institutions. The PAC will meet quarterly by web conference throughout the project period to provide insight and guidance.
Project Collaborators: For the focus group phase of this project, we will partner with Geisinger Health System, the Chicago-Area Patient-Centered Outcomes Research Network (CAPriCORN), and several CAPriCORN partnering institutions, including Rush University Health System, Hines VA Hospital, John H. Stroger Hospital, and the Alliance of Chicago Community Health Centers.