RAND Health, Santa Monica, California, USA.
Implement Sci. 2011 Apr 4;6:34. doi: 10.1186/1748-5908-6-34.
Translating the extraordinary scientific and technological advances occurring in medical research laboratories into care for patients in communities throughout the country has been a major challenge. One contributing factor has been the relative absence of community practitioners from the US biomedical research enterprise. Identifying and addressing the barriers that prevent their participation in research should help bridge the gap between basic research and practice to improve quality of care for all Americans.
We interviewed over 200 clinicians and other healthcare stakeholders from 2004 through 2005 to develop a conceptual framework and set of strategies for engaging a stable cadre of community clinicians in a clinical research program.
Lack of engagement of community practitioners, lack of necessary infrastructure, and the current misalignment of financial incentives and research participation emerged as the three primary barriers to community clinician research participation. Although every effort was made to learn key motivators for engagement in clinical research from interviewees, we did not observe their behavior and self-report by clinicians does not always track with their behavior.
A paradigm shift involving acknowledgement of the value of clinicians in the context of community research, establishment of a stable infrastructure to support a cohort of clinicians across time and research studies, and realignment of incentives to encourage participation in clinical research is required.
将医学研究实验室中发生的非凡的科学和技术进步转化为全国社区患者的护理一直是一个主要挑战。一个促成因素是社区从业者相对缺席于美国生物医学研究企业。确定和解决阻碍他们参与研究的障碍，应该有助于弥合基础研究与实践之间的差距，从而提高所有美国人的护理质量。
我们在 2004 年至 2005 年间采访了 200 多名临床医生和其他医疗保健利益相关者，以制定一个概念框架和一系列策略，使稳定的社区临床医生群体参与临床研究计划。
缺乏社区从业者的参与、缺乏必要的基础设施，以及当前的财务激励和研究参与之间的错位，是社区临床医生研究参与的三个主要障碍。尽管我们尽了一切努力从受访者那里了解参与临床研究的关键动机，但我们并没有观察到他们的行为，而且临床医生的自我报告并不总是与其行为相符。
需要进行范式转变，包括承认社区研究中临床医生的价值、建立一个稳定的基础设施来支持一段时间和研究中的一批临床医生，以及调整激励措施以鼓励参与临床研究。
