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基层医疗保健改进科学:以实践为基础的研究网络为研究向实践转化而进行的社区参与式研究的潜力和应用。

The science of primary health-care improvement: potential and use of community-based participatory research by practice-based research networks for translation of research into practice.

机构信息

Department of Family Medicine, Charlotte, NC 28207, USA.

出版信息

Exp Biol Med (Maywood). 2010 Mar;235(3):290-9. doi: 10.1258/ebm.2009.009265.

Abstract

There is a need for new approaches to supplement the existing methods of taking research from bench to bedside and from bedside to practice. Community-based participatory research (CBPR) is an emerging model of research that enhances ongoing clinical research by involving key stakeholders, including community members and patients. A practice-based research network (PBRN) is a group of primary care practices devoted principally not only to the primary care of patients, but also with a mission to investigate questions related to community-based practice and to improve the quality of primary care. Traditionally, PBRN research has not included patients or community members, while CBPR has excluded health providers as key stakeholders. Typical overlap topics of PBRN and CBPR research are health-care disparities, prevention, chronic disease management and mental health. The inclusion of CBPR within a PBRN has been identified as an important next step with the potential to significantly enhance the research process. This review focuses on bringing together the ideals of CBPR and PBRNs in order to tackle intractable problems such as disparities in health-care access and outcomes and translate these results into practice. Specifically, the CBPR PBRN approach can: (1) guide the research process so that studies more closely match the needs of all stakeholders (including providers, patients and community members); (2) assist in the development of the research protocol and identification of research methodologies so that the study is more amenable to participants; (3) facilitate recruitment of research participants; (4) enrich the data collection and analysis; and (5) allow rapid translation of results from the study back into clinical practice and the community. Once these mechanisms have been clearly elucidated, their widespread adoption will positively impact overall health at both a local and national level.

摘要

需要新方法来补充将研究从实验室推向临床和从临床推向实践的现有方法。基于社区的参与式研究(CBPR)是一种新兴的研究模式,通过让包括社区成员和患者在内的主要利益攸关者参与进来,增强了正在进行的临床研究。基于实践的研究网络(PBRN)是一群主要致力于患者初级保健的初级保健实践,其使命不仅是进行与社区实践相关的问题调查,还致力于提高初级保健质量。传统上,PBRN 研究不包括患者或社区成员,而 CBPR 将卫生提供者排除在主要利益攸关者之外。PBRN 和 CBPR 研究的典型重叠主题是医疗保健差距、预防、慢性病管理和心理健康。将 CBPR 纳入 PBRN 已被确定为重要的下一步,有可能显著增强研究过程。本综述的重点是将 CBPR 和 PBRN 的理想结合起来,以解决医疗保健获取和结果方面的差距等棘手问题,并将这些结果转化为实践。具体来说,CBPR PBRN 方法可以:(1)指导研究过程,使研究更符合所有利益攸关者(包括提供者、患者和社区成员)的需求;(2)协助制定研究方案和确定研究方法,使研究更符合参与者的要求;(3)促进研究参与者的招募;(4)丰富数据收集和分析;(5)允许将研究结果迅速转化为临床实践和社区。一旦这些机制得到明确阐明,它们的广泛采用将对地方和国家一级的整体健康产生积极影响。

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