Bakken Suzanne, Lantigua Rafael A, Busacca Linda V, Bigger J Thomas
School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY, USA.
J Am Board Fam Med. 2009 Jul-Aug;22(4):436-45. doi: 10.3122/jabfm.2009.04.090017.
Supported by a supplement to our Clinical and Translational Science Award, we studied the feasibility of implementing clinical research in Northern Manhattan community practices that primarily serve Hispanic patients.
We applied a mixed-methods approach (surveys, focus groups, interviews) based on the PRECEDE-PROCEED model to determine the level of interest in clinical research among community clinicians (both practice-based research network [PBRN] members and non-PBRN members), the perceived barriers that hamper participation in clinical research, and the perceived facilitators for conducting research in such practices.
Survey and qualitative data indicated strong interest in clinical research among current and potential PBRN members if it was relevant to improving quality of care in their practice or community. They also identified important perceived barriers (lack of time, inadequate training in research methods, lack of collaborators and support staff, institutional review board hurdles, and community distrust of research) and the necessary requirements for overcoming barriers to conducting research in busy clinical settings, which included collaborators, mentors, research support staff, and a trusting patient-clinician relationship.
It is feasible to conduct clinical research studies in urban community medical practices if the topics are relevant to the community and appropriate enabling structures and processes are put into place.
在我们的临床与转化科学奖的一项补充资助的支持下，我们研究了在主要服务西班牙裔患者的曼哈顿北部社区医疗机构开展临床研究的可行性。
我们基于“教育诊断与评价-计划执行模式”（PRECEDE-PROCEED模型）采用了混合方法（调查、焦点小组、访谈），以确定社区临床医生（基于实践的研究网络[PBRN]成员和非PBRN成员）对临床研究的兴趣程度、阻碍参与临床研究的感知障碍以及在此类医疗机构开展研究的感知促进因素。
调查和定性数据表明，当前和潜在的PBRN成员对与改善其实践或社区医疗质量相关的临床研究兴趣浓厚。他们还确定了重要的感知障碍（时间不足、研究方法培训不足、缺乏合作者和支持人员、机构审查委员会的障碍以及社区对研究的不信任）以及在繁忙的临床环境中开展研究克服障碍的必要条件，其中包括合作者、导师、研究支持人员以及信任的医患关系。
如果研究主题与社区相关且建立了适当的支持结构和流程，那么在城市社区医疗实践中开展临床研究是可行的。
