Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
Acad Emerg Med. 2012 Feb;19(2):161-73. doi: 10.1111/j.1553-2712.2011.01283.x.
Recent efforts to increase emergency medical services (EMS) prehospital research productivity by focusing on reducing systems-related barriers to research participation have had limited effect. The objective of this study was to explore the barriers and motivators to participating in research at the agency and provider levels and to solicit suggestions for improving the success of prehospital research projects.
The authors conducted a qualitative exploratory study of EMS personnel using focus group and focused interview methodology. EMS personnel affiliated with the Pediatric Emergency Care Applied Research Network (PECARN) hospitals were selected for participation using a purposive sampling plan. Exploratory questioning identified identified factors that influence participation in research and suggestions for ensuring successful research partnerships. Through iterative coding and analysis, the factors and suggestions that emerged from the data were organized into a behavioral change planning model.
Fourteen focus groups were conducted, involving 88 EMS prehospital providers from 11 agencies. Thirty-five in-depth interviews with EMS administrators and researchers were also conducted. This sample was representative of prehospital personnel servicing the PECARN catchment area and was sufficient for analytical saturation. From the transcripts, the authors identified 17 barriers and 12 motivators to EMS personnel participation in research. Central to these data were patient safety, clarity of research purpose, benefits, liability, professionalism, research training, communication with the research team, reputation, administrators' support, and organizational culture. Interviewees also made 29 suggestions for increasing EMS personnel participation in research. During data analysis, the PRECEDE/PROCEED planning model was chosen for behavioral change to organize the data. Important to this model, factors and suggestions were mapped into those that predispose (knowledge, attitudes, and beliefs), reinforce (social support and norms), and/or enable (organizational) the participation in prehospital research.
This study identified factors that influence the participation of EMS personnel in research and gathered suggestions for improvement. These findings were organized into the PRECEDE/PROCEED planning model that may help researchers successfully plan, implement, and complete prehospital research projects. The authors provide guidance to improve the research process including directly involving EMS providers throughout, a strong theme that emerged from the data. Future work is needed to determine the validity of this model and to assess if these findings are generalizable across prehospital settings other than those affiliated with PECARN.
最近，通过专注于减少参与研究的系统相关障碍来提高急诊医疗服务（EMS）现场院前研究生产力的努力收效有限。本研究的目的是探讨机构和提供者层面参与研究的障碍和动机，并征求有关改善现场院前研究项目成功的建议。
作者使用焦点小组和重点访谈方法对 EMS 人员进行了定性探索性研究。使用目的抽样计划选择与儿科急诊护理应用研究网络（PECARN）医院有关的 EMS 人员参加。探索性提问确定了影响参与研究的因素，并提出了确保成功研究合作的建议。通过迭代编码和分析，将数据中出现的因素和建议组织到行为改变计划模型中。
进行了 14 次焦点小组讨论，涉及来自 11 个机构的 88 名 EMS 现场院前提供者。还对 35 名 EMS 管理人员和研究人员进行了深入访谈。该样本代表了为 PECARN 集水区提供服务的现场院前人员，并且足以进行分析饱和。从记录中，作者确定了 17 个障碍和 12 个 EMS 人员参与研究的动机。这些数据的核心是患者安全、研究目的的明确性、收益、责任、专业性、研究培训、与研究团队的沟通、声誉、管理人员的支持和组织文化。受访者还提出了 29 条增加 EMS 人员参与研究的建议。在数据分析过程中，选择 PRECEDE/PROCEED 规划模型来组织数据，以改变行为。对于这个模型来说，重要的是，因素和建议被映射到那些预先存在的因素（知识、态度和信念）、强化因素（社会支持和规范）和/或使能因素（组织）中，这些因素与 EMS 人员参与现场院前研究相关。
本研究确定了影响 EMS 人员参与研究的因素，并收集了改进的建议。这些发现被组织到 PRECEDE/PROCEED 规划模型中，该模型可以帮助研究人员成功地规划、实施和完成现场院前研究项目。作者提供了改进研究过程的指导，包括在整个过程中直接让 EMS 提供者参与，这是数据中一个突出的主题。需要进一步的工作来确定这个模型的有效性，并评估这些发现是否可以推广到 PECARN 以外的其他现场院前环境。
